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LEG REG REVIEW  Health Edition
2018, 15th Issue *** April 30, 2018

LEG REG REVIEW is a periodic newsletter produced by PHILLIPS ASSOCIATES, a professional lobbying and consultant firm located near the State Capitol.  It contains news on Pennsylvania legislation and regulations impacting the Insurance and Business Communities.  Subscriptions are $100 per year and further information may be obtained by contacting PHILLIPS ASSOCIATES at 717/728-1217 FAX 717/232-7005 or e-mail at xenobun@aol.com.

TELEMEDICINE MOVES FORWARD
On April 24, the Senate gutted the original language of a bill meant to regulate and enhance the practice of telemedicine – something seen as vital to meeting health needs of rural populations and for those who are largely house-bound.  Senate Bill 780 (Vogel-R-Beaver) was amended to strengthen regulatory oversight of health care providers who practice telemedicine and also to require health insurance coverage for these services.  The bill says that insurers shall provide coverage and may not exclude coverage solely because care is delivered by way of telemedicine.  Reimbursement rates shall be the same for telemedicine and in-person health care.  SB 780 still needs final passage by the Senate.  The House counterpart is House Bill 1648 sponsored by Rep. Marguerite Quinn (R-Bucks).

WOLF VETOES WORKERS COMPENSATION Rx FORMULARY BILL
On Friday, April 27, Governor Tom Wolf vetoed Senate Bill 936 (White-R-Indiana).  This legislation would require that a Workers’ Compensation prescription drug formulary be established with the stated purpose of reducing drug costs and reducing what is termed over-prescribing of opioids within the Workers’ Compensation system.  In anticipation of his veto, the Governor announced a set of administrative measures on April 26 which he said would achieve the same goal.  Parts of his plan include:

  • Establishing a working group to set guidelines for prescribing opioids
  • Training of Workers’ Compensation judges and health care providers as well as Utilization Review Organizations on the dangers of opioid over-prescription
  • Calling for legislation to limit opioid prescriptions for most patients to seven days

In announcing his plan, Wolf said that “these steps limit over prescribing of opioids to injured workers…without rationing health care for millions of workers or severely limiting treatment options for workers and their doctors beyond opioids.” 
Details: https://www.governor.pa.gov/governor-wolf-takes-executive-action-curb-overprescribing-opioids-workers-compensation/

Reaction by Republicans was swift with Speaker of the House Mike Turzai (R-Allegheny) stating
“Gov. Wolf caved to powerful special interests today with his veto of a bill which would combat the opioid crisis, protect injured workers and rein in prescribing abuses within the Workers’ Compensation system. During the debate in both the House and Senate, the governor was nowhere to be found, nor did he weigh in or offer any meaningful solutions to the prescribing abuses occurring in Workers’ Compensation. Instead, today he served as a backstop for his wealthy trial attorney friends who apparently profited from the abuses and demand they continue.”

Prospects for overriding the veto are cloudy given that the House only narrowly voted 101-92 for final passage of SB 936.

ANOTHER FLASHPOINT…  The House passed House Bill 2050 (Turzai-R-Allegheny) on April 16 by a 139-56 vote to prohibit abortions to unborn children diagnosed with Down’s Syndrome.  The vote had most Republicans except for three voting for and most Democrats except for 22 voting against.  The Senate now takes up the bill.  If ultimately passed by the General Assembly, it faces a likely veto from Governor Wolf.

HEALTH INSURANCE LEGISLATION TO WATCH

  • House Bills 2127 and 2128 (Christiana-R-Beaver/Washington) attempt to bring about what the sponsor calls “a fairer, more competitive marketplace”.  They seek to address integrated delivery systems where hospital systems also provide insurance.  Hospitals and physicians operating as part of an integrated delivery system would be required to contract with all insurers and consumers would not be denied care or losing mid-term treatment simply because they have one insurance card over another.  The legislation also attacks “the ability of any dominant hospital system from demanding unreasonable rates for services from insurers.”  The bills are currently in the House Health Committee.
  • House Caucus Secretary Donna Oberlander (R-Clarion/Armstrong/Forest) introduced House Bill 2113 amending the Unfair Insurance Practices Act to prevent health insurance companies from changing terms of coverage within a policy year for policyholders who are already receiving coverage for a specific treatment.  Status:  House Commerce Committee
  • House Bill 1800 sponsored by Rep. Eric Nelson (R-Westmoreland) addresses medical synchronization where prescription refill dates are lined up to fall due on one date.  It is meant to accommodate those who have physical difficulty in making numerous trips to the pharmacy.  It is ready for second consideration by the House. The House must consider it on one more legislative day before final passage.  HB 1800 mandates health insurers to pay for the partial prescriptions necessary to reach synchronization.
  • Senate Bill 373 (Eichelberger-R-Blair) allows for reimbursement for dental services to go directly to the dentist instead of the patient assuming all agree.  Status: House Insurance Committee
  • Senate Bill 257 (Ward-R-Westmoreland) prohibits insurers from setting fees for non-covered contracts with eye care providers, provide uniformity in payment procedures to eye care providers for both those in and out of network.  Called Eye Parity, the bill is on the Senate calendar.

POLITICS
U.S. Representative Patrick Meehan (R-7) has resigned his congressional seat effective immediately.  Embroiled in a legal situation where a former staffer accused him of sexual harassment, he was being investigated by the House Ethics Committee.  In announcing his resignation, Meehan stated, “While I do believe I would be exonerated of any wrongdoing, I also did not want to put my staff through the rigors of an Ethics Committee investigation and believed it was best for them to have a head start on new employment rather than being caught up in an inquiry. And since I have chosen to resign, the inquiry will not become a burden to taxpayers and committee staff.” Originally, Meehan had thought to fill out his term.

INSURANCE CANDIDATES
For the May 15 primary, there are a number of candidates with insurance credentials:

  • Ray Sosa, a licensed insurance producer from Montgomery County, is running for Lt. Governor in the Democratic primary.
  • John Eichelberger owns a P/C agency in Altoona.  He is running in the Republican primary to succeed retiring Rep. Bill Shuster.
  • Insurance agency owner Rep. Mike Tobash (R-Schuylkill) is seeking re-election.
  • Also seeking another term, Rep. Michael Corr (R-Montgomery) has an insurance license.

IN CASE YOU MISSED THIS RESOLUTION BY THE PA HOUSE

  • House Resolution 728 (Christiana-R-Beaver/Washington) was adopted by the House to designate April 17, 2018 as “World Hemophilia Day”.  The Resolution does not call for hemophilia to be an additional health insurance mandate but simply says that people living with hemophilia and those providing care are “strongly united in advocating for access to treatment and care.”