LEG REG REVIEW Health Edition
2019, 4th Issue *** February 11, 2019
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.
UPMC GENERATES OFFICIALS’ IRE
Pittsburgh’s UPMC has come under renewed fire from Harrisburg stemming from its acrimonious contractual breakup with Highmark. On February 7, PA Attorney General Josh Shapiro announced that his office was filing a lawsuit in Commonwealth Court to force access to UPMC’s health care services and products through negotiated contracts with any health plan and compulsory arbitration if contract negotiations fail. In his press conference, Shapiro said, “As the Chief Law Enforcement Officer for the Commonwealth of Pennsylvania, it is my constitutional mandate to ensure that charitable organizations like UPMC comply with our laws governing their conduct. We have concluded that UPMC is not fulfilling its obligation as a public charity.”
The court petition stems from the 2014 consent agreement where both Highmark and UPMC accepted terms for making sure that patients would not be left adrift because of the competitive animosity between the two health insurance rivals. The Attorney General’s action noted that unless extended, the consent agreement will expire on June 30, 2019.
Adding to the firestorm, Senate Minority Leader Jay Costa (D-Allegheny) issued a sponsorship memo February 6 for his legislation that would amend the Health Care Facilities Act to require hospital systems to contract with any willing insurer and to “prohibit hospitals operating as part of an integrated delivery network when contracting with insurers from …business practices that impede the availability of quality health care at affordable prices and that restrict access to facilities or services.” In addition, Senator Costa’s legislation would set up an oversight board, the Health Care Competition and Oversight Board, to ensure that a truly competitive marketplace exists in Pennsylvania.
House Minority Leader Frank Dermody (D-Allegheny) issued his own sponsorship memo February 7. It would amend the PA Constitution regarding non-profit hospitals to “make sure that tax-exempt hospitals live up to their charitable missions.” His memo used an example to make his point: |
“Imagine riding in the back of an ambulance with lights flashing and sirens blaring with your spouse or child being rushed to the nearest emergency room. Then imagine being handed a large bill because this particular hospital has its own health insurance plan and won’t accept your insurance. Every day this tragedy happens in our state and it must stop now. That is why I am proposing to amend the Pennsylvania Constitution to require hospital systems that avoid taxes by operating as a non-profit or charity and selling their own insurance plans to accept reasonable reimbursement payments from uninsured patients and patients covered by other health insurance plans.”
PA House Health Committee Minority Chair Rep. Dan Frankel (D-Allegheny) previously commented that “Scaring seniors into thinking they can’t get medical care unless they get on board with what a ‘health care system’ wants doesn’t convince me that this conflict is about health, or caring at all. This looks like the actions of revenue-generating businesses, not community assets.” |
SENATE SEEKS HOLD ON VENUE RULE CHANGE
The PA Senate has engaged the issue of medical malpractice attorney venue-shopping by adopting Senate Resolution 20 sponsored by Judiciary Committee Majority Chair Lisa Baker (R-Luzerne/Pike/Susquehanna/Wayne/Wyoming). SR 20 directs the Legislative Budget & Finance Committee to research the medical malpractice market in PA after a 2003 requirement went into effect dictating that lawsuits must be tried in the county in which the alleged incident occurred. The study would document the venue rule’s effect on the number of lawsuits. This resolution comes in response to a proposal before the PA State Supreme Court to rescind the venue restriction. The February 5 vote was 31 to 18 with Democratic Senators Lisa Boscola (Northampton), Andy Dinniman (Chester) and Judy Schwank (Berks) crossing over to join with Republicans in adopting SR 20. A link to the legislation follows:
https://www.legis.state.pa.us/CFDOCS/Legis/PN/Public/btCheck.cfm?txtType=PDF&sessYr=2019&sessInd=0&billBody=S&billTyp=R&billNbr=0020&pn=0155
In the House, the Republican Policy Committee plans a hearing February 12 at St. Luke’s Hospital in Bethlehem on this issue. Live web streaming will be at 1:00 p.m. PAGOPPolicy.com.
MEDS SYNCHRONIZATION BILL PASSES HOUSE
On February 4, the PA House passed House Bill 195 (Nelson-R-Westmoreland) allowing for synchronizing prescription renewal dates. Its purpose was to help older Pennsylvanians and those with disabilities from having to come to the pharmacy many times because of differing refill dates. HB 195 also requires insurers to pay for the partial refill in order for patients to reach this one-trip goal with their prescription medicine. The House vote was 194-0. It was referred to the Senate Banking & Insurance Committee February 8.
LEGISLATIVE UPDATES
- Adopted by the Senate was Senate Resolution 25 sponsored by Senator Don White (R-Indiana) proclaiming February as PA Mutual Insurance Companies Month. This may be Senator White’s last sponsored legislation before his retirement.
- The Governor presented his State Budget request to the General Assembly on February 5.
- Although vigorously denying accusations of sexual misconduct and suing the accuser, Senator Daylin Leach (D-Montgomery/Delaware) relinquished his position as Minority Chair of the Senate Judiciary Committee as a way to recuse himself from any relevant legislation. Added to the Senate Judiciary Committee is new Senator Maria Collett (D-Berks/Montgomery).
- Rep. Brian Ellis (R-Butler) was stripped of his chairmanship of the House Consumer Affairs Committee after allegations surfaced January 25 that Dauphin County prosecutors are investigating an alleged sexual assault. His position is assumed by Rep. Brad Roae (R-Crawford/Erie).
ELECTORAL NOTE…March 12 is the date of the special elections for the two open House seats vacated by Rep. Vanessa Brown (D-Phila.) who resigned and for Rep. Sid Kavulich (D-Lackawanna) who passed away shortly before the 2018 general election.
REGULATORY UPDATE
On February 9, the State Board of Pharmacy issued income eligibility requirements in order to participate in the Cancer Drug Repository, a program which accepts donations of unused cancer drugs and provides them to those in need of these expensive medications. Annual income limit for one person is $42,490, a family of four $87,850, etc. Details: 717-783-7156
