LEG REG REVIEW
2018, 24th Issue *** July 23, 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.

JUA SURVIVAL CONTINUES…FOR NOW
Again, the Joint Underwriting Association (JUA), the insurer of last resort for medical malpractice insurance, received yet another stay of execution thanks to a July 18 preliminary injunction issued by U.S. District Judge Christopher Conner. At issue was Act 41 of 2018 (Fiscal Code) which would have ended JUA’s life as an independent entity and made it a special fund under the control of the PA Insurance Department. Act 41 was seen as a strategy to get around JUA’s opposition to previous attempts to take $200 million in JUA reserves and move it to the General Fund to help balance the State Budget. JUA had successfully argued that although having been created by statute, its’ money came from premiums paid by doctors and hospitals. As such (JUA said), the state had no legal basis in taking money from the insurers’ reserves. Act 41 would have made the funds transfer simpler since the Insurance Department would control the JUA reserves.

SUPREME COURT: UPMC/HIGHMARK CONSENT DECREE DECISION
The PA Supreme Court ruled July 18 that the Consent Decree requiring UPMC to treat Highmark Medicare Advantage policyholders would end as originally scheduled on December 31, 2018 with a run-out period through June 2019. An earlier Commonwealth Court decision was that the termination date would be at the end of December 2019 with a run-out period ending the following June. The opinion of Commonwealth of Pennsylvania (Shapiro, Altman, Levine) v. UPMC; UPA aka Highmark Health and Highmark, Inc. is available here.
https://law.justia.com/cases/pennsylvania/supreme-court/2018/5-map-2018.html

WOLF ADMINISTRATION RELEASES OWN PLAN FOR WC PRESCRIPTIONS
On July 16, the Wolf Administration issued Workers’ Compensation opioid prescribing guidelines. The focus is on providing guidance to health care providers when prescribing pain medication. There are now eleven prescribing guidelines for health care providers including:

Worker’s Compensation Prescribing Guidelines;
Treating Chronic Non-Cancer Pain;
Emergency Department Pain Treatment Guidelines;
Opioids in Dental Practice;
Opioid Dispensing Guidelines;
Obstetrics and Gynecology Opioid Prescribing Guidelines;
Geriatric Pain;
Use of Addiction Treatment Medications in the Treatment of Pregnant Patients with Opioid-Use Disorder;
Safe Prescribing Benzodiazepines for Acute Treatment of Anxiety and Insomnia;
Safe Prescribing Guidelines for Orthopedics and Sports Medicine; and
Safe Prescribing of Opioids in Pediatric and Adolescent Populations.

For more information about the Wolf Administration’s response to the opioid crisis, visit www.pa.gov/opioids. To view the prescribing guidelines, click here.
This poses a strong contrast to recently vetoed Senate Bill 936 (White-R-Indiana) which would have amended the Worker’s Compensation Act to establish a drug formulary. Proponents said that SB 936 would control WC prescription costs and reduce the numbers of opioid prescriptions. The Governor’s plan does not appear to restrict what may be prescribed. Rather, it seeks to establish guidelines. That approach mirrors opponents’ arguments against SB 963 that a formulary would result in fewer choices available to workers in meeting their pharmaceutical needs.

MEDICARE SUPPLEMENT RULE APPROVED
On July 19, the Independent Regulatory Review Commission (IRRC) voted to adopt proposed Insurance Department Regulation #11-256 to update Pennsylvania’s rules governing Medicare Supplement (Medigap) Insurance. The purpose is to make PA rules consistent with changes in Federal law and the NAIC model. http://www.irrc.state.pa.us/regulations/RegSrchRslts.cfm?ID=3200

POLITICS

Rep. Michael O’Brien (D-Phila.) announced that he is no longer a candidate for re-election to the PA House. Democrats will select his replacement for the general election.

PRIVACY RULE UPDATE PROPOSED
On July 21, the Insurance Department published an updated regulation, Privacy of Consumer Financial Information (Chapter 146b), on required privacy notices and how consumers may prevent a licensee (including insurance agents/ brokers/agencies) from sharing nonpublic personal financial information. This rule stems from the Gramm-Leach-Bliley Act (GLBA) and NAIC Model Regulation 672. The Rule incorporates changes to GLBA per 2015 Federal legislation allowing for exceptions to the annual notice requirements and a simplified privacy notification. This exception applies to a licensee which has not changed its practices regarding disclosure of nonpublic personal financial information from the most recent notice sent to consumers.

Preliminary comments were received from Insurance Federation of PA, PA Association of Mutual Insurance Companies, Insurance Agents & Brokers (IA&B), and American Insurance Association before this was formally proposed by the PA Insurance Department. There will be additional opportunities for public comment as the rule makes its way through the regulatory review process.

REGULATORY UPDATES

Four companies have filed requests for renewal of their Insurance Department designation as Certified Reinsurers: ACA INA Overseas Insurance Company; LLC, Chubb Reinsurance (Switzerland), Ltd.; Chubb Tempest Reinsurance, Ltd.; and Equator Reinsurance Limited.
On July 21, the PA Insurance Department issued a data call for automobile insurance companies. Also known as the ‘Act 6 Data Call’, this is an annual status report on the private passenger automobile insurance market in PA. Instructions may be found at www.insurance.pa.gov (select ‘Companies’, then ‘Industry Activity’, then ‘Data Calls’ under ‘Product and Rate Activity’). Reports are due to the Insurance Department by October 15, 2018. Questions: Dennis Sloand, Bureau of P/C Insurance, 717-214-1927, desloand@pa.gov

HEARINGS THIS WEEK…The House Democratic Policy Committee will hold a hearing on House Bill 465 (Hanna-D-Clinton) today to mandate that small employers participate in a state-run pension program where employees will automatically be enrolled (and have the premium come out of their paychecks) unless they affirmatively opt-out. The House Democratic Policy Committee also has a July 25 hearing on House Bill 2552 introduced by Rep. Peter Schweyer-D-Lehigh). This would continue the no pre-existing medical condition stipulation for health insurance under the Affordable Care Act in the event that this part of ACA is repealed at the Federal level.