CPM Winter 2020 - 29

daup h i n c m s .o rg

Senate Bill 675 seeks to restrict the use Bill 533 seeks to limit the amount of time sides rise additional expense if taken to
of medically assisted treatment (MAT) for insurers can take to approve, or deny, creden- IDR through the American Arbitration
patients suffering from opioid use disorder. tial applications to 45 days and standardizes Association (AAA).
Drugs like buprenorphine have been proven the process by requiring the use of CAQH
to be the most effective treatment for patients application forms. Several organizations,
PAMED is seeking to amend or repeal Act
who suffer from addiction. Currently, the including the Hospital Association, have 112 of 2018. The Act requires physicians
bill also requires patients to seek behavioral joined with PAMED to see this measure who interpret imagining studies that show
therapy to qualify for buprenorphine treat- cross the finish line.
a "significant abnormality" must notify
ment. While it is considered best practices
patients that the studies have been read and
to receive counselling in addition to MAT,
There are several other important issues that follow-up with the referring physician
PAMED opposes the language mandating either pending before the state legislature or is recommended. Recently, Rep. Jozwiak
therapy. PAMED, part of a broad-based "waiting in the wings." These include, but authored HB 2103 which seeks to exempt
coalition, strongly opposes this legislation. are by no means limited to, the following: specific cardiac testing from notification
requirements. PAMED continues to support
Another opioid bill to highlight, Senate
Out of Network Billing, - House Bill legislation aimed to amend and improve
Bill 572 requires patients to submit to a drug 1862 has been formally introduced and Act 112 of 2018.
test and to have the patient sign an opioid passed the House Insurance committee.
treatment agreement prior to receiving an PAMED and the broad coalition of proTelemedicine - Senate Bill 857 has passed
initial opioid prescription. Interestingly, viders oppose the bill as written and have the House and is back in the Senate for
while the bill mandates the screening, it slowed the momentum of this bill. Efforts concurrence on amendments since the bill
does not require health insurers to pay for are underway to seek amendments to the has been amended since it left the Senate.
it... Without mandatory insurance coverage legislation that will level the playing field
for the screening, patients who cannot between providers and insurers while at
Medical ID Badges - Senate Bill 842/
afford the tests would be unable to receive the same time remove patients from the House Bill 1880 aim to remove the requireappropriate treatment for their chronic pain. middle. PAMED supports the following ment for surnames to be displayed on health
PAMED understands and recognizes that two amendments:
care employees' identification badges. Senate
more needs to be done to help those with
Bill 842 passed the senate and was referred
opioid use disorder such as alternatives
The Kaufer amendment (#A3599) - to the House Health Committee. PAMED
therapies, non-opioid medications, and Supported by the provider community, continues to support both bills.
early and effective substance use disorder this amendment will remove the median
treatment. Senate Bill 572 recently passed in-network rate as the state mandated
Rural Health - Senate Bill 314, which
the General Assembly and was signed by payment standard and put in its place "all was signed into law as Act 108 of 2019.
the Governor as Act 112 of 2019.
reasonably necessary costs," which is the Senate Bill 314 creates the Pennsylvania
existing payment standard for emergency Rural Health Redesign Center Authority
For several legislative sessions, PAMED services in our state and has been for the and the Pennsylvania Rural Health Redesign
has been seeking a legislative remedy that past 20 plus years.
Center Fund.
would speed up the health insurance credentialing process for physicians. PAMED
The Rothman amendment (#A3601) -
Tobacco - Senate Bill 473 recently was
is pleased that House Bill 533, legislation As currently drafted, this bill only permits signed into law as Act 111 of 2019. This
to address this issue, is beginning to get arbitration to look at the accuracy of a increases Pennsylvania's minimum legal sales
some traction in the General Assembly. payment determined by an insurer, with age for tobacco from 18 to 21. PAMED
Newly licensed physicians, or physicians no checks and balances in place. This supported this initiative.
moving into a different insurance market, amendment calls for independent dispute
often experience lengthy delays in getting resolution (IDR) to look at whether the
credentialed by insurers. During that process payment is appropriate. Further, it enthese individuals are unable to treat patients, courages fair physician claims and insurer
often denying patients access to care. House payments from the beginning, as both
For more information about any of the items mentioned above,
please visit the Advocacy Section of PAMED's web site at

Central PA Medicine Winter 2020 29

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

CPM Winter 2020

Table of Contents for the Digital Edition of CPM Winter 2020

CPM Winter 2020 - 1
CPM Winter 2020 - 2
CPM Winter 2020 - 3
CPM Winter 2020 - 4
CPM Winter 2020 - 5
CPM Winter 2020 - 6
CPM Winter 2020 - 7
CPM Winter 2020 - 8
CPM Winter 2020 - 9
CPM Winter 2020 - 10
CPM Winter 2020 - 11
CPM Winter 2020 - 12
CPM Winter 2020 - 13
CPM Winter 2020 - 14
CPM Winter 2020 - 15
CPM Winter 2020 - 16
CPM Winter 2020 - 17
CPM Winter 2020 - 18
CPM Winter 2020 - 19
CPM Winter 2020 - 20
CPM Winter 2020 - 21
CPM Winter 2020 - 22
CPM Winter 2020 - 23
CPM Winter 2020 - 24
CPM Winter 2020 - 25
CPM Winter 2020 - 26
CPM Winter 2020 - 27
CPM Winter 2020 - 28
CPM Winter 2020 - 29
CPM Winter 2020 - 30
CPM Winter 2020 - 31
CPM Winter 2020 - 32