PSG, in cooperation with the Pennsylvania Medical Society (PAMED) and other state societies, continues to track health care legislation introduced into the Pennsylvania General Assembly.
Click the bill number (example: HB 608) for a link to more information.
DOH Guidance: Act 122-Clinical Laboratory Act
View the most recent DOH guidance on Act 122.
Pennsylvania’s Medical Marijuana Act (Act 16): Pennsylvania is the 24th state in the U.S. to offer medical marijuana. Governor Wolfe signed the bill into law on April 17, 2016. Act 16 allows physicians to prescribe marijuana to patients who have qualifying conditions. It may be prescribed in pill, liquid form that can be vaporized or inhaled, oil, or ointment form. Smoking is currently not permitted.
The Department of Health has until November 17 to start publishing temporary regulations, although it has issued the first round of temporary rules. During implementation, the Department is investigating the possibility of providing temporary legal protections for patients.
Before physicians can recommend medical marijuana to patients, they must participate in a four-hour course developed by the Department of Health. This will likely become available in the fall or winter. After the physician has taken the course and registered with the department, he/she may write recommendations for patients who suffer from qualifying conditions. After receiving the doctor recommendation, a patient will then register with the Department to receive a certification from the state, which will allow the patient access to state-permitted dispensaries.
The health department will regulate 25 processors/growers, along with 50 dispensaries, which may have up to three locations each. The details of implementation are progressing such that we should see dispensaries open in the near future.
Independent Nurse Practitioner Reform Bill (SB 717): Recall SB 717 amends the Professional Nursing Law, further providing for definitions, and providing practice autonomy for licensed certified nurse practitioners. Under the current state law, nurse practitioners may practice alone only if they have a collaborative agreement with 2 physicians. SB 717 grants them full authority to practice without collaboration. The bill remains in Committee since Pennsylvania Congress has returned from summer recess after previously been marked up. As of the time of this writing, it is unclear whether the Independent Nurse Practitioner Reform Bill will come up for a vote later this year. Hepatitis C Screening Act (Act 87): On July 20, 2016, Governor Wolf signed this Act into law. The Act took effect September 18th. It requires each individual born between 1946 and 1965, who receives primary care services in an outpatient setting of a hospital, health care facility, physician’s office, or health services as an inpatient in a hospital, to be offered a Hepatitis C screening or diagnostic test.
The patient is not mandated to accept the test. If the individual consents to being tested, and he/she is positive for HCV, the health care provider must either offer the patient follow-up care or refer the individual to a health care provider who can follow and treat the person accordingly. Follow-up care must include a HCV diagnostic test if not initially done.
Exceptions exist under Act 87 such that the health care practitioner is not required to provide screening services if he/she reasonably believes one of the following:
The patient is being treated for a life-threatening emergency; or
The patient was previously offered or has been the subject of a HCV screening test; or
The patient lacks the capacity to consent to a HCV screening test.
Telemedicine Act(s) (HB 2267 & SB 1342):
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Patient Protection and Affordable Care Act (PPACA), served to establish Telemedicine as another modality to deliver health care. This has created a number of legal issues, as physician licensure and practice scope are determined by State law.
HB 2267 and SB 1342, referred to as the Telemedicine Act(s), are mirror bills providing for Telemedicine and for insurance coverage of the service in Pennsylvania. The bills define Telemedicine services and would require private insurance and Medicaid reimbursement. HB 2267 was referred to the Committee on Insurance on July 21, 2016 and remains there at the time of this writing. These bills address several barriers and bring some clarity to the expanded use of Telemedicine in the Commonwealth.
Opioid Legislation & PA Prescription Drug Monitoring Program (PDMP): The number of bills that are currently being introduced to deal with the growing epidemic of prescription opioid abuse are almost too numerous to count and beyond the scope of our discussion. A number of them are directed at physician requiring education for pain management and prescribing practices of opioids including continuing medical education credits as requirements for licensure and renewal.
The PSG calls your attention to recent launching on August 25, 2016 of the Pennsylvania PDMP (PA PMP AWARxE). Pennsylvania physicians who are licensed, registered, or otherwise lawfully authorized to prescribed controlled substances in the course of professional practice or research in Pennsylvania are required by law to register in PA PMP AWARxE. The link is: https://pennsylvania.pmpaware.net/login
By law, prescribers must query the system for each patient the first time the patient is prescribed a controlled substance by the prescriber for purposes of establishing a baseline and a thorough medical record. A prescriber shall also query the system if he/she believes or has reason to believe, using sound judgement, that a patient may be abusing or diverting drugs.
To make consistent use of the PA PDMP more practicable, prescribers and pharmacists may grant access to any delegates under their employment or supervision to query the system on their behalf. Delegates register for their own accounts and enter the email address of their supervising prescriber(s) or pharmacist(s) to request access to the database.