LCHM Winter18 - 29
L C M E D S O C .O R G
Prior Authorization Legislation
Introduced by Rep. Marguerite Quinn (R-Bucks)
Representative Marguerite Quinn, along with 38 bi-partisan
co-sponsors, introduced HB 1293 earlier this session. This
legislation will improve transparency, accessibility and the consistent application of prior authorization by including a standard
definition. It will also significantly streamline the process by
requiring insurers to make available an electronic communications
network that permits prior authorization requests to be submitted
electronically, and authorizations and adverse determinations to
likewise be returned electronically.
Over the past several months, government relations staff has
worked closely with Representative Quinn in developing HB
1293 and making improvements over last session's version. Prior
to its introduction, staff met with House members to explain
the need for the legislation and to secure an adequate number
of legislative sponsors.
A significant grassroots effort that asks physicians to engage
patients is already underway. The goal of this initiative is for
patients to ultimately share their medical challenges with the prior
authorization process with their legislators.
HB 1293 has been referred to the House Insurance Committee.
PAMED is now arranging direct physician contacts with committee
members and continuing the process of educating legislators as to
how prior authorization can negatively impact patient care. The
next legislative goal is to secure a committee vote on the bill before
the end of the year, if not sooner.
Pennsylvania Orders for Life-Sustaining Treatment (POLST)
In early September, House Majority Whip Bryan Cutler
introduced House Bill 1196, the Pennsylvania Orders for Life
Sustaining Treatment (POLST) Act. The introduction of this
legislation, and with such a highly-regarded sponsor, represents a
major step forward for a multi-year, collaborative effort that drew
on the expertise of twenty-seven health care and patient advocacy
organizations. During a press conference this Spring, Senator Gene
Yaw also announced his intention to introduce similar legislation
in the Senate. He is expected to formally introduce that bill soon.
To prepare for its introduction in the Senate, PAMED's
lobbyists recently joined Daniel Kimball, MD, in meeting with
Senator Lisa Baker, chairwoman of the Senate Health Committee
where the legislation will likely be sent. The meeting was quite
productive and the Senator expressed interest in addressing this
issue. In the House, the POLST Act has been sent to the Judiciary
Committee, but PAMED expects that it may soon be rereferred
to the Health Committee.
In cooperation with the Hospital and Health Systems Association
(HAP), PAMED was successful in securing the passage of House
Bill 125 from the House Health Committee. The legislation was
subsequently passed by the full House on May 24, 2017 (190-0).
HB 125 will now be considered by the Senate Banking and Insurance
Committee, where it will continue to face strong opposition from
the insurance industry.
Last session, legislation was introduced in both the Senate and
House of Representatives to provide statutory guidelines related to
the practice of telemedicine. As expected, the bills did not move but
succeeded in generating discussion among key stakeholders. This
session, ongoing efforts, largely taking place in the Senate, to address
concerns from all stakeholders has delayed formal introduction of
legislation. Two primary issues, guaranteed reimbursement for
telemedicine services and a question of mandating the availability
of video (PAMED and HAP are opposed to audio only), slowed
down the advancement of this issue.
Before the legislature recessed in July, Senator Elder Vogel formally
introduced SB 780, a version that has the support of both PAMED
and HAP. Representative Marguerite Quinn is expected to introduce a companion bill, with identical language, in the near term.
Federal Medical Liability Legislation
HR 1215 has cleared both the House Judiciary and the House
Energy and Commerce committees. PAMED had previously sent
a letter to the House delegation from PA as well as key congressional staff urging support for HR 1215. The bill may come up
for a vote soon but because it is identified as health care reform,
it could be delayed.
WINTER 2018 | Lehigh County Health & Medicine 29