2021-22 LEGISLATIVE SESSION WRAP-UP

Looking back at the General Assembly’s 2021-22 legislative session, PAMED’s legislative activity was robust. We saw the final passage of a number of bills in which PAMED was actively engaged. Additionally, PAMED was instrumental in blocking the passage of other proposals that were not consistent with our policy. The past year also marked the first time PAMED had been actively engaged in the budget process as we successfully secured 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.

While PAMED focused our advocacy efforts on the legislative arena, the undercurrent of “politics” seemed pervasive in 2022, as many legislators turned their focus towards the electoral process. While always sensitive to the politics that drives the development of public policy, PAMED successfully highlighted the impact that some legislative proposals would have on both physicians and the patients they treat. It will come as no surprise, especially to those who follow policy making at both the Federal and State level, that political discord has reached an all-time high. The legislative process should be about compromise. But it seems that the proverbial “middle ground” no longer exists in the traditional process of legislative compromise. Instead, both sides of the aisle are entrenched in their beliefs and reluctant to give in to the other side. Though exceptions do exist…they’ve just become harder to find.

PAMED is unique in that the breadth of our legislative interests range from legal reform to scope of practice to insurance reform, and everything in between, with each of these subjects garnering interests from different subsets of the General Assembly. As a result, our legislative priorities are often influenced by political expediency, and we often find ourselves shifting gears on issues depending on the interest and will of legislative leaders, committee chairs, and our legislative champions. Having said that, PAMED remains steadfast in its commitment to core priorities such as prior authorization reform and scope of practice.

Prior Authorization Reform (Senate Bill 225)

Prior authorization reform has been a priority issue for PAMED and our 40+ member coalition of physician organizations and patient advocacy groups for over six years. Earlier in the past session, Senator Kristin Phillips-Hill introduced Senate Bill 225, and championed the effort to achieve Senate passage before the 2022 summer recess. We were extremely pleased to see her efforts, and the efforts of many others, pay off when the Senate approved Senate Bill 225 in June.

Since the measure was referred to the House Insurance Committee, PAMED had been part of a coalition of individual organizations that met regularly with Senate staff and representatives of the insurance industry to hammer out language that could ultimately pass the House of Representatives. The meetings were contentious, as one might expect, with the industry pushing back on nearly every provision of the original bill. PAMED remains focused on how prior auth impacts patient care.

Signed by the Governor as Act 146 of 2022

Scope of Practice

When it comes to legislation addressing scope of practice, PAMED has always viewed patient safety as our number one concern, not the potential competition from our non-physician colleagues. As a result of the COVID-19 waivers that granted pharmacists with expanded authority to provide COVID19 vaccines, pharmacists began efforts in early January 2022 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 five. 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 became part of a legislative proposal.

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

Other scope of practice issues, such as the interests of CRNPs and psychologists looking to either seek independent practice authority or expand their existing scope were kept from advancing during this past legislative session. Though we expect all of the scope, issues to return in the 2023-24 legislative session.

PA Supreme Court Action Taken on Venue

After the Pennsylvania Supreme Court issued a statement earlier last year that the current venue rule related to medical liability cases would revert to its pre-2003 status, PAMED engaged in advocating for the passage of House Bill 2660. This proposal, 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 did not advance beyond the House Judiciary Committee. PAMED was not alone in advocating for the passage of House Bill 2660. We were joined by the Hospital and Healthsystem Association of Pennsylvania and several business groups, all of which are members of the Pennsylvania Coalition for Civil Justice Reform (PCCJR). 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.

The following are legislative initiatives that either made it to the Governor’s desk during 2022 or fell short of making it through the legislative process prior to the end of this legislative session.

Senate Bill 317 – Expedited Partner Therapy (EPT)

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. This is 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).

Signed by the Governor as Act 147 of 2022

Senate Bill 818 – Licensing of Health Care Facilities

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

Senate Bill 106 – Constitutional PA Amendments

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 a 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 this 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. Given the outcome of the election and the uncertainty of what party will control the House of Representatives, Senate Bill 106 will likely not be considered in 2023, putting an end to a possible constitutional referendum question on the primary election ballot in 2023.

House Bill 681 – Restricted Covenants

Introduced at PAMED’s request, this legislation would significantly alter the parameters by which restricted covenants could be used in physician employment contracts. The bill had been approved by the House Health Committee but did not advance any further. PAMED continues work toward finding a legislative pathway to see this bill through the process. Alternatives are also being explored to negate strong opposition from hospitals. PAMED will be seeking to have legislation addressing restricted covenants reintroduced in this current legislative session.

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Legislative Updates

House Bill 1280 – Patient Test Results

Amends the Patient Test Results Information Act. Provides for certain exclusions, and definitions within the Patient Test Results Information Act.

Current Status—Failed to win approval by the Senate Health and Welfare Committee. This measure will be reintroduced in 2023.

House Bill 1393 – Fentanyl Test Strips

Amends the Controlled Substance, Drug, Device and Cosmetic Act to legalize the use of drug testing products like fentanyl test strips for personal use. PAMED supported this initiative.

Signed by the Governor as Act 111 of 2022

House Bill 1421 – Primary Care Loan

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

House Bill 1563 – PA Drug and Alcohol Abuse

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.)

House Bill 1630 – Pharmacy Benefits Manager

This legislation, which PAMED supported, grants power to Pennsylvania’s Auditor General to audit Pharmacy Benefits Managers (PBMs) that do business with the state, namely through the Medicaid program. While the bill doesn’t provide complete PBM transparency, it is a good first step.

Signed by the Governor as Act 98 of 2022

House Bill 2419 – Outpatient Telehealth

Allows psychiatrists and other mental health providers to provide telehealth services.

Signed by the Governor as Act 76 of 2022

House Bill 2604 – Health Care Facilities

Allows name badges to have the health system a health care 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

House Bill 2679 – Pharmacy Act

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

Legislative Reorganization

As is customary before the start of a new legislative session, lawmakers from both the Senate and House of Representatives go through the process of electing their individual caucus leaders for the upcoming session. Below are the leaders in place for the 2023-24 legislative session.

2023-2024 House Leadership Election Results

House Republican Leadership:

• Leader: Bryan Cutler (R-Lancaster)

• Whip: Tim O’Neal (R-Washington)

• Appropriations Chair: Seth Grove (R-York)

• Caucus Chair: George Dunbar (R-Westmoreland)

• Caucus Secretary: Martina White (R-Philadelphia)

• Policy Chair: Josh Kail (R-Beaver)

• Caucus Administrator: Sheryl Delozier (R-Cumberland)

House Democratic Leadership:

• Leader: Joanna McClinton (D-Philadelphia)

• Appropriations Chairman: Matt Bradford (D-Montgomery)

• Whip: Jordan Harris (D-Philadelphia)

• Caucus Chair: Dan Miller (D-Allegheny)

• Caucus Secretary: Tina Davis (D-Bucks)

• Policy Chair: Ryan Bizzarro (D-Erie)

• Caucus Administrator: Mike Schlossberg (D-Lehigh)

2023-2024 Senate Leadership Election Results

Senate Republican Leadership:

• Interim President Pro Tempore: Kim Ward (R-Westmoreland)

• Leader: Joe Pittman (R-Indiana)

• Whip: Ryan Aument (R-Lancaster)

• Appropriations Chair: Scott Martin (R-Lancaster)

• Caucus Chair: Kristin Phillips-Hill (R-York)

• Caucus Secretary: Camera Bartolotta (R-Washington)

• Policy Chair: Dan Laughlin (R-Erie)

• Caucus Administrator: Lisa Baker (R-Luzerne)

Senate Democratic Leadership:

• Leader: Jay Costa (D-Allegheny)

• Appropriations Chair: Vincent Hughes (D-Philadelphia)

• Appropriations Vice Chair: Tim Kearney (D-Delaware)

• Whip: Tina Tartaglione (D-Philadelphia)

• Caucus Chair: Wayne Fontana (D-Allegheny)

• Caucus Secretary: Maria Collett (D-Montgomery)

• Policy Chair: Katie Muth (D-Montgomery)

• Caucus Administrator: Judy Schwank (D-Berks)

For more information about any of the items mentioned above, please visit the Advocacy Section of PAMED’s web site at www.pamedsoc.org/advocacy