LEG REG REVIEW Health Edition
2019, 8th Issue *** April 9, 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.
DEMOCRATS SCORE ANOTHER SEAT
In the suburban Pittsburgh special election April 2, Democrat Pam Iovino won to be Pennsylvania’s newest Senator. Her election reduces the Republican majority to 26-22 for right now. She defeated Republican businessman D. Raja. Two Senate vacancies -- former Sen. Don White’s Indiana/Armstrong Counties seat and former Sen. Rich Alloway’s Franklin County seat -- will be filled on May 21. Both of those are Republican districts.
Still, Iovino’s win is a setback for the GOP following last fall’s election of Pittsburgh Democrat Lindsay Williams flipping former Senator Randy Vulakovich’s seat from the Republican column in 2018. Its implication is that the rightward shift of Democratic voters in southwest PA who embraced Donald Trump are reverting back to their historic voting patterns.
INSURANCE BILLS ON HOUSE CALENDAR
On the House’s voting calendar is House Bill 629 (Rapp-R-Warren). It requires health insurers to cover Lyme Disease and Tick-borne illnesses. Coverage will include both treatment and diagnostic treatment. A companion bill, Senate Bill 100 sponsored by Senator Michele Brooks (Erie/Warren/Crawford/Mercer), is in the Senate Banking & Insurance Committee.
Another insurance bill is slated for a House vote. House Bill 328 (Warren-D- Bucks) establishes the Flood Insurance Assistance Task Force. This Task Force would look at affordability and accessibility of Flood Insurance. HB 328 does not specifically include a licensed insurance agent who sells Flood Insurance as part of the Task Force.
On second consideration in the House (meaning one more day of legislative consideration must take place before a vote) is another mandated benefit bill. House Bill 427 (Benninghoff-R-Centre) addresses health insurance coverage of stage IV, advanced metastatic cancer. Specifically, insurers would be barred from excluding or limiting drugs for patients if the drugs have been approved by the U.S. Food and Drug Administration. According to Rep. Benninghoff’s sponsorship memo, insurance companies now require stage IV patients to try a mandated series of medicines that fail to improve the condition before advanced medicine therapy can be tried.
HEALTH COMMITTEE CONSIDERS INSURANCE LEGISLATION
On April 9, the House Health Committee will consider two insurance bills. First is House Bill 833 sponsored by Rep. Clint Owlett (R-Bradford/Tioga/Potter) to require that a non-custodial parent seeking to have their child enrolled in Medicaid first enroll the child in their own health insurance plan. Its purpose is to ensure that Medical Assistance remain the insurer of last resort.
The second piece of legislation is House Bill 924 sponsored by Rep. Tarah Toohill (R-Luzerne). This bill would prohibit discrimination in the provision of life, accident, and health insurance based on the insured’s status as a living organ or tissue donor. It also authorizes for family leave to provide care during transplant preparation and recovery.
SENATE BANKING & INSURANCE COMMITTEE NEWS
On April 10, the Senate Banking & Insurance Committee will convene a hearing to consider the re-confirmation of Jessica Altman as Insurance Commissioner. This will be the first meeting of the committee under its new chair, Senator Mario Scavello (R-Monroe). It will also be the first Banking & Insurance Committee meeting for new committee member Senator Kristin Phillips-Hill (R-York).
REGULATORY UPDATES
- On April 6, the PA Insurance Department issued Notice 2019-01 regarding the maximum benefit adjustment for Autism Spectrum disorders coverage from $40,501 per year to $41,271 for policies issued or renewed in calendar year 2020.
- The Department of Labor & Industry issued proposed rulemaking on the Special Rules of Administrative Practice and Procedure before the Workers’ Compensation Appeal Board. (34 PA Code, Chapter 11). Among other things, its purpose is to address delays in processing appeals from less populated areas. Details: https://pabulletin.com/secure/data/vol49/49-14/487.html
UPMC VS. HIGHMARK (Continued)
On April 3, the Commonwealth Court ruled that the original end of the Consent Decree between UPMC and Highmark would remain June 30, 2019. Attorney General Josh Shapiro unsuccessfully argued that the contract between the two disputants should be indefinitely extended. The ruling said that the courts do not have the authority to modify the original date without both parties agreeing. Attorney General Shapiro will likely appeal the decision.
HOUSE AGING & OLDER ADULT SERVICES MOVES Rx BILLS
On March 27, the House Aging & Older Adult Services reported out three bills designed to help seniors to receive state- subsidized prescription benefits. They are:
House Bill 754 would ensure any individual enrolled in PACE and PACENET by Dec. 31, 2018 remains eligible as long as their maximum income limit is exceeded due solely to a Social Security cost-of-living adjustment.
House Bill 375 would exclude savings bonds cashed by seniors age 65 and older from being counted towards income when applying for lottery funded programs. This also includes PACE and PACENET.
House Bill 684 pertains to income eligibility calculations for the PACE and PACENET programs and would not count the value of federal veterans’ disability payments/all state service-connected payments.
In a related item, the PA Department of Aging has a new resource to help seniors compare drug prices. The state Department of Aging maintains a database to help consumers compare the cost of frequently used medications. This online tool updates prices weekly, lists prices by ZIP code or distance from location, includes pharmacy store details, and lists pharmacies with low-cost generics and those that match lower prices. You can learn more about the tool by clicking here or calling 1-800-835-4080.
CMS PLANS AGENT AND BROKER SUMMIT
Centers for Medicare & Medicaid Services (CMS) is organizing an Agent and Broker Summit in Baltimore July 1, 2019. In addition to discussing the Trump Administration’s major health care priorities, it also intends to afford insurance producers the opportunity to provide feedback to CMS in advance of the 2020 enrollment period. Details: Registrar@REGTAP.info/REG_tips.php
