NOTE FROM THE PRESIDENT
Prior Authorization Legislation
It’s hard to believe the summer is nearly over! I hope you all have had an opportunity to enjoy the weather and enjoy some vacation time with friends and family.

As the fall begins to approach, it will be important to focus our attention on some important legislation that is in the news. Pennsylvania Senate Bill 225, or the prior authorization legislation, is currently sitting in the Senate chamber for consideration at the time that this is being written. This bipartisan bill aims to provide for definitions and responsibilities for managed care plans, provide for preauthorization review standards and costs, and provide for required disclosure and operational standards for initial review of preauthorization requests. Essentially, this legislation would reduce many of the restrictions and “fail first” practices that insurers require of us now.

As we all know, the frustrations that prior auths cause us are extensive, from navigating lengthy and convoluted approval processes to increased administrative burden to delays in treatment for our patients. I encourage each of you to reach out to your legislators to let them know this is an important issue for both you and your patients. An easy way to connect is through the PAMED website. Simply click on “Take Action Now: Prior Authorization” and then click “Take Action”. This will submit an email to your local legislator with your information, voicing your support.
In Good Health,

Lisa Goss, M.D.
ADVOCACY UPDATE FROM PAMED
Legislature Recesses Early for the Summer

Please note: This article is current as of July 1, 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.
 
Pennsylvania lawmakers have historically waited until the very last minute to approve the state budget. This year, the General Assembly exceeded all expectations by approving a nearly $40.8 billion dollar budget on June 25…five days before the constitutional deadline. The frenzy of legislative activity, immediately prior to the budget deadline, often results in “legislative surprises” where bills that had otherwise languished for one reason or another suddenly make it across the finish line. This year was no exception.

For the Pennsylvania Medical Society (PAMED), legislation to address the process by which physicians obtain informed consent from patients passed both chambers and was signed by the Governor on June 30, 2021, as Act 61. The measure, formerly Senate Bill 425, had originally been introduced several sessions ago after a state Supreme Court ruling materially changed the informed consent process, no longer allowing physicians to delegate that authority. The change significantly disrupted patient flow in hospitals often leading to surgical delays. Physicians will once again have the authority to delegate informed consent to another colleague or other qualified individual. Members can learn more in PAMED’s Quick Consult on Act 61 at www.pamedsoc.org/QuickConsult.

Other PAMED supported bills were advanced in the legislative process prior to the summer recess. These included:

  • Senate Bill 225 (PAMED supports) – Legislation to reform the prior authorization process. Approved by the Senate Banking and Insurance Committee.
  • Senate Bill 705 (PAMED supports) – A telemedicine measure that will, among other things, mandate insurers to pay for telemedicine. The bill was approved by the Senate Banking and Insurance Committee.
  • House Bill 681 (PAMED supports) – A measure to limit restricted covenants in physician contracts was approved by the House Health Committee and awaits final consideration by the full House.
  • House Bill 1280 (PAMED supports) – Legislation changing the process by which patients are informed about the results of imaging studies. The bill was recently approved by the House Health Committee.
  • Senate Bill 416 (PAMED supports) – This legislation officially recognizes certified registered nurse anesthetists (CRNAs) in the Commonwealth of Pennsylvania as well outlining requirements for certification of CRNAs. PAMED followed the anesthesiologists lead in supporting this effort. The bill was signed into law by the Governor on June 30 as Act 60.
  • House Bill 1420 (PAMED supports) –The Health Care Heroes Act will establish a public awareness campaign to provide information regarding the programs and services available for first responders, health care workers, and other workers suffering from mental health issues related to COVID-19.
  • House Bills 1700-1701 (PAMED supports) – Newly Introduced – Disclosure of disingenuous physician complaints. This bill would no longer require physicians to acknowledge the existence of a complaint filed against their medical or osteopathic license if the case were closed without any formal action. PAMED supports this effort and will advocate to advance these bills. This legislation has been referred to the House Professional Licensure Committee.

While the advancement of legislation listed above positively reflects PAMED’s legislative efforts and the efforts of engaged physicians, there are several bills that we continue to oppose and actively monitor. It is important for legislators to hear from their physician constituents on all of these pieces of legislation to either thank them or explain why specific legislation is not in the best interest of patient care.

PAMED is closely monitoring and engaging in the following:

  • Senate Bill 25 (PAMED opposes) –The bill, introduced in this same form since 2015, would grant CRNPs independent practice authority. PAMED has long opposed these efforts and will continue to do so. This bill was recently voted out of the Senate Consumer Protection and Professional Licensure Committee.
  • Senate Bills 397-398 (PAMED opposes in current form) – Since late 2019, PAMED has been working with representatives of physician assistants (PAs) to reach an agreement on several changes to the existing rules governing the physician supervision. Legislation introduced this session, Senate Bills 397-398, were approved by the full Senate before the summer recess. PAMED, working with our physician coalition, is seeking critical changes to the bill that would ensure appropriate oversight of newly graduated PAs in addition to those who are changing from one specialty to another. PAMED is seeking to improve physician workflow related to PAs, while at the same time ensuring appropriate supervision and state oversight of the process.

Over the summer recess, PAMED encourages physicians to set aside time to reach out to their local legislators and begin to develop a personal relationship. For those who already know their representative or senator, it is a good time to simply touch base. The first lesson in effective advocacy is to avoid your first meeting with lawmakers to be the one where you are asking for help. Physicians interested in engaging in the issues above, or on any legislative proposal, are encouraged to reach out to PAMED’s Governmental Relations staff for assistance at 800-228-7823.

Stay up to date on PAMED’s legislative priorities at www.pamedsoc.org/Advocacy. 
SUMMER SOCIAL RECAP
WCMS members enjoyed the Society’s first in-person event since March of 2020 on August 24. Members reunited at Southpointe Country Club and enjoyed great food and even better company! 

Keep an eye out for information about a virtual Opioid education event, being planned for late fall, early winter!

Are you interested in a topic for CME in 2021? Let us know! Email Washington@pamedsoc.org to share your thoughts.
JOIN THE WCMS BOARD OF DIRECTORS
The Washington County Medical Society Board of Directors is looking for new members to join the Board. Email Washington@pamedsoc.org if you are interested in joining the board or have questions about joining the board.