Legislative Update: 3.25.19 – Pennsylvania American College of Physicians

March 25, 2019

Harrisburg Update
The Pennsylvania General Assembly began 2019 with 47 new members, a half dozen new caucus leaders, and twenty new committee chairs in the House and Senate, and changes continue to take place. At the same time, after only five weeks of session this year, members have circulated more than 2,000 cosponsor memos, and introduced more than 400 Senate Bills and 670 House Bills.

PA-ACP ACTIVE EARLY IN 2019 LEGISLATIVE SESSION
PA-ACP and its lobbyists ERG Partners are active in the Capitol on behalf of its members and patients. The first bill passed by the House of Representatives was HB 195, sponsored by Rep. Eric Nelson (R, Westmoreland), to permit patients to synchronize their prescription medications. PA-ACP was a strong supporter of the bill as an advocate for our patients, working with the Insurance Committee and sponsor to secure its early passage. This is a convenience for the patient, especially the elderly, and it is aimed at reducing poor healthcare outcomes that result from decreased medication adherence.

Surprise Balance Billing – Patient Protection, Access Improvement
PA-ACP also testified to the House Insurance Committee on surprise balance billing, another patient protection initiative. In its testimony, the Chapter called for legislation that would include several key elements to limit surprise billing including contracting changes, and strict enforcement of network adequacy requirements as part of any solution.

Scope of Practice Legislation
Legislation to allow Certified Registered Nurse Practitioners to practice in Pennsylvania without collaborative arrangements was reintroduced as SB 25. PA-ACP has consistently opposed this legislation. Amy Davis, DO, Chair of the Chapter’s Health and Public Policy Committee met with the Chairman of the House Professional Licensure Committee to express the Chapter’s concerns about patient safety, quality and educational issues involved.

Med Mal Venue Rules Study
The State Supreme Court’s Civil Procedural Rules Committee proposed changes that would allow venue shopping in Pennsylvania med mal cases. PA-ACP met with House and Senate leadership and to call attention to the possible overturn of a 16-year-old state law that mandates medical malpractice claims be filed in the county where the alleged action occurred. In the Senate, a Resolution requiring the Legislative Budget and Finance Committee to study the history of the venue rule and the impact of the 2003 Act, to determine whether there is sufficient data to support a change, and consider what the impacts to access to quality care might be if the rule is changed was passed 31-18, after PA-ACP contacted all members of the PA State Senate in support of the Resolution. Chief Justice Tom Saylor agreed that the Court would not make any changes until after the LBFC report is completed. The Chapter also wrote to the State Insurance Department requesting consideration of changes in venue rules when determining whether a sufficient market for medical malpractice insurance exists to justify increasing the private coverage limit from $500,000 to $750,000.

Prior Authorization
PA-ACP has had a series of meetings with House and Senate leadership to enlist support for movement of prior authorization reform legislation. We are working with a coalition of provider groups and a large group of patient advocacy organizations to educate legislators on the issue, and to secure cosponsors. We hope to have a bill introduced this spring and to get action on the bill this year.

Other Legislation on the Agenda
The General Assembly’s agenda for the first half of 2019 includes action on several bills that PA-ACP prioritized last session. These include telemedicine, drug price transparency, POLST orders and bills attempting to impact the opioid crisis. Other issues include pharmacy scope of practice and informed consent for vaccinations.

Further action is also expected at some point to take a legislative look at the marketplace battle between UPMC and Highmark as UPMC moves its footprint further and deeper into eastern Pennsylvania. There’s also recognition of the growing power of both insurers and hospital systems in the new health care marketplace.

Firearms Issues
PA-ACP is engaged with legislators and Governor Wolf on the need to implement legislation and policies to enact child access prevention laws, Extreme Risk Protection Orders, close loopholes in background checks, ban high capacity magazines.

PA-ACP Working on State Budget Items
​The Health and Human Services Department Budgets account for $14.5 billion – 37.3% of the state general fund budget with long term living costs expected to approach $4.0 billion and Medicaid nearing $5 billion. PA-ACP is opposing a work requirement for Medicaid and seeking to restore Governor Wolf’s proposed reductions in MA payments to Academic Medical Centers, which were estimated to decrease $15.1 million. Similarly, we are working to restore funding for education programs in the Health Department budget.