Lancaster Physician Winter 2020 - 38

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

Legislative Updates

issue since overcoming the political influence
of the state's health insurance industry will
be challenging.

OPIOIDS AND MAT

Opioid awareness is ubiquitous throughout
the physician community and remains a top
priority in the legislature. As the new year
begins, two opioid bills have the potential of
moving-Senate Bills 566 and 675. The first
would take existing opioid prescribing guidelines
developed by PAMED, in cooperation with the
Department of Health, and codify them in regulations. While the intention of the legislation is
to ensure that physicians adhere to the guidelines,
PAMED feels strongly that guidelines should not
be mandated and must, by their very nature, be
flexible given the uniqueness of each and every
patient. In addition, treatment protocols change
often and placing guidelines into the regulatory
process would likely result in physicians being
caught between new treatment protocols and
outdated regulations-potentially denying
patients the most up-to-date care.
Senate Bill 675 seeks to restrict the use of
medically assisted treatment (MAT) for patients
suffering from opioid use disorder. Drugs like
buprenorphine have been proven to be the
most effective treatment for patients who suffer
from addiction. Currently, the bill also requires
patients to seek behavioral therapy to qualify for
buprenorphine treatment. While it is considered
best practices to receive counselling in addition
to MAT, PAMED opposes the language mandating therapy. PAMED is part of a broad-based
coalition, which strongly opposes this legislation.
Another opioid bill to highlight, Senate Bill
572 requires patients to submit to a drug test
and to sign an opioid treatment agreement prior
to receiving an initial opioid prescription. Interestingly, while the bill mandates the screening,
it does not require health insurers to pay for it.
Without mandatory insurance coverage for the
screening, patients who cannot afford the tests
would be unable to receive appropriate treatment
for their chronic pain. PAMED understands and
recognizes that more needs to be done-such as
alternatives therapies, non-opioid medications,
and early and effective substance use disorder

treatment-to help those with opioid use disorder. Senate Bill 572 recently passed the General
Assembly and was signed by the Governor as
Act 112 of 2019.

HEALTH INSURANCE
CREDENTIALING

For several legislative sessions, PAMED has
been seeking a legislative remedy that would
speed up the health insurance credentialing
process for physicians. PAMED is pleased
that House Bill 533, legislation to address this
issue, is beginning to get some traction in the
General Assembly. Newly licensed physicians,
or physicians moving into a different insurance
market, often experience lengthy delays in getting
credentialed by insurers. During that process
these individuals are unable to treat patients,
often denying patients access to care. House Bill
533 seeks to limit the amount of time insurers
can take to approve, or deny, credential applications to 45 days and standardizes the process by
requiring the use of CAQH application forms.
Several organizations, including the Hospital
Association, have joined with PAMED to see
this measure cross the finish line.
There are several other important issues either
pending before the state legislature or "waiting in
the wings." These include, but are by no means
limited to, the following:
Out of Network Billing - House Bill 1862 has
been formally introduced and passed the House
Insurance committee. PAMED and the broad
coalition of providers oppose the bill as written
and have slowed the momentum of this bill.
Efforts are underway to seek amendments to
the legislation that will level the playing field
between providers and insurers, while removing
patients from the middle. PAMED supports the
following two amendments:
* The Kaufer amendment (#A3599) -
Supported by the provider community,
this amendment will remove the median
in-network rate as the state-mandated
payment standard and put in its place "all
reasonably necessary costs," which is, and has
been for over 20 years, the existing payment
standard for emergency services in our state.

* The Rothman amendment (#A3601) - As
currently drafted, this bill only permits arbitration to look at the accuracy of a payment
determined by an insurer, with no checks
and balances in place. This amendment calls
for independent dispute resolution (IDR) to
look at whether the payment is appropriate.
Further, it encourages fair physician claims
and insurer payments from the beginning,
as both sides would incur additional expense
if they take to IDR through the American
Arbitration Association (AAA).
Call to amend or repeal Act 112 of 2018 - The
Act requires physicians who interpret imagining
studies that show a "significant abnormality" to
notify patients that the studies have been read
and that follow-up with the referring physician is
recommended. Recently, Rep. Jozwiak authored
HB 2103, which seeks to exempt specific cardiac
testing from notification requirements. PAMED
continues to support legislation aimed to amend
and improve Act 112 of 2018.
Telemedicine - Senate Bill 857 has passed the
House and is back in the Senate for concurrence
on amendments since the bill has been amended
since it left the Senate.
Medical ID Badges - Senate Bill 842 and
House Bill 1880 aim to remove the requirement
for surnames to be displayed on health care
employees' identification badges. Senate Bill
842 passed the Senate and was referred to the
House Health Committee. PAMED continues
to support both bills.
Rural Health - Senate Bill 314, which was
signed into law as Act 108 of 2019, creates the
Pennsylvania Rural Health Redesign Center
Authority and the Pennsylvania Rural Health
Redesign Center Fund.
Tobacco - Recently, Senate Bill 473 was signed
into law as Act 111 of 2019. This increases
Pennsylvania's minimum legal sales age for
tobacco from 18 to 21. PAMED supported
this initiative.

For more information about any of the items mentioned above, please visit the Advocacy Section of PAMED's website

www.pamedsoc.org/Advocacy
LANCASTER

PHYSICIAN

http://www.pamedsoc.org/Advocacy

Lancaster Physician Winter 2020

Table of Contents for the Digital Edition of Lancaster Physician Winter 2020