By Michael D.I. Siget, JD, MPA, PAMED's Legislative & Regulatory Counsel
As Pennsylvania lawmakers prepared to adjourn until next year, several health-related bills recently began moving through the legislature. In today's Bills on the Hill, we will review JUA funding, ambulatory surgery centers, access to patient test results, amendments to the Abortion Control Act, emergency prescriptions, and PDMP querying exemptions.
HB 674 contains a section that deals with the transfer of funds from the Pennsylvania Professional Liability Joint Underwriting Association (JUA) to the Commonwealth's treasury. Under the Commonwealth's Mcare Act, physicians and other health care practitioners are generally required to obtain medical malpractice liability insurance. The JUA, a nonprofit joint underwriting association, serves as an insurer of last resort. HB 674 seeks to transfer $200 million from the JUA to the state to help balance the budget. The JUA had until Dec. 1 to transfer the funds. If it did not, it would be abolished on Dec. 1.
Soon after HB 674 was signed into law as Act 44-2017, the JUA sued the Commonwealth in federal court. Prior to the Dec. 1 deadline, U.S. District Court Judge Christopher Connor granted a prelmininary injunction to stop the transfer of funds and the dissolution of the JUA pending the outcome of the court case.
PAMED will continue to monitor this case and provide updates to its members.
Length of stay in an ambulatory surgical center
HB 1234, sponsored by Rep. Florindo Fabrizio, would align the length of stay in licensed ambulatory surgery centers (ASCs) with that of other states and federal Centers for Medicare and Medicaid Services (CMS) guidelines. Under current Pennsylvania Department of Health regulations, ASC stays are limited to a total of 4 hours of operating time and a total of 4 hours of directly supervised recovery. Under HB 1234, authorized services would be permitted in an ASC where the expected duration of services would not exceed 24 hours following an admission.
HB 1234 passed the House of Representatives in July and the Senate in December. It is now before the Governor for approval.
Access to Patient Test Results
HB 1884, introduced by Rep. Marguerite Quinn, would require an entity performing a diagnostic imaging service, in addition to sending the results to the ordering practitioner, to directly notify the patient or the patient's designee of the results of the test when there is a finding of a significant abnormality. Under this bill, a "significant abnormality" is defined as "a finding by a diagnostic imaging service of an abnormality or anomaly which would cause a reasonably prudent person to seek additional or follow-up medical care within three months." Included in this notice would be the summary of the report, otherwise known as an impression or conclusion, or the complete results of the diagnostic imaging service provided to the ordering practitioner.
Generally, the results must be sent to the patient no sooner than seven days, nor later than 20 days, after the date the results were sent to the ordering practitioner. Exceptions in this bill would include routine obstetrical ultrasounds used to monitor the development of a fetus, diagnostic imaging services performed on a patient who is being treated on an inpatient basis, and diagnostic radiographs.
HB 1884 passed the House Health Committee in December and is currently being considered by the House of Representatives.
Amendments to the Abortion Control Act
SB 3, introduced by Sen. Michele Brooks, would reduce the maximum gestational age for legal abortions from 24 to 20 weeks. As in current law, this limitation would not apply in situations where an abortion is necessary to prevent the death or impairment of a major bodily function of a woman. However, it provides no exception for rape or incest.
SB 3 would also prohibit dilation and evacuation procedures upon another individual when the gestational age of the unborn child is less than 20 weeks unless certain conditions apply. The conditions require two physicians to separately concur, in writing, that based upon a medical examination of the pregnant woman and the physicians' medical judgments, the abortion is necessary to prevent either the death of the pregnant woman or the substantial and irreversible impairment of a major bodily function of the woman. A physician who violates this provision commits a felony of the third degree.
SB 3 passed the Senate in February and the House of Representatives in December. On Dec. 18, 2017, Gov. Wolf vetoed the bill.
SB 542, introduced by Sen. Patrick Browne, would authorize pharmacists to fill an emergency prescription for up to a 30-day supply in situations where a prescription is not dispensed or sold in a 72-hour supply, such as insulin. Under current law, pharmacists are limited to emergency refills up to a 72-hour supply.
SB 542 passed the Senate in October and the House Health Committee in December. It is currently before the House of Representatives.
PDMP Querying Exemption
As discussed in the October Bills on the Hill, SB 728, introduced by Sen. Gene Yaw, would exempt Schedule V epilepsy and seizure disorder drugs from the Prescription Drug Monitoring Program (PDMP) querying requirements.
PAMED supported SB 728 and advocated for its passage. SB 728 passed the Senate in October and the House of Representatives in December. It is currently before the Governor for approval.