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Legislative Update

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Legislative Update - March 16, 2017

CALL TO ACTION - Certified Registered Nurse Practitioners

POMA is asking members to communicate their opposition to Senate Bill 25 to their Senators before it is scheduled for consideration in the Senate Committee on Consumer Protection and Professional Licensure.

Senate Bill 25 would allow certified registered nurse practitioners (CRNPs) to diagnose, treat and prescribe medications without the oversight or co-signature of a doctor of osteopathic medicine (DO) or doctor of allopathic medicine (MD). It would effectively allow CRNPs the same authority and clinical autonomy as a physician, without the necessary education and training.

Full text of the bill can be found at http://bit.ly/2nsnTEt.

 

Other Noteworthy Legislative Issues

Pennsylvania Tightens Medicaid Rules to Help Combat Opioid Crisis

On May 6, 2017, Governor Tom Wolf announced that the Commonwealth will be taking several additional steps to help combat the opioid addiction crisis. In order to make sure medication is used appropriately, the Department of Human Services (DHS) will be taking the following steps for Medicaid providers:

  • Require all ordering, prescribing or referring providers who are identified on claims be enrolled in the Medicaid program. This will prevent current cash providers who are not enrolled in the Medicaid program from having their prescriptions filled at the pharmacy;
  • Work with the Department of Drug and Alcohol Programs (DDAP) to cease allowing providers to accept cash payments from Medicaid recipients;
  • Audit and potentially un-enroll providers who prescribe medication such as buprenorphine without an office visit;
  • Encourage Medicaid Managed Care Organizations (MCOs) to terminate poor providers that do not meet certain quality metrics;
  • Implement standardized prior authorization guidelines similar to those most recently implemented for the Medicaid Fee-For-Service Program; and
  • Refer high-volume providers with poor quality records to DHS Bureau of Program Integrity for reviewand action.

 

Prescribing Guidelines

On March 1, 2017, the Commonwealth of Pennsylvania published “The Safe Prescribing of Opioids in Orthpedics and Sports Medicine.” The document, as well as several other pain treatment and opioid guidelines, can be downloaded at http://bit.ly/2nwo1j8

 

American Health Care Act

Two House committees have advanced a major health care reform bill aimed at repealing and replacing the
Affordable Care Act (Obamacare). It is too early in the process to determine the bill’s fate and ultimate language, but notable are significant concerns for the recently expanded Medicaid population and drug and mental health benefit provisions. The issue will dominate congressional attention for the foreseeable future.

 

Medical Malpractice Caps

Seemingly under the shadow of the health care reform effort, the House passed major reforms to limit monetary awards in malpractice suits to $250,000 for non-economic damages, which includes pain and suffering. The second of four proposals narrowly passed in the House would shift some claims to the federal court system from the state courts, which have tended to be more sympathetic to plaintiffs. The third measure would require federal judges to sanction attorneys whose claims are later found to be frivolous. The fourth measure, which has not been scheduled for a vote, would place a three-year statute of limitation for filing civil lawsuits where patients and families believe negligent health care resulted in injury or death.

 

PA General Assembly Returns to Legislative Session

The House Human Services Committee conducted a public hearing with the Department of Human Services to review the proposed consolidation of the agency with the Department of Drug and Alcohol Programs. Additionally, the committee moved HB 45, an act providing for the use of investigational drugs, biological products and devices by terminally ill patients.

The House Human Services Committee also meets on March 22 to consider HB 396, which would require prescribers to check ABC-MAP every time they write a prescription for a controlled substance.


Pennsylvania Legislature Session Days

The full calendar of session days for the Pennsylvania House of Representatives and Senate follow below:

2017 House Session Schedule

March 13, 14, 15, 20, 21, 22
April 3, 4, 5, 18, 19, 24, 25, 26
May 8, 9, 10, 22, 23, 24
June 5, 6, 7, 12, 13, 14, 19, 20, 21, 22, 26, 27, 28, 29, 30

2017 Senate Session Schedule
March 20, 21, 22, 27, 28, 29
April 17, 18, 19, 24, 25, 26
May 8, 9, 10, 22, 23, 24
June 5, 6, 7, 12, 13, 14, 19, 20, 21, 22, 26, 27, 28, 29, 30


2017-2018 House and Senate Leaders

House Republican Leaders
Leader: Dave Reed
Appropriations Chair: Stan Saylor
Whip: Bryan Cutler
Caucus Chair: Marcy Toepel
Caucus Administrator: Kurt Masser
Caucus Secretary: Donna Oberlander
Policy Chair: Kerry Benninghoff

House Democratic Leaders
Leader: Frank Dermody
Appropriations Chair: Joe Markosek
Whip: Mike Hanna
Caucus Chair: Dan Frankel
Caucus Administrator: Neal Goodman
Caucus Secretary: Rosita Youngblood
Policy Chair: Mike Sturla

Senate Republican Leaders
Leader: Jake Corman
Appropriations Chair: Patrick Browne
Whip: John Gordner
Caucus Chair: Bob Mensch
Caucus Administrator: Charles McIlhinney
Caucus Secretary: Richard Alloway
Policy Chair: David Argall

Senate Democratic Leaders
Leader: Jay Costa
Appropriations Chair: Vincent Hughes
Whip: Anthony Williams
Caucus Chair: Wayne Fontana
Caucus Administrator: Unfilled
Caucus Secretary: Larry Farnese
Policy Chair: Lisa Boscola

 

A Closer Look at Pennsylvania’s Newly Enacted Opioid Legislation

On November 2, 2016, Governor Wolf signed several pieces of legislation designed to address opioid abuse in Pennsylvania. He was joined by a group of more than 20 legislators and department secretaries during a press conference in the Capitol’s Main Rotunda to commemorate the event.

Bills that received Governor Wolf ’s signature during the press conference included:

House Bill 1699 (Act 122) limits opioid prescriptions to no more than seven days for those seeking treatment in an emergency department or urgent care facility. An exception is made for the treatment of an acute medical condition and for pain associated with cancer or for palliative care.

House Bill 1737 (Act 123) expands drop-off locations for expired or unwanted prescription drugs and over-the-counter pharmaceuticals.

Senate Bill 1202 (Act 124) requires physicians and other health care providers to complete at least two hours of continuing medical education in pain management, identification of addiction, or the practices of prescribing, or dispensing of, opioids for licensure renewal. Initial licensure will require four hours of CME. The act also requires prescribers to query the Prescription Drug Monitoring Program (PDMP) each time a patient is prescribed an opioid drug product or a benzodiazepine.

Senate Bill 1367 (Act 126) limits opioid prescriptions for minors to a seven-day duration when consent is given by the minor’s parent or legal guardian, except in cases of medical emergencies. Chronic pain, cancer treatment and palliative care or hospice care are also listed as exceptions. Opioids may be prescribed to a minor for 72 hours when an authorized adult, not a parent or guardian, is available for consent. Written consent for a prescription must be obtained from the minor’s parent, legal guardian or an authorized adult and maintained in the prescriber’s medical records for the minor. A consent form to be created by state licensing boards will be required to comply with the law. POMA will notify members once the forms are available.

Senate Bill 1368 (Act 125) requires a safe opioid prescribing and pain management curriculum in both medical colleges and other medical training facilities. The act also allows patients to sign a form prohibiting a health care provider from prescribing or administering a controlled substance containing an opioid to the patient.

 

Hepatitis C Screening Act Summary

On June 20, 2016, Pennsylvania Governor Tom Wolf signed House Bill 59 into law, creating the Hepatitis C Screening Act (Act 87 of 2016). The new legislation requires that all individuals born between the years 1945 and 1965 (i.e., baby boomers) be offered a Hepatitis C screening or diagnostic test if receiving: inpatient services in a hospital; or primary care services in an outpatient department of a hospital, a health care facility or a physician’s office.

If a patient is tested and the results are reactive, the bill calls for the health care provider to either offer follow-up care or a referral for follow-up care, including a hepatitis C diagnostic test.

Under Act 87, a health care practitioner does not have to offer the test if it is reasonably believed that the individual is being treated for a life-threatening emergency; has previously been offered or been the subject of a hepatitis screening test, unless otherwise indicated; or lacks the capacity to consent to a screening test.


Pa. Child Abuse CME Required as of January 1, 2015

The Commonwealth of Pennsylvania Bureau of Professional and Occupational Affairs, in conjunction with the Department of Public Welfare (DPW), has announced new licensure requirements for all health-related licensees and funeral directors that are considered “mandatory reporters” under section 6311 of the Child Protective Services Law (CPSL) (23 P.S. § 6311).

Effective January 1, 2015, all persons applying for issuance of an initial license are required to complete three hours of DHS-approved training in child abuse recognition and reporting requirements as a condition of licensure.

All health-related licensees applying for license renewal after January 1, 2015, are required to complete at least two hours of board-approved continuing education in child abuse recognition and reporting requirements as a condition of renewal.

Please note, Act 31 applies to all health-related licensees, regardless of whether they are subject to the continuing education requirements of the applicable board.  This includes active/retired and volunteer licensees.

Child abuse credits cannot be substituted for any board-specific credits, such as ethics, public health, etc.  This includes the patient safety/risk management requirement.

For more information related to child protection and mandated reporters, please visit the state’s
Keep Kids Safe PA website at http://keepkidssafe.pa.gov/training/index.htm. A list of approved courses for child abuse recognition and training is also available at http://keepkidssafe.pa.gov/cs/groups/webcontent/documents/document/c_227007.pdf.

The Department of State also provides a list of Act 31 "Frequently Asked Questions" at http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Documents/Act-31-Frequently-Asked-Questions.pdf.


 

Legislative Links

Pennsylvania General Assembly

Pennsylvania General Assembly Electronic Billroom

Governor Tom Wolf

Congress.org

Senator Robert P. Casey, Jr.

Senator Pat Toomey

 

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