Spring 2024 Legislative Update


PA-ACP is in the Capitol

General Assembly

The State House of Representatives, remains 102-101 in Democratic control, while the state Senate has 28 Republicans and 22 Democrats.  Both chambers will be in session throughout June and we expect to see the House and Senate in town until either a deadlock occurs or we get passage of a state general fund budget.

This session has already seen seven special elections to fill vacant House and Senate seats.  Most recently, Representative Jeff Olsommer (R) was sworn into the PA House on May 21. He replaced the recently resigned Joe Adams (R) from Pike and Wayne Counties.

The one-vote margin for Democrats in the House lets them set the agenda, but it also because of the narrow split, requires their leaders to keep every one of their members on board for passage of bills that are not bipartisan.  This has become even more critical this spring, in having to deliver a constitutional majority to pass law.

There have been staff and committee changes throughout this two-year session as well.  The House Insurance Committee, which had not met since last October, has had a change of leadership, with leadership’s removal of Rep. Kevin Boyle as chair.  He’s been replaced by Rep. Patty Kim of Dauphin County, who is running for the State Senate this fall.

The House Health Committee continues to be an activist center, with Chairman Dan Frankel pushing out multiple bills on issues of importance to the Democratic caucus.  And committee staff changes, retirements present an ongoing challenge that we have to operate with.

In key committees and focus areas, the House has forwarded dozens of bills relating to children, education, mental health, women’s health, firearms, and social issues - legislation they’ve sought but could not advance in the past with GOP control in the House.  These do not necessarily receive favorable consideration in the Republican Senate.


As May ends, serious budget talks are just beginning, and we have heard no one yet project more than “hope” that a budget can get done on time by June 30.  Governor Shapiro and the House leadership are looking to spend the state’s current $14 billion surplus on education funding, public transit and worker protection/economy development plans, while Republicans are pushing for tax cuts and reasonable out year budgeting, returning tax dollars to constituents.

In May, the Senate, with a 36-14 vote (and the support of eight Democrats), passed a bill to cut the state’s personal income tax from 3.07% to 2.7%. and eliminate the gross receipts tax on private electric utilities. Meanwhile House Democrats are saying there could be compromises if the Senate moves things like a minimum wage increase, expanded nondiscrimination protections, and healthcare worker protections.

The state’s Independent Fiscal Office is still saying the state has a structural budget deficit of from $4-6 billion annually if the Governor’s budget is passed as offered, a point voiced often by Senate and House Republicans.

Medicaid and the Budget

Medicaid reform will have a huge impact on the state’s budget this year.  Between the recertification program and the overall costs of the program, it consumes nearly 40 percent of the General Fund budget and impacts other insurance program costs.  Republicans have sought to place additional guardrails on Medicaid to dictate who qualifies for the program. Meanwhile, the waiver request submitted by the Shapiro administration for the Medicaid program would increase state Medicaid expenditures by over $3 billion annually. And Medicaid payments to providers are “nowhere near” the true cost of service.

Other health care related issues that may become part of the budget include the medical debt relief program, an effort to automatically provide health insurance for all children, and funding for community health centers.

PA-ACP Priority Issues


We have continued to work the issue with members and staff on both sides of the Capitol on behalf of members.  In mid-April, the House passed HB 1512 which mandates coverage of telemedicine.  The Senate passed SB 739, with language that was agreed to over the last three legislative sessions.  The changes made to the bills are beneficial to providers, taking away options that some insurers may have used to deny payment.  Insurers have expressed concerns about those changes and with language making payment mandated regardless of “place of service.”  We hope to secure passage of this legislation in June.

Interstate Licensure 

The House passed HB 2200 by a 200-0-2 vote, in May, after he Department of State was finally able to get agreement from the FBI on terms for use in establishing PA membership in the various interstate compacts.  This legislation accommodates the FBI requests.  Sen. Lisa Boscola has introduced a similar bill in the Senate, SB 1165, which has also been voted out of Committee and is teed up for a vote in that Chamber in early June, depending on other negotiations with the House.

Noncompete Contracts

The House passed HB 1633, which bans noncompete clauses in health care provider contracts by a 150-50 vote.  The bill passed by the House, does include exceptions for 34 smaller counties, where noncompete clauses could be enforced for two years and within 45 miles of the provider’s place of service.  SB 521, the Senate version of the policy, does not have those exceptions, which were sought by the PA Medical Society.

Coincidentally, the Federal Trade Commission voted 3-2 to ban noncompete clauses for most U.S. workers April 23. The rule will take effect in 120 days and makes it illegal to include noncompetes in contracts and requires employers with noncompetes to tell workers that they are void. Existing noncompetes are enforceable only for senior executives making $140,000/year or more.

This move could shift the contracts of the employed physician workforce. Between 35% and 45% of physicians are bound by noncompete clauses, and nearly 87% of physicians said they supported the proposed rule, according to a March Doximity poll.

The FTC said in its rule that nonprofit organizations are not "categorically beyond" its jurisdiction and that it assesses whether an entity or its members derive a profit. Employees of a physician group that work for a nonprofit hospital would fall under the commission's jurisdiction and would be subject to the noncompete ban, according to the FTC.

The day after the ruling, the U.S. Chamber of Commerce and the Business Roundtable sued in federal district court in Dallas, arguing that the FTC exceeded its authority in finalizing the rule. It’s likely that rulings and appeals may take years to reach final resolution, heightening the need for state legislation.

Scope of Practice

A series of bills continues to be introduced and moved in the House for expanding the scope of practice or regulation of midlevel health care providers.  Discussions are ongoing over CRNPs/APRNs, psychologists prescribing controlled substances, pharmacists providing immunizations, injections, biologicals and ordering tests for children 3 and up, and supervision of Physician Assistants.  We have continued to be actively involved in those discussions and negotiations.

Rural Health Initiatives

The Pennsylvania Rural Health Redesign Center Authority will remain in place after passage of legislation removing its sunset provisions.

Rep. Kathy Rapp (R, Warren County) is circulating a cosponsorship memo for a bill that attempts to address the healthcare practitioner shortage and rural access to healthcare by creating incentives for licensed nurses and physicians to live and work in rural communities, similar to the provisions of the Primary Care Practitioner Loan Program.  Her Rural Healthcare Grant Program would provide financial incentives through the Department of Health to do that.

Under her proposal, hospitals in rural counties or in designated medically underserved areas could apply for grants from the Department of Health to assist with the hiring of healthcare practitioners at their facility, using this funding to incentivize licensed nurses and physicians to apply for open positions with the grant funds used to pay off their student loans.

Separately, the PA Association of Community Health Centers, FQHCs and FQHC look-alikes are advocating and lobbying for a g $10 million line item in the state budget to assist FQHCs in covering the costs of care for uninsured Pennsylvanians and to cover many of the additional unfunded costs, such as Community Health Workers, transportation, care coordination, technology costs, etc. ACP policy supports this effort.

Med Mal – Tort Reform

PA-ACP has taken a lead role for the states practitioners in efforts toward med mal/tort reform and venue reform.  We are currently working to get support for SB 1182, sponsored by Sen. David Argall, which would change the rules on certificates of merit.  Discussions are also taking place about a second piece that would reinstitute the Interbranch Commission on Venue, similar to what was done in 2001-2.  Our educational effort will continue, and through both lobbying and grassroots/grass tops advocacy, PA-ACP will encourage elected officials to support efforts to rein in costs of insurance and fix the broken system (again.)

Because of the venue rule change, the Philadelphia Court of Common Pleas reported 59 new medical liability cases filed in April 2024 (only 20 could be confirmed that the cause of action was in Philadelphia County.)  This is the highest case count since January 2023, the first month after the med mal venue rule was rescinded. So far this year there are an average of 49 cases being filed in Philadelphia each month only about half from events in the city.

Last month, the Chapter also joined in an amicus curiae brief in a case before the state Supreme Court where a lawsuit was filed in Philadelphia Common Pleas Court despite the fact that the accident giving rise to these claims occurred in Westmoreland County; none of the Plaintiffs reside in Philadelphia; none of the Plaintiffs received medical care in Philadelphia; none of the Defendants reside or maintain a principal place of business in Philadelphia; and of the dozens of potential witnesses, including emergency, medical, police, and investigating officers, none work or reside in Philadelphia. In fact, many reside no closer than 240 miles from Philadelphia.

Momnibus Bills

This spring, the Black Maternal Health Caucus introduced a set of bills which are intended to decrease maternal morbidity and mortality in Pennsylvania.

The bills would:

  • Require health-related boards within the Department of State to complete implicit bias training as part of continuing education requirements.
  • Extend Medicaid coverage to cover doula services and establish the Doula Advisory Board to set standards and requirements for doulas.  Require non-MA health insurance to cover doula services.
  • Require health insurance to cover costs of blood pressure monitors for pregnant and postpartum enrollees. Expand Medicaid to cover blood pressure monitors for pregnant and postpartum enrollees.
  • Designate maternal health deserts to target investments in maternal health care services.
  • Mandate perinatal and postpartum depression screening at specific intervals.
  • Enhance access to mental health services for pregnant or postpartum patients.
  • Establish a program to distribute essential supplies and resources to new mothers.


We continue to work toward passage of legislation (HB 1754 and SB 954) to mandate payment/coverage of biomarker testing by physicians when supported by scientific/medical evidence.  Again, PA-ACP has taken the lead on this legislation, which is scheduled to run from the House Insurance Committee June 3.

The bills would ensure all insurers play by the same rules, aligning coverage of biomarker testing for diagnosis, treatment, appropriate management, or monitoring of an enrollee’s disease or condition, when supported by scientific and medical evidence, the bills would align prior authorization and appeals requirements for biomarker testing with existing PA law.

The legislation does not mandate coverage of biomarker tests for screening purposes or genetic testing.