Pa. Physicians Tackle Informed Consent, Scope of Practice, and More at 2017 PAMED House of Delegates

Last Updated: Oct 17, 2017

More than 200 physician and medical student delegates met at the 2017 House of Delegates (HOD) to debate many of the biggest current and emerging issues affecting Pennsylvania health care today.

During the meeting – which was held on Oct. 13-15, 2017 in Hershey, Pa. – delegates representing counties, specialties, and member sections addressed avenues for clarifying Pennsylvania's informed consent statute, reaffirmed PAMED’s support for physician-led, team-based care, and proposed solutions for numerous public health issues.

Check out the links below to get a closer look at the health care resolutions that physicians either adopted or directed PAMED’s Board to study further:

  1. Health Care Legislation and Regulations (Issues addressed included informed consent, scope of practice, hospital privileges, opposition to mandated clinical guidelines, and more.)
  2. Public Health and Education (Issues addressed included medication-assisted treatment for substance use disorders, safe sleeping environments for Pennsylvania infants, disparity in access to care for women veterans, and more.)
  3. Practice Issues and Reimbursement (Issues addressed included air ambulance regulations, the Direct Primary Care practice model, access to care, and more.)

 

Health Care Legislation and Regulations

The physician leaders in attendance sought to address the wide variety of health care laws and regulations that Pennsylvania physicians are required to navigate. Topics addressed at the HOD included:

  • Clarifying Informed Consent - A recent Pa. Supreme Court ruling limits the duty to obtain informed consent to the physician performing the surgery or treatment. Pa. physicians voted to work 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, patient’s condition, and the procedures to be performed.
  • Scope of Practice - Physicians voted to approve two resolutions that reaffirmed support of physician-led, team-based care. PAMED will continue to strongly oppose current and future legislation which would establish independent practice for certified registered nurse practitioners (CRNPs). Similarly, PAMED will oppose any legislation that promotes the independent practice of physician assistants (PAs) or erodes the supervisory role of the physician with or in relation to PAs.
  • Hospital Privileges - Physicians voted for a resolution to work with the legislature and state agencies to establish regulation or legislation to eliminate the preferential treatment of physicians with hospital privileges in Pennsylvania. Furthermore, PAMED is charged with seeking additional restrictions that would prohibit a health insurer from granting or denying preferred network status to a physician based on the presence or absence of their hospital privileges.
  • Pa.'s Hepatitis C Screening Act - PAMED will work with the legislature to draft an amendment to the Act to better clarify what physicians are required to do under this law.
  • National Practitioner Data Bank - PAMED will educate members about the National Practitioner Data Bank and its dispute process, and oppose the use of this Data Bank to dissuade physicians from participating on medical staffs.
  • Basic Life Support (BLS) Training - Physician delegates directed PAMED to support state legislation advocating for BLS training in schools for students prior to high school graduation.
  • Formulary Equivalent Alternatives from Denying Insurers - Physicians directed PAMED to seek legislation or regulation that requires insurers to provide formulary alternatives with similar mechanisms of action at the time of prescription denial.
  • Opposition to Mandated Clinical Guidelines - PAMED will oppose legislation seeking to mandate clinical guidelines (for example, mandated opioid prescribing guidelines) and inform membership of any new legislation that seeks to mandate such guidelines.
  • Immunity for Health Care Providers of Free, Low-Cost, or Emergent Health Care - Physicians voted to continue to seek an active stance to support legislation related to immunity protections for physicians providing charitable care.
  • Pennsylvania Deferred Action for Childhood Arrivals (DACA) Individuals - Delegates voted to support legislative efforts to protect DACA medical students, patients, and physicians.
  • Hospital and Health System Consolidation - Physicians voted to direct PAMED’s Board to decide whether a physician survey is needed to review the effect of hospital consolidation on physicians.

 


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Public Health and Education

Physicians addressed these issues affecting the health and well-being of Pennsylvania patients:

  • Support Pennsylvania Immunization Coalition (PAIC) - PAMED will monitor developments to help ensure the state provides annual funding for PAIC.
  • Physician Workforce - PAMED is working to ensure parity for international medical graduates with U.S. medical graduates in years of graduate medical education for licensure. Pa. Rep. Aaron Kaufer has announced his intention to introduce a bill that would amend Pa.’s Medical Practice Act to ensure this parity, and PAMED will support the bill.
  • Teen Health Week - County and specialty associations will be encouraged to join with their local schools to participate in Pennsylvania’s Teen Health Week, being held March 18-24, 2018.
  • Support VA Health Services for Women Veterans - PAMED recognizes the disparity in access to care for women veterans and encourages research to address the needs of this population with the focus on improving outcomes. This resolution requests that this resolution be presented at the AMA Interim Meeting.
  • Stop the Bleed National Educational Campaign - PAMED will support the American College of Surgeons’ “Stop the Bleed” campaign and encourage counties, specialties, and Pa. physicians to promote this education for the health of all patients.
  • Medication-Assisted Treatment (MAT) for Substance Abuse Disorders - Physicians voted for PAMED to promote training programs for Pa. physicians interested in becoming MAT providers.
  • Safe Sleeping Environments for Pa. Infants - PAMED will encourage the research of safe sleeping environments for infants, which could include the study of the safety and efficacy of boxes for babies to sleep in.
  • Inequality in Access to Women's Reproductive Health Care Services - Physicians in attendance voted to have PAMED’s Board study the issue further, determining that inequality of access may have a broad impact in the state.

 


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Practice Issues & Reimbursement

The way physicians practice medicine is transforming due to value-based payment models, technology, and many other factors. Physicians addressed these issues relating to practice issues and reimbursement:

  • Air Ambulance Regulations and Reimbursements - Physicians voted to direct the Pa. Delegation to the AMA to present a resolution for study of the role of air ambulance services, clinical efficacy, cost-effectiveness, barriers to competition, reimbursement, and quality improvement.
  • Direct Primary Care (DPC) - Physicians voted for PAMED to prepare a written document of the DPC model to educate members on this alternative practice model, exploring opportunities to ensure that evidence-based guidelines are followed and quality is achieved in practices utilizing DPC. The resolution also calls on PAMED to work with state legislators to support the practice of DPC models.
  • Access to Care for Medicaid Patients - PAMED’s Board will study this complex issue to determine the viability of offering payment models such as Direct Care services to Pa. Medicaid patients and to investigate the possibility of pursuing the Section 1332 State Innovation Waiver to authorize the creation of innovative payment models for Medicaid beneficiaries.
  • Translation and Interpretation Services - Delegates voted for PAMED to advocate for state Medicaid funding for medical interpretive services and to urge for Pa. legislation to install a system of reimbursement for interpretive and translation services during medical encounters.

 

Physicians also discussed ways to enhance the PAMED member experience, such as improving transparency, finding new ways to engage members, and more.

PAMED thanks the physician and medical student leaders who attended this year’s House of Delegates and Annual Education Conference. Your engaged and thoughtful debate helped make this year’s event a success.

Have a question about any of the topics addressed at this year’s meeting? Don’t hesitate to contact PAMED’s Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org for assistance.

To learn more about PAMED’s advocacy initiatives for patients and physicians, visit www.pamedsoc.org/advocacy.

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