Bills on the Hill: New Health Care Legislation on Credentialing, Non-Compete Clauses, and More

Last Updated: Mar 20, 2019

Mike-Siget-ThumbnailBy Michael D. I. Siget, JD, MPA, PAMED’s Legislative & Regulatory Counsel

With the start of a new legislative session, numerous bills have been filed that may affect physicians across the Commonwealth. In Part I of Bills on the Hill, we will focus on: immunizations by pharmacists; continuing education for Lyme disease and other tick-borne diseases; informed consent for vaccinations; credentialing; restrictive covenants not to compete for employees of purely public charities; and non-compete clauses in physician contracts. 

  1. Immunizations by Pharmacists 
    HB 91, introduced by Rep. Seth Grove, and SB 274, introduced by Sen. Judy Ward, would revise Act 8-2015. Act 8 authorized pharmacists to administer flu shots to children ages nine and older with parental consent. Under these bills, pharmacists would be authorized to administer any immunization shot to children more than nine years old with parental consent. In addition, these bills would allow the Pharmacy Board to accept as proof of education and training standards the immunization credentials or a license of an individual who, at the time of filing an application, is licensed as a pharmacist and has immunization credentials or a license, if applicable, in another state or territory of the United States. 

    HB 91 was referred to the House Health Committee on Jan. 28, 2019. SB 274 was referred to the Senate Consumer Protection and Professional Licensure Committee on Feb. 7, 2019.

    PAMED opposes these bills.

  2. Continuing Education for Lyme Disease and Other Tick-Borne Diseases
    HB 96, introduced by Rep. Rosemary Brown, would require physicians, physician assistants, and nurse practitioners to complete at least two hours of continuing education in the assessment and diagnosis of, and treatment options for, Lyme disease and other tick-borne diseases as a portion of the total continuing education required for license renewal.  

    The bill would also require the State Boards of Medicine and Nursing to establish the content of continuing medical education addressing, at minimum, the most current, evidence-based research regarding assessment and diagnosis, current diagnostic options, and current treatment options and prevention. To do this, the boards must seek input from various resources, including universities involved in the research of Lyme disease and related tick-borne diseases. The boards also must take into consideration the philosophies of the Centers for Disease Control and Prevention, the guidelines established by the National Institutes of Health, International Lyme and Associated Diseases Society, and the Infectious Diseases Society of America, as well as the latest scientific evidence and research.  

    If enacted, HB 91 would sunset on Dec. 31, 2024 unless renewed by a future act.

    HB 96 was referred to the House Professional Licensure Committee on Jan. 28, 2019. 

    PAMED opposes this bill.

  3. Informed Consent for Vaccinations
    HB 286, introduced by Rep. Daryl Metcalfe, would prohibit:

    • A health care practitioner or facility from refusing to treat a child whose parent or guardian has chosen to delay or decline one or more vaccines;
    • A health care practitioner from requiring a patient or guardian to sign a waiver as a condition for continuing to provide medical care;
    • A health care practitioner from accepting a financial incentive from an insurance or pharmaceutical company for vaccinating patients or for maintaining a certain rate of vaccinated patients within his or her medical practice.
    • An insurer from denying a health care practitioner’s participation in an insurance plan or decrease the practitioner’s reimbursements through fines or financial penalties due to low patient vaccination rates or due to a practitioner’s decision not to vaccinate a patient. 
    Violations under this bill for practitioners include a fine of $1,000 for a first offense and licensure sanctions for a second or subsequent offense.  

    HB 286 was referred to the House Health Committee on Jan. 30, 2019. 

    PAMED opposes this bill.

  4. Credentialing
    HB 533, introduced by Rep. Clint Owlett, would require health insurers licensed to do business in the Commonwealth to accept the Council for Affordable Quality Healthcare (CAQH) credentialing application or other nationally recognized form designated by the Pennsylvania Insurance Department as a credentialing application. The bill would require health insurers to issue a credentialing determination within 45 days after receiving a completed CAQH credentialing application. 

    HB 533 provides the Insurance Department with the authority to assess administrative penalties on health insurers for failure to utilize CAQH (or other designated application), or for intentionally and routinely failing to complete the credentialing process as required. 

    While this bill would require a standardized credentialing process, it would not guarantee the rights of a health care practitioner to participate in any health insurer network in this Commonwealth nor would it require a health insurer to accept any willing health care provider to an insurance network.

    HB 533 was referred to the House Health Committee on Feb. 19, 2019. 

    PAMED supports this bill.

  5. Prohibiting Restrictive Covenants for Employees Who Work for Public Charities
    HB 597, introduced by Rep. Anthony DeLuca, would prohibit restrictive covenants not to compete for employees who work for purely public charities. Purely public charities must meet certain requirements under The Institutions of Purely Public Charity Act (Act 55-1997), including:

    • Advancing a charitable purpose;
    • Operating entirely free from a private profit motive;
    • Donating or rendering gratuitously a substantial portion of its services; and
    • Benefiting a substantial and indefinite class of persons who are legitimate subjects of charity. 
    Under HB 597, the criteria for operating entirely free from a private profit motive would be revised to include a provision that the institution does not enter into a restrictive covenant not to compete or attempt to enforce such covenant.  

    A “restrictive covenant not to compete” is defined as, “An agreement between an employer and an employee that is designed to impede the ability of the employee to compete with the employer when a separating event occurs.” A separating event occurs when an employee discontinues employment with a current employer and moves to employment with a different employer in the same field.

    HB 597 was referred to the House Finance Committee on March 1, 2019.  

    PAMED supports this bill.

  6. Non-Complete Clauses in Physician Contracts
    HB 601, introduced by Rep. Anthony DeLuca, entitled the “Health Care Practitioner Employment Act,” would prohibit a contract or agreement entered into after the effective date of this bill “that creates or establishes the terms of an employment relationship with a health care practitioner that includes a restriction of the right of the health care practitioner to practice in a geographic area for a period of time after the termination of the employment relationship or prohibits a health care practitioner from treating a prior patient.”  

    This bill would not render void or unenforceable the remaining provisions of a contract or agreement, including a buyout clause that requires a health care practitioner to reimburse an employer for reasonable expenses incurred in recruiting the health care practitioner and establishing the health care practitioner’s patient base. However, a buyout clause would be deemed void if it contains a term fixing unreasonably large liquidated damages or the employer terminates the employment relationship actually or constructively.

    HB 601 was referred to the House Health Committee on March 1, 2019.  

    PAMED supports this bill.

Track Priority Health Care Legislation

Interested in seeing bills that PAMED is tracking? PAMED has two bill tracker websites, one for high priority legislation and one for all bills. You can find both bill tracker websites here.

You can read Part 2 of this Bills on the Hill article, in which we focus on telemedicine; any willing providers; tiered providers; CRNPs; POLST; CRNAs; assault against a health care practitioner; and optometrists, here.


2 comments

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  1. Kristen Ehrenberger | Mar 22, 2019
    Not only do I agree with Dr. Hoffman, but I really don't think 2 hours of training on Lyme Disease is a good use of our time.
  2. Holly Hoffman | Mar 21, 2019

    I agree with PAMED's opposition to both bills regarding immunization.

     

    HB 91   Pharmacists who administer vaccines are NOT the ones who have to field phone calls about reactions at all odd hours of the day ;  and physicians may not know exactly what was given when receiving the calls. Most pharmacies do send records but those are not received and doses logged in in the first 12-24 hrs. when most calls would come in. This is also very antithetical to the Patient Centered Medical Home concept.

    HB 286 Likewise, I will NOT accept restrictions on my ability to prevent "non-vaxxers" from exposing my immuno-compromised and newborn patients to preventable diseases. Educated persons who make good decisions about their childrens' healthcare should not bear the burden of others' poor choices.

     

    Holly Hoffman, MD

    Carlisle Pediatric Assoc.

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