Berks County Medical Society Medical Record Winter 2019 - 32

Drug Costs, Drug Shortages and Group Purchasing Organizations
continued from page 31

mandate for Schedule II-V controlled substances. Emergency
situations, temporary technological malfunctions, lack of
access to the Internet/EHR system, and direct administration
by a physician were listed as exceptions.
Act 96 was signed by the Governor on Oct. 4, 2018. Any
physician, pharmacy, or health care facility that does not
meet one of the exceptions in Act 96 but is unable to timely
comply with the electronic prescribing requirements may
petition the Department of Health for an exemption from
the requirements based upon economic hardship, technical
limitations, or exceptional circumstances. The Department
is required to adopt rules establishing the form and specific
information that must be included in a request for an
exemption. The exemption may not exceed one year from the
date of approval but may be renewed annually upon request
and approval. The Department, in its discretion, may establish
additional exemptions through the regulatory process.
Act 96 does not take effect until Oct. 24, 2019. As the law
just was enacted on Oct. 24, 2018, the Department has not
released its rules establishing the form and specific information
that must be included in a request for an exemption. Once the
Department does so, PAMED will provide this information to
its members. Members can also access PAMED's informational
Quick Consult at www.pamedsoc.org/QuickConsult. It is
recommended that physicians not wait until next fall to begin
preparing for this e-prescribing requirement. Physicians who
may be seeking a hardship exemption are encouraged to
continue to plan for the e-prescribing requirement, as that
requirement must be implemented unless an exception applies,
or the Department grants a hardship exemption.
Another bill, SB 655, would
have created an Advisory Council
within the Department of Health
that could have mandated that
physicians follow guidelines, such
as the current voluntary guidelines,
when prescribing opioids.
PAMED opposes legislation that
would force physicians to practice
"cookie-cutter" medicine. PAMED
was at the Capitol in Harrisburg
on Sept. 25, 2018, visiting the
offices of House Health Committee members to talk about
why cookie-cutter approaches don't work well in medicine. It
was a chance to deliver our message in a unique way - with

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sugar cookies and caduceus cookie cutters. We urged House
members to oppose SB 655 and instead focus on a more
immediate need in this crisis: increasing funding and access
for those who need treatment for an opioid use disorder. This
legislation was passed unanimously in the Senate but was never
voted on in the House of Representatives.
Of particular concern was HB 1987, which would have
limited the use of fentanyl to surgery within a health care
facility or to a hospice patient. PAMED and The Hospital and
Healthsystem Association of Pennsylvania (HAP) wrote a joint
opposition letter expressing concern over appropriate use of the
drug in clinical settings and preventing patients from receiving
appropriate care. Through our concerted lobbying efforts, HB
1987 was successfully amended to include "chronic pain not
associated with cancer" and therefore, our position moved to
neutral. It is also important to note that HB 1987 was voted
on favorably within the House of Representatives, but it saw
no action within the Senate Health and Human Services
Committee or on the Senate floor.
Thanks to strong lobbying efforts, PAMED was able to
advocate for bills that do not infringe on physicians' ability to
address the individual needs of their patients. PAMED worked
closely with legislative leaders and staff to ensure that what
ultimately was signed into law was clinically sound and in the
best interest of patient care.

Public Health Advocacy Issues - Lyme Disease and
Sunscreen in Schools
HB 174, introduced by Rep. Matt Baker, would have
required insurance coverage for Lyme disease and related
tick-borne diseases as prescribed by a patient's health care
practitioner, regardless of if the treatment plan includes shortterm or long-term antibiotic treatment. Similar legislation was
introduced in the Senate (SB 100) by Sen. Stewart Greenleaf.
Both bills never made it out of the Senate Banking and
Insurance Committee.
HB 2301, introduced by Rep. Rosemary Brown, would
have established that a licensing board require a licensee
complete at least two hours of continuing education in the
assessment, diagnosis, and treatment options for Lyme disease
and other related tick-borne diseases as a portion of the total
continuing education required for license renewal. The bill was
introduced in April 2018 and saw no movement in the House
or Senate.


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Berks County Medical Society Medical Record Winter 2019

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Winter 2019

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