Pennsylvania Medical Society (PAMED) and state specialty society leaders hosted several prominent state government officials and lawmakers during a busy Board of Trustees meeting held on Feb. 6-7, 2018. Several important issues were discussed such as the opioid abuse crisis and prior authorization, as well as the importance of physician engagement in advocacy efforts.
Physicians received an update on state efforts to combat the opioid abuse crisis from Rachel Levine, MD, Pennsylvania Physician General and Acting Secretary of Health. Dr. Levine provided details on initiatives such as the Commonwealth’s plans for expanding access to medication-assisted treatment (MAT). She also noted that the use of the PA PDMP, in combination with other state efforts, has drastically reduced patient doctor-shopping in Pennsylvania.
Insurance Commissioner Jessica Altman provided insight on the role of the Pa. Insurance Department on issues like access to health care. Her department plays an important part in ensuring stability for the insurance market and communicating accurate, timely information to consumers. She also said patient feedback is very important in addressing issues like prior authorization. Patients should be aware that they can contact the Insurance Department with any complaints on issues like prior authorization.
Speaker of the House Mike Turzai braved a snow and sleet-filled morning to talk with physicians about issues like scope of practice and medical liability. He encourages physicians to get involved and share perspectives with lawmakers. “Numbers matter,” he says. “Take the time to get to know your legislators.”
2018 PAMED Legislative Priorities
Physician leaders also focused attention on setting these PAMED’s legislative and advocacy priorities for 2018:
- Informed Consent: We are working with stakeholders to introduce legislation to allow a qualified physician to delegate his or her duty to obtain informed consent to another provider that has knowledge of the patient’s condition and the procedures to be performed. Visit www.pamedsoc.org/informedconsent for an overview of the informed consent process in Pennsylvania.
- Team-based care and scope of practice: PAMED advocates for team-based care within a physician-led team. We will continue to oppose SB 25 and HB 100, legislation that would allow CRNPs in the state to practice independently. Additionally, PAMED leadership and members of PAMED’s Board of Trustees are currently in the process of reviewing legislative language in physician assistant legislation (SB 895 and 896) to ensure that patient safety concerns are adequately addressed and that the supervisory role of physicians with physician assistants is not eroded.
- Prior Authorization Reform: PAMED supports legislation that streamlines prior authorization process with insurance plans. HB 1293 was introduced on May 1, 2017, and is now in the Pa. House Insurance Committee. Find details about PAMED’s grassroots advocacy initiative on prior authorization and how you and your patients can help at www.pamedsoc.org/priorauth.
- Continuing to Address the Opioid Abuse Crisis: This legislative session, more than 25 pieces of opioids legislation that could affect physicians and patients have been introduced. PAMED is committed to ensuring that the legislation preserves the physician-patient relationship as well as allowing a physician to treat a patient as he/she sees fit. You can find PAMED resources, including CME, to help physicians address opioid abuse at www.pamedsoc.org/OpioidResources. Our CME can also help you meet the new licensure requirement.
- Maintenance of Certification (MOC): PAMED will be exploring possible legislative solutions to ensure that the MOC process is fair for all physicians. Find news and updates on MOC at www.pamedsoc.org/MOC.
- Telemedicine: PAMED believes that, if properly regulated, telemedicine has the potential to improve patient access to care. On Jan. 30, 2017, telemedicine legislation (SB 780) passed the Pa. Senate Banking and Insurance Committee. SB 780 now moves to the full Senate for consideration. A telemedicine bill (HB 1648) has also been introduced in the House by Rep. Marguerite Quinn and has been referred to the House Insurance Committee.
- Drug Formularies: Under current law, insurers are not required to provide practitioners with drug alternatives when a drug prescribed by a practitioner is denied for not being in the patient’s insurance drug formulary. As a result, practitioners must expend time and resources to figure out what alternatives are available as part of a patient’s insurance coverage. PAMED will explore legislative or regulatory opportunities to require that all insurers provide formulary alternates with similar mechanism of action at the time of a prescription denial.
Additionally, PAMED’s Board voted to work with specialty-society physicians at the Pennsylvania Psychiatric Society and the Pennsylvania College of Emergency Physicians to strongly oppose all proposed legislation and policy initiatives that seek to mandate involuntary commitment for any individuals presenting in an emergency setting for a drug overdose or in need of more intensive substance use treatment.
Physician leaders also chose to appoint a task force to explore new ways to facilitate the work of the House of Delegates, PAMED’s policymaking body, and gather more grassroots membership engagement, through methods that could include virtual participation.
Minutes from the February 2018 meeting will be posted to PAMED’s Board of Trustees webpage by the end of May 2018, and minutes from previous meetings are available now.