Central PA Medicine Spring 2018 - 32

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LEGISLATIVE UPDATES

LEGISLATIVE UPDATE
Pennsylvania Medical Society
Quarterly Legislative Update
Spring 2018

Prior Authorization Reform
The Pennsylvania Medical Society
(PAMED) is advocating for reforms
to the prior authorization process. We
continue to urge affected physicians and
their patients to file complaints with the
Pennsylvania Insurance Department, contact their State Representative in support
of HB 1293, and share patient stories at
www.pamedsoc.org/PriorAuth.

that all PAMED members push for
this legislative change, which aims to
increase transparency and standardization
and improve response times with prior
authorization.
Recently, this issue has gained increased
attention due to a CNN story outlining
details of an investigation into Aetna,
where a former medical director admitted
under oath that he never looked at patients'
records when deciding to approve or
deny care. The Scranton Times also ran
an editorial titled "Stop insurers from
dragging feet on care," which ran in all
the Times-Shamrock family of newspapers.

Please note: The Pennsylvania Insurance
Department does not have jurisdiction
over, and therefore cannot investigate,
self-insured plans as a result of the Employee Retirement Income Security Act of
1974 (ERISA). The Pennsylvania Insurance
PAMED has used the media activity as
Department can investigate complaints a springboard, writing a letter to Acting
from most other insurance plans.
Insurance Commissioner Jessica Altman
urging her to review all licensed insurers
PAMED is hopeful that the House and their prior authorization processes, and
Insurance Committee, where HB 1293 writing to the full House of Representatives
currently awaits consideration, will take urging their support of HB 1293.
some action on the measure in the near future. Now more than ever, it is imperative
32 Spring 2018 Central PA Medicine

In March, Gov. Tom Wolf removed prior
authorization requirements for opioid
treatment under Medicaid. PAMED
applauds Governor Wolf for recognizing
negative consequences prior authorization
can have on this population of patients.

Informed Consent
In a June 2017 ruling, the Pennsylvania
Supreme Court held that, under the
MCARE Act, the duty to obtain a patient's
informed consent is a non-delegable
duty. Under the MCARE Act, except
for emergencies, physicians must obtain
informed consent from their patients,
or their authorized representative, prior
to conducting the following procedures:
* Performing surgeries (including the
related administration of anesthesia)
* Administering radiation or
chemotherapy


http://www.dauphincms.org http://www.pamedsoc.org/PriorAuth

Table of Contents for the Digital Edition of Central PA Medicine Spring 2018

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https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring19
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter19
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall18
https://www.nxtbook.com/hoffmann/CPAMed/Summer2018
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring18
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter18
https://www.nxtbook.com/hoffmann/CPAMed/Fall2017
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Summer17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Spring17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Feb2017
https://www.nxtbookmedia.com