July 10, 2019

PA-ACP State Budget and Legislative Summary

PA-ACP worked with the General Assembly to reinstate many health related budget line items this year, after Governor Wolf recommended significant decreases. Notably, all of the Health Department line items zeroed out by Wolf's proposed budget for programs including Cooley's Anemia, Hemophilia, Lupus, Sickle Cell, Regional Poison Control Centers, Trauma Prevention, Epilepsy Support Services, Bio-Technology Research, Tourette Syndrome, Amyotrophic Lateral Sclerosis (ALS) Support Services and Leukemia/Lymphoma – were all restored in the state budget.

And MA funding to academic medical centers, where the Governor proposed a $7 million cut, was restored to last year’s total at $24.68 million.

he House and Senate finished their budget season business June 28, with the passage of the last of 24 separate bills affecting the Fiscal, Administrative and Tax Codes, plus the Human Services Code and a School Code bill.

The General Fund Budget bill allocates $33.997 billion for government operations in 2019-2020 fiscal year without tax increases, expands workforce development initiatives and adds $317 million to the state’s Rainy Day Fund.

Among the major legislation PA-ACP supported, that passed at the end of June is creation of a state Health Insurance Exchange under the ACA. This will save the state as much as $80 million and under a federal waiver for reinsurance, will attract $140-180 million in federal funds to reduce premiums from 5-10% for the 400,000 Pennsylvanians who use the exchange.

PA-ACP was also pleased to help secure passage of HB 195, sponsored by Rep. Eric Nelson of Westmoreland County. The bill allows Pennsylvania patients to synchronize their prescription medication, saving time and money, and improving medication adherence; and allows phar4macies to dispense partial quantities of a patient’s medication to have all with the same fill dates.

Other legislation passed in June includes two bills allowing physicians to designate another person to enter written agreements and the related documents into the PALS licensing system, and legislation that makes changes to the funding formula for Pennsylvania trauma centers to encourage better quality of care regardless of patient volume.

The General Assembly put language in the Fiscal Code bill that essentially takes control of the Joint Underwriting Association as a commonwealth agency. (Attempts to transfer $200 million from the JUA to the General Fund over the last three years were all stymied by the Courts because the Association was not a state agency, and thus could not have health care providers’ funds from JUA “taken” for government operations.)

PA-ACP was directly involved in several other legislative issues in June, including a package of bills intended to help control the opioid epidemic via controls on buprenorphine (Suboxone).

The House Human Services Committee took up bills that would require the Department of Drug and Alcohol Programs to continue to use client placement criterial developed by Pennsylvania rather than simply accepting ASAM guidelines for Medicaid recipients (House Bill 386); add Suboxone and Buprenorphine-related deaths and incidents to the Methadone Death and Incident Review Act (House Bill 1662); and legislation which would provide for licensure of office-based Buprenorphine prescribers (Senate Bill 675); PA-ACP opposes this bill, as written, and lobbied the Administration, Committee members and leadership against it.

The bill was intended to control street diversion of suboxone and prevent physicians from charging MA recipients cash for prescriptions. We were successful in getting SB 675 held over until the fall, over concerns about duplicative licensing requirements and licensing fees, and the barriers disincentivizing providers from treating addiction and decreasing access to treatment at a critical time.

We’ve also been active in working toward legislation on surprise balance billing, prior authorization reform, telemedicine, and contracting bills, with subjects Legislation on contracts ranging from non-compete clauses to terminations without cause, to credentialing issues circulating. Little room and appetite for these bills with the general feeling that market takes care of itself – despite the fact that we know the insurance law changes and vertical integration have impacted the health insurance/network/credentialing/contracting market significantly.

​The House and Senate are in recess until September, when the House returns Sept. 17 and the Senate on Sept. 23.