Legislative Update: Informed Consent, Physician Assistants, and More

Last Updated: Jun 3, 2021

Please note: This article is current as of June 10, 2021. As legislation is often on the move, visit www.pamedsoc.org and check The Dose for the latest updates on this and other legislation.

As summer approaches, legislative activity begins to narrowly focus on the passage of a state budget.  With significant monies coming from the Federal government, the political struggle this budget cycle will be more about where the money goes as opposed to where its coming from. Though June is traditionally budget time in Harrisburg, there are a number of “bills in play” that PAMED is actively engaged in and some behind the scenes activity of which you should be aware.

Informed Consent

Several years ago, the Pennsylvania State Supreme Court made a significant ruling on a case involving physician informed consent that sent the physician and hospital community into a tailspin. Under the ruling, physicians could no longer delegate the process of gaining informed consent to a physician assistant, nurse practitioner, or even a physician colleague. The court ruled that only the physician performing the test or procedure could provide informed consent to patients. Working jointly with the Hospital and Healthsystem Association of Pennsylvania, PAMED is on the verge of reversing the action taken by the Supreme Court through language found in Senate Bill 425. In essence, this legislation statutorily returns the process of informed consent back to the way it was done prior to the court ruling.  The bill has been approved by the Senate and House Health Committee and now awaits final consideration by the full House. A vote is expected in early June.

Physician Assistants

For the past two years, PAMED has been meeting with physician assistants (PAs) who are seeking to change some of the processes by which they are approved to practice along with alternatives to the current requirements for physician supervision. Legislation (Senate Bill 397/Senate Bill 398) has been introduced that would, among other things, no longer require the state medical and osteopathic boards to approve PA agreements.  The bill also would allow supervising physicians to determine the frequency of which they are currently required to review and countersign patient charts where PAs were involved in providing care.

PAMED has been working closely with a coalition of physician organizations representing family physicians, internists, pediatricians, and orthopedic surgeons. The Pennsylvania Osteopathic Medical Association (POMA) has also been intimately involved. The coalition has expressed concerns with the current versions of Senate Bills 397-398 and are still determining their overall positions. The Senate Consumer Protection and Professional Licensure Committee voted to approve both bills during their meeting on June 8. However, the sponsor of the bills, Sen. Joe Pittman (Indiana) commented during the meeting that PAMED and POMA have expressed concerns with the current language and that discussions would continue before a final vote in the Senate takes place. PAMED formally opposes the bills until critical elements can be appropriately addressed.

Restrictive Covenants

PAMED has also been engaged in helping to advance legislation to address the issue of restricted covenants in physician employment contracts. House Bill 681, supported by PAMED, is awaiting a final vote in the House before it makes its way to the Senate for consideration. Though the legislation may need additional amendments to “fine tune” its effectiveness, PAMED is urging its passage in the House. As one would expect, hospital and health systems across the state are opposed to the measure. PAMED continues to remind legislators that non-compete contracts routinely disrupt patient care and long-term physician/patient relationships when circumstances require physicians to change employment. PAMED urges its members to engage in support of House Bill 681 by reaching out to their local state representative and asking them to support patients by approving this proposal.

Prior Authorization

The tug of war between physicians and health insurers on reforming prior authorization continues.  However, efforts by PAMED and patient advocacy organizations are beginning to move the needle on Senate Bill 225. A recent press event, featuring patients whose health was negatively impacted by prior authorization delays, was picked up by several media outlets including the Philadelphia Inquirer. Our grassroots and coalition efforts will continue on both Senate Bill 225 and House Bill 225 throughout the summer with the hope of seeing movement of these proposals in the fall…if not sooner.

Telemedicine

The COVID-19 pandemic has changed our lives in many ways. One positive change has been the efficacy and benefits of telemedicine. Patients and physicians alike have personally experienced the benefits telemedicine can provide to the health care delivery system. Working with other stakeholders, PAMED is happy to see that telemedicine has again been placed on the legislative agenda with the introduction of Senate Bill 705. Though similar legislation has previously stalled in the House after having been approved by the Senate, PAMED will be working with other stakeholders to see this bill cross the finish line this legislative session.

Physician Complaints

Lastly, PAMED is awaiting the introduction of legislation that will absolve physicians of the requirement that they disclose frivolous patient complaints filed with the state medical and osteopathic boards.  Health insurers and other entities often ask physicians if they have been the subject of medical or osteopathic board complaints filed by patients. Few of these complaints result in any formal action taken by the boards yet physicians are required to acknowledge them. Legislation that will soon be introduced by Rep. Curt Sonney (Erie) will allow physicians to forget about patient complaints that their professional oversight boards found them to have no merit.

Physician Advocacy

Physicians are encouraged to reach out to their elected officials to discuss these and other issues that impact their ability to appropriately and effectively provide patient care. For guidance in getting to know your legislators or specifics on currently legislative activity, please reach out to PAMED’s Government Affairs staff by emailing David Thompson, Senior Director, at dthompson@pamedsoc.org.

2 comments

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  1. PAMED Staff Response: | Jun 09, 2021

    Dr. Leonard,

    Thank you for your comment. We want to assure you that MOC has not fallen off PAMED’s radar. We are continuing to work to address the issues associated with MOC. We will be preparing comments to the ABMS’ Draft Standards for Continuing Certification and will be encouraging our members to do the same through our communication channels before the July 8 comment deadline. You can learn more here: https://www.pamedsoc.org/home/news-resources/pamed-news/articles/abms-calls-to-comments-on-draft-standards-for-continuing-certification-comments-due-july-8.

    Thank you for your comment and for your valued membership.

  2. Daniel Leonard | Jun 08, 2021
    All the above are extremely important to get addressed. I hope that addressing/ending MOC has not fallen off of PA Med Society’s radar. Obviously with the current Physician shortage, numerous other requirements on Doctors’ time (like those above), and a continuing pandemic to boot, MOC is a very time consuming process that needs addressed. 

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