LEGISLATIVE UPDATES

Summer Recess

For those engaged in the daily grind of the legislative process, summer has finally arrived with the passage of a $39.8B state budget. In the days leading up to the June 30 budget deadline—and a few days afterwards—we saw activity on an unusually large number of legislative proposals on which PAMED has been actively engaged. A number of them made it across the finish line and to the Governor’s desk, while a few could still see passage when the General Assembly returns in the fall.

Suffice it to say legislative activity has been somewhat contentious over the past few months as lawmakers positioned themselves politically for either the recent primary election or the upcoming election this fall. While PAMED’s government affairs staff is always sensitive to the “politics” that drives the development of public policy, we do our best to limit our focus on the impact legislation has on physicians and the patients they treat.

While the list below reflects the entirety of legislation that has been “active” since the current legislative session began in January of 2021, there are several items that deserve special recognition.

Prior authorization reform (SB 225) has been a priority issue for PAMED and our 40+ member coalition of physician organizations and patient advocacy groups for over six years. Earlier this session, Senator Kristin Phillips-Hill introduced SB 225, and has since been championing the effort to achieve senate passage before this year’s summer recess.

Over the past 6 months, various coalition partners met countless times with senate staff and representatives of the insurance industry to hammer out language that could pass the senate. These meetings were often contentious, as one might expect, with the industry pushing back on nearly every provision of the original bill. Again, PAMED remained focused on how prior auth impacts patient care. Happily, her efforts, along with the efforts of key staff and our coalition partners, resulted in the unanimous approval of SB 225 by the full senate on June 29th. The bill now moves to the House Insurance Committee for consideration.

In the past, legislative activity during fall sessions has been robust as lawmakers work to wrap up their business before the end of the year. This year may prove different as there are only twelve legislative session days currently scheduled with rumors that a few additional days may be cut. With that in mind, PAMED will be aggressively pushing for the House of Representatives to approve SB 225 before they break for the November election…which will ostensibly end the legislative session.

When it comes to legislation addressing scope of practice, PAMED has always viewed patient safety as our number one concern… not as competition against our non-physician colleagues. As a result of the COVID-19 waivers that granted pharmacists with expanded authority to provide COVID-19 vaccines, pharmacists began efforts in early January to further expand their role into the realm of childhood immunizations, seeking the authority to provide this service to their “customers” over the age of 5. Working in concert with the PA Academy of Family Physicians (PAFP) and the PA Chapter of the American College of Pediatrics (PA-ACP), that effort was stopped before it even became part of a legislative proposal.

Though the child vaccine issue was sidelined, PAMED along with PAFP and PA-ACP did agree to allow pharmacists to provide seasonal flu and COVID-19 vaccines to individuals aged 5 and above. This “compromise” should serve to keep the issue of child vaccines off the table for the foreseeable future.

Speaking of the future, PAMED was successful during the recent budget process in securing additional funding for the state’s Primary Care Loan Repayment Program. This program provides loan forgiveness, presently up to $80,000, for physicians who choose to practice in a rural or underserved community for two years. PAMED secured an additional $2.5M to bring the program’s total allocation to $7M. This is the first time in more than a decade that the legislature has increased this line item.

PAMED was also engaged in advocating for the passage of HB 2660, a legislative resolution that would have been the first step in potentially amending Pennsylvania’s constitution to place the question of judicial “venue” in the hands of the legislature instead of the state Supreme Court.

Unfortunately, efforts by PAMED, the Hospital Association, and a number of business groups, all of which are members of the Pennsylvania Coalition for Civil Justice Reform (PCCJR), were unsuccessful. Though the bill only won committee approval in the House of Representatives, it was successful in getting the issue before the legislature. PAMED will continue to work within the framework of PCCJR to ensure that Pennsylvania’s legal climate is improved.

At this point, the state Supreme Court has not taken any formal action to change venue thresholds.

However, we continue to keep our ear to the ground in the event a potential change is once again made public.

PAMED encourages all physicians to engage in the legislative process by getting to know your individual representatives in Harrisburg. Nothing is more important than developing a trusting relationship with lawmakers so that your concerns are heard and respected.

The following are legislative initiatives that either made it to the Governor’s desk thus far this year or are still “in play” between now and the November General election.

SB 818

Amends the Health Care Facilities Act to allow ambulatory surgical facilities to perform certain permitted surgical procedures without seeking a waiver/exception from the Department of Health. The bill creates an updated waiver/exception process for surgical procedures not on the 2022 CMS ASC-CPL list or otherwise prohibited by state regulation. Signed by the Governor

as Act 87 of 2022

HB 1421

Provides additional funding for the Primary Care Loan Repayment Program. Raises funding from $4.5 million to $7 million

Signed by the Governor as Act 54 of 2022

Continued on page 22

HB 1563

Amends the Pennsylvania Drug and Alcohol Abuse Control Act (DAACA). This legislation brings DAACA into alignment with HIPAA to create a consistent and easily understandable standard and revises outdated regulations. The bill also provides consistency between statutory and regulatory language. Signed by the Governor as Act 33 of 2022 (Note: HB 1561, now Act 32, was a companion bill that amended the Mental Health Procedures Act.)

HB 2419

Allows psychiatrists, and other mental health providers, to provide telehealth services. Signed by the Governor as Act 76 of 2022

HB 2604

Allows name badges to have the health system a healthcare provider works for on the badge. Previously name badges had to be specific to the location the provider was working, becoming an issue for providers who work in multiple locations.

Signed by the Governor as Act 79 of 2022

HB 2679

Amends the Pharmacy Act to allow pharmacists, and supervised pharmacy interns, to administer influenza and COVID-19 vaccines to children ages five and older.

Signed by the Governor as Act 80 of 2022

SB 106

A Joint Resolution proposing five separate and distinct amendments to the PA Constitution. 1. Establishes that the PA Constitution does not grant any right to abortion or taxpayer funding for an abortion.

2. Allows the General Assembly to disapprove regulations by its own vote with no signature by the Governor required.

3. Eliminates separate election for Lieutenant Governor. Allows the gubernatorial candidate to select his own running mate.

4. Requires all voters, whether in person or not, to present a government-issued form of identification prior to voting.

5. Requires the General Assembly to provide by statute for the auditing of elections and election results. Current Status—Passed the General Assembly on July 8, 2022. Identical language must pass again next session and then the ballot questions can be presented to the voters at the next statewide election, possibly as early as the 2023 Primary Election.

SB 225

Amends the Insurance Company Law of 1921 to standardize and streamline the practices of prior authorization. Current Status—Unanimously passed the Senate on June 29, 2022. Referred to House Insurance Committee.

SB 317

Provides health care practitioners the authority to prescribe or personally furnish antibiotics to treat sexually transmitted infections, without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy (EPT) in the Management of Sexually Transmitted Diseases guidance document issued by the United States Center for Disease Control(CDC). Current Status—Unanimously passed the Senate in April 2022. Reported out of House Health Committee on April 26 but no further movement.

HB 1280

Amends the Patient Test Results Information Act. Provides for certain exclusions, and definitions within the Patient Test Results Information Act. Current Status—Waiting Consideration from the Senate Health and Human Services Committee.

HB 1393

Amends the Controlled Substance, Drug, Device and Cosmetic Act to legalize the use of drug testing products like fentanyl test strips for personal use. Current Status—Passed the House on June 20, 2022. Referred to Senate Judiciary Committee but no further movement.

HB 2660

Proposed Constitutional amendment that would put the current Venue Rule into the Pennsylvania Constitution. Current Status—Referred to House Rules.