Bills on the Hill: 6 Health-Related Issues Getting Attention

By Michael D.I. Siget, JD, MPA, PAMED's Legislative & Regulatory Counsel

Mike-SigetWith the budget recently completed, the legislature has acted upon some bills of importance to physicians. In this Bills on the Hill, I will be reviewing some bills from past articles and some new bills as well, including Right-to-Try legislation, Pennsylvania Professional Liability Joint Underwriting Association (JUA) funding, direct primary care, opioid prescribing limits, emergency prescriptions, and Prescription Drug Monitoring Program (PDMP) querying exemptions.

1. Opioid Prescribing Limits – Senate Bill (SB) 472, introduced by Sen. Gene Yaw, would expand the current requirements under Act 125-2016 which limits prescribing opioids to minors to no more than a quantity sufficient to treat a minor for seven days, subject to specified exceptions. SB 472, if enacted, will expand this seven-day limit to all patients.

SB 472 passed the Senate on Oct. 18, 2017. It is currently before the House Health Committee.

2. PDMP Querying ExemptionSB 728, introduced by Sen. Gene Yaw, would exempt Schedule V epilepsy and seizure disorder drugs from the PDMP querying requirements.

SB 728 passed the Senate on Oct. 18, 2017. It is currently before the House Human Services Committee.

3. Emergency PrescriptionsSB 542, introduced by Sen. Patrick Browne, would amend the Pharmacy Act to permit pharmacists to dispense emergency prescription refills for up to 30 days under certain restrictions. The bill provides that a patient who is taking a drug essential to sustaining his or her life or essential to maintaining a consistent drug therapy, and is not a controlled substance, to be able to receive a 30-day emergency refill without a prescription.

Under current law, a pharmacist can only provide one refill of a prescription limited to a 72-hour emergency supply. This legislation cites that certain drugs are not available in a 72-hour supply, such as insulin, so the law needs to be amended to allow for 30-day emergency prescription refills.

SB 542 passed the Senate on Oct. 23, 2017. It is currently before the House Health Committee.

4. Direct Primary Care ­– House Bill (HB) 1739, introduced by Rep. Matt Baker, would remove certain regulatory hurdles concerning the direct primary care (DPC) model. A primary element of the DPC model is the replacement of the fee-for-service model that most health insurance policies are structured around. Under DPC, patients pay a monthly, quarterly, or annual fee that covers all or most primary care services including clinical, laboratory, and consultative services, and care coordination and comprehensive care management. Because some services are not covered by this fee, patients often acquire a high-deductible policy to cover emergencies and other non-covered services. This model seeks to incentivize both the patient and the provider to seek the most appropriate treatment regimen in the fewest visits without dis-incentivizing the patient from seeking primary care throughout the year.

This bill would not require practitioners to switch to a DPC model but rather removes certain regulatory hurdles to encourage more practitioners to consider this model.

HB 1739 passed the House of Representatives on Sept. 27, 2017. It is currently before the Senate Banking and Insurance Committee.

5. Right-to TryHB 45, introduced by Rep. Robert Godshall and cited as the "Right-to-Try Act," will allow eligible patients with a terminal illness to seek access to investigational drugs, biological products, and devices not yet approved by the U.S. Food and Drug Administration.

Under this bill, a manufacturer of an investigational drug, biological product, or device may make them available (but is not required to), and an eligible patient may request them, if the patient has a terminal illness and meets other requirements in the bill. A health care provider who in good faith recommends or participates in the use of an investigational drug, biological product, or medical device under this bill will be immune from criminal or civil liability or professional misconduct.

HB 45 was signed into law by Gov. Wolf on Oct. 11, 2017, as Act 33 and will take effect on Dec. 11, 2017.

6. JUA Funding – Both HB 118 and HB 674 are pieces of legislation dealing with the 2017-2018 budget. HB 118 addresses the Administrative Code and HB 674 addresses the Fiscal Code, with each Code being a component of the budget. Within each bill is a section that deals with the transfer of funds from the JUA to the Commonwealth's treasury. Under the Commonwealth's Mcare Act, physicians and other health care practitioners are required to obtain medical malpractice liability insurance. The JUA, a nonprofit joint underwriting association, serves as an insurer of last resort.

Both HB 118 and HB 674 seek to transfer $200 million from the JUA to the state to help balance the budget. Under HB 118, if the JUA does not transfer this money by Nov. 1, the JUA will be abolished effective Dec. 1 and its duties will be transferred to the Pennsylvania Insurance Department. Under HB 674, the JUA has until Dec. 1 to transfer the funds. If it does not, it will likewise be abolished on Dec. 1.

On Oct. 30, 2017, HB 118 and HB 674 were signed into law as Acts 40 and 44, respectively. Because HB 674 was signed into law after HB 118, the provisions regarding the JUA in HB 674 cancel out the provisions in HB 118.

Additional Resources

The Pennsylvania Medical Society (PAMED) monitors hundreds of bills each session on issues that impact physicians and their patients. Get details about PAMED's advocacy priorities and more at

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