Legislative Priorities in Medicine

2021 Year-end Legislative Update

December 16, 2021

Midway Point 2021-2022 Regular Session of the Pennsylvania General Assembly

As we come to a close on the 2021 calendar year, we also reach the midway point of the 2021-2022 regular legislative session of the Pennsylvania General Assembly. 2021 saw a return to a bit of normalcy at the state Capitol amidst the COVID-19 pandemic, but a new normal has certainly arrived. While many legislators are present on session voting days, remote voting is an option that many legislators have decided is the safest way for them to represent their constituents. Many offices, which had previously been easily accessible, are now locked or require advance appointments.

Across the country we’re seeing tensions rise in state capitols, and in Washington, over election reforms, mask and vaccine mandates, over-crowded hospitals, and the overall impact COVID-19 has had on businesses and our economy. It has been challenging for all, especially those dedicated to patient care.

As we look to 2022, politics may very well trump policy as legislators and legislative candidates eye the May primaries and November General Elections. 2022 also marks the creation of new legislative district maps that could potentially change the composition of the General Assembly and leave some legislators to decide if they should bow out of office or face the harsh reality of running against a colleague. Further, the eyes of the nation have shifted to the Commonwealth as we near a primary election for an open U.S. Senate seat in addition to the election of a new Governor’s. At last count, there are currently ten announced candidates seeking the republican nomination for Governor while Attorney General Josh Shapiro stands as the only democratic candidate.

Despite the currently political environment, the Pennsylvania Medical Society (PAMED) continues to work tirelessly to defend the practice of medicine, protect the physician-patient relationship and ensure that we are always mindful of legislation and regulation that could potentially impact the practice of medicine. The pandemic continues to provide policy issues and challenges in addition to the existing priority issues that PAMED advocates on behalf of, which include scope of practice and prior authorization.

The first year of the current legislative session provided a few highlights for PAMED. Among these were the enactment of Senate Bill 425 as ACT 61 of 2021. ACT 61 was a PAMED-supported effort to provide a remedy to the Pennsylvania Supreme Court ruling which had changed how consent was obtained in hospitals and other clinical settings by attending physicians.

PAMED was able to support or provide neutrality on various agreements with Advanced Practice Providers including the passage of Senate Bill 416 (CRNAs) and Senate Bills 397/398 (PAs).

Another key issue that saw movement was Senate Bill 225, an extensive effort to reform the prior authorization process. While this effort has a long road ahead, it advanced out of the Senate Banking and Insurance Committee for the first time and there is some level of optimism that it may be taken up before the full Senate early next year.
House Bill 681 seeks to provide a fair approach to both employed physicians and provider employers while setting specific requirements for when the use of restrictive covenants is appropriate. This bill has advanced out of the House Health Committee and is awaiting final consideration before the full House.

Lastly, Senate Bill 705 that seeks to provide legislative framework for the practice of telemedicine has advanced out of the Senate. We have seen this effort reach the Governor’s desk in the past only to see it vetoed. We are hopeful that this effort might reach a compromise in the second year of this session.

While these are only a few highlights of the current legislative session, detailed below is a list of other issues that we are actively monitoring along with a brief summary. PAMED continues to engage in a number of legislative issues as well as participating in a large coalition to prevent any changes to the current Pennsylvania Supreme Court Civil Procedure rules regarding venue in medical malpractice professional liability cases.

House Bill 245 – (Kaufer) – International Medical Graduates (IMGs). Seeks to modernize the process by which graduates of international medical schools become licensed. Passed the House (201-0) and has advanced out of the Senate Consumer Protection & Prof. Licensure Committee and now awaits action from Senate Appropriations. We anticipate this bill to get to the Governor’s desk in the near future.
Senate Bill 705 – (Vogel) – Telemedicine-This legislation was voted favorably out of the Senate (46- 4) and has been referred to the House Insurance Committee. PAMED supports this effort and will work to move this bill through the legislative process once again.
Senate Bill 416 – (Gordner) – This legislation officially recognizes certified registered nurse anesthetists (CRNAs) in the Commonwealth of Pennsylvania as well outlining requirements for certification of CRNAs. PAMED followed the anesthesiologists lead in supporting this effort. This legislation has unanimously passed both the Senate (50-0) and the House (201-0). Signed into law as Act 60 of 2021.
House Bill 931 – (Toohill) – House Companion legislation.
Senate Bill 425 – (Gordner) – Informed Consent-PAMED supported this effort to provide a remedy to a court ruling which had changed how consent was obtained in hospitals and other clinical settings by attending physicians. PAMED supported this effort which passed the Senate (50- 0) and the House (201-0). Signed into law as Act 61 of 2021.
House Bill 1420 – (Thomas) – Health Care Heroes Act-PAMED supports this effort to establish a public awareness campaign to provide information regarding the programs and services available for first responders, healthcare workers, and other workers suffering from mental health issues related to COVID-19. Having unanimously passed the House (202-0), this bill now awaits a vote in the Senate Health and Human Services Committee.
House Bill 1082 – (DelRosso) – PAMED supports this legislation, which establishes an education program for providers on early diagnosis of Alzheimer’s disease and other dementias and incorporates information about the disease into existing public health outreach programs. This bill passed the House (201-1) and is now awaiting final consideration by the full Senate.
House Bill 1280 – (Jozwiak) – Patient Test Results-PAMED will be working with the cardiologists to advance this bill through the House after it recently was voted favorably out the House Health Committee. This bill amends the Patient Test Result Information Act in addressing how patients receive notifications after certain tests, etc.
Senate Bill 397 – (Pittman) – Physician Assistants (PAs); seeking to help physician assistants work and practice with increased efficiency. The bill allows for modernization for physician assistants to practice while maintaining their role under supervising physicians. This legislation has recently passed the Senate (50-0) and House (200-0); signed into law as Act 78 of 2021. (DO ACT)
Senate Bill 398 – (Pittman) –This legislation has passed the Senate (50-0) and House (200-0) and has been signed into law as Act 79 of 2021. (MD ACT)
Senate Bill 225 – (Phillips-Hill)- Prior authorization reform bills. There is a large coalition with multiple provider entities and patient advocacy groups seeking to make wholesale changes to the prior authorization process in the Commonwealth. PAMED has played an integral role in developing this legislation and working to advance it. While this legislation will require ongoing efforts to continue to advance it through the legislative process, it was voted out of the Senate Banking and Insurance Committee. PAMED continues to work with a broad coalition to pass this important legislation.
House Bill 225 – (Mentzer) – House Companion legislation.
Senate Bill 25 – (Bartolotta) – PAMED opposes this legislative effort which seeks to grant CRNPs independent practice authority. PAMED has long opposed these efforts, but last session agreed to listen/negotiate a pilot program where CRNPs would be granted independent practice with specific guidelines and restricts. This bill was recently voted out of the Senate Consumer Protection and

Prof. Licensure Committee, but it is not anticipated that this bill will advance beyond the Senate in its current form. Likely, any movement on this issue would come in the form of a bill/amendment that starts from the agreed upon pilot program.

(HCO2108) – (Hickernell) – Co-sponsorship memo recently introduced to advance the pilot program legislation.
House Bill 681 – (Ecker) – PAMED has worked closely with the sponsor of this bill, Rep. Ecker to advance legislation dealing with restrictive covenants in health care practitioner employment contracts. This effort would seek to provide a fair approach to both employed physicians and provider employers while setting specific requirements for when the use of restrictive covenants is appropriate. This bill has advanced out of the House Health Committee and is awaiting final consideration before the full House.
House Bill 958 – (Zimmerman) – PAMED opposed this effort that would prohibit pediatricians from deciding not to provide care to unvaccinated patients or patients whose parent or legal guardians choose to utilize a vaccination schedule that varies from the vaccination schedule recommended by the CDC. While this bill advanced out of the House Health Committee, PAMED does not believe this effort will advance beyond there.
House Bill 1033 – (Rapp) – This bill requires health insurers to cover treatment plans of Lyme disease or related tick-borne illnesses as prescribed by a health care practitioner; issues over what type of treatments could be covered (experimental long-term antibiotic for example). Although PAMED opposed this effort, this legislation has passed the House (136-66) and has been referred to the Senate Banking and Insurance Committee.
Senate Bill 621 – (Brooks) – Publishing of vaccine availability by physicians-PAMED opposed this legislation which would require physicians that provide the COVID-19 vaccine to pay for the weekly publication of vaccine data, such as the number of vaccines they have available, in local newspapers. Further, it would require that physicians in private practice vaccinate any individual who shows up even when an established relationship does not exist. This bill failed at the Senate Health and Human Services Committee level and has been referred to the committee by a motion to reconsider.
Senate Bill 671 – (Hutchinson) – Retaining Health Care Innovations Act-PAMED opposes this effort to extend the emergency administrative regulation changes granted to health care facilities, practitioners, and providers by Governor Wolf during the COVID-19 pandemic. This bill has advanced out of the Senate Health and Human Services Committee and has been referred to Senate Appropriations.
House Bill 1700 – (Sonney) – Disclosure of disingenuous physician complaints-This bill would no longer require physicians to acknowledge the existence of a complaint filed against their medical license if the case were closed without any formal action. PAMED supports this effort and will advocate to advance these bills. This legislation has been referred to the House Professional Licensure Committee. (DO ACT)
House Bill 1701 – (Sonney) – (MD ACT)
House Bill 192 – (Topper) – Interstate Medical Licensure Compact Act-PAMED supports this effort which would allow Pennsylvania to fully join the Interstate Medical Licensure Compact Act (IMLC). The IMLC provides a streamlined process that allows physicians to become licensed in multiple states with a mission of increasing access to health care. This bill has passed the House (201-0) and now awaits consideration in the Senate Consumer Protection and Prof. Licensure Committee.
House Bill 1774 – (Flood) – PAMED support this effort to extend the sunset date for the Achieving Better Care by Monitoring All Prescriptions Program. This bill as signed into law as Act 72 of 2021.
House Bill 1319 – (DelRosso) – This legislation is intended to curb the predatory practices of Pharmacy Benefit Managers (PBMs) by targeting the practices being used by them to interfere with the funding stream health centers and 340(b) plans use to fund the care they provide to low-income, uninsured residents. PAMED supports this effort and anticipates a committee vote in House Health during early 2022.
House Bill 1440 – (Millard) – PAMED supports this legislation that would establish a Medical Imaging and Radiation Therapy Board of Examiners which would license and establish qualifications for individuals in the Commonwealth of Pennsylvania who perform medical imaging or radiation therapy procedures. The House Professional Licensure Committee held an information hearing on the topic and the bill awaits action by this committee.
House Bill 1562 – (Pickett) – PAMED strongly worked to oppose this effort to expand access to the PDMP and as of this time, this legislation has yet to be brought up for a committee vote. It is currently sitting in House Insurance and at this time we do not anticipate movement on this bill that grant private health care insurers access to the PDMP, when they have no enforcement abilities and no compelling rationale as to why they should have access to this hypersensitive information.
House Bill 1005 – (Cox) – PAMED is opposing this effort that would require emergency physicians to provide information that is frequently not available during the time in which care to a patient is being delivered. Specifically, this bill requires information to be added to the PDMP when Narcan/Naloxone is used to combat an overdose by emergency responders or medical professionals. This bill advanced out of the House Health Committee and PAMED will continue to work to prevent this effort from becoming law.
House Bill 1959 – (Pennycuick) – This legislation authorizes the clinical study of the efficacy and cost/benefit optimization of the psilocybin-assisted therapy in the treatment of PTSD, traumatic brain injury and various mental health conditions. PAMED has new policy to support clinical studies to determine the full efficacy of the use of psilocybin as appropriate. This bill is currently awaiting a vote by the House Health Committee.
Senate Bill 196 – (Ward) – Co-pay accumulator legislation; requires insurers or pharmacy benefit managers to count any amounts paid by the enrollee or paid on behalf of the enrollee by another person when calculating an enrollee’s overall contribution to the plan’s deductible. PAMED is still working through this effort to determine a position while the bill awaits action from the Senate Banking and Insurance Committee.
House Bill 1664 – (Gleim) – House companion legislation
House Bill 605 – (Ecker) – This COVID liability legislation specifically requires certain cases alleging personal injury damages because of exposure to COVID-19 to be subject to expedited compulsory arbitration programs. Having passed the House (107-94) this bill now awaits action from the Senate Judiciary Committee. Should this legislation advance to the Governor’s desk, it is likely it would be vetoed as similar legislative efforts have ended in the same result.
House Bill 1186 – (Quinn) – Legislation to amend the Acupuncture Licensing Act to provide for the title protection for licensed acupuncturists and practitioners. PAMED worked to provide language on amending this bill that resulted in a position of neutrality. HB1186 advanced as amended out of the House Professional Licensure Committee and is to now before the full House.