In terms of legislation that the POA had been working hard to
accomplish this session, one, the “Quality Eye Care for Insured Pennsylvanians
Act,” earned the Governor’s signature on October 24. The bill, HB
1013, was amended to include the language the POA had negotiated with the
insurers in SB
257. The Senate passed the House bill, sponsored by Rep. Steve Barrar (R-Delaware), and the House agreed with the
addition of the vision plan language, and the Governor approved it. POA members
are to be commended for their efforts over the past several years to get this
bill done.
Unfortunately, the optometry scope bill didn’t fare as
well. Despite overwhelmingly passing the Senate in September, SB
668 was not considered by the House Professional Licensure Committee. That
clock will start over in January, as will the efforts by the POA to see the act
updated for the first time in over 16 years. With the impending retirement of House Professional Licensure Committee Chairman Mark Mustio (R-Allegheny), along with dozens of his House and Senate colleagues, POA
Keypersons will be counted on heavily, again, to education the new legislators
about optometry, and to counter the misinformation spread this session by
organized ophthalmology. A comprehensive post-election report will be
distributed in mid-November.
The House and Senate will convene for perhaps one day each
in November, for what is traditionally non-voting sessions, other than to elect
temporary leaders to preside between the constitutional end of session on
November 30 and the convening of the 2019-20 session in January, and to hold
closed-door caucus elections for their respective leaders for next session. It
is anticipated that no more votes on bills will be held after the November 6
election. POA members are reminded to VOTE on Election Day!
Last month, we reported that the General Assembly came close to
passing legislation to create rules for PA to allow for the use of “telehealth”
in the Commonwealth. Unfortunately, SB
780, sponsored by Sen. Elder Vogel
(R-Beaver), got sidetracked by a host of amendments being offered, most
lethal of which was a proposal by Rep.
Kathy Rapp (R-Warren) to include language in the bill prohibiting the
performance of “abortions” via telemedicine. Most of the other amendments were
withdrawn, but Rapp held fast, and the vote on her amendment, and the bill
itself, never was called. Although it appears to be dead for this session,
Vogel and many in the provider community are committed to bringing the issue
back in a new bill in 2019.
The Medical Assistance Advisory Committee (MAAC) held its
regular monthly meeting on October 25. Some highlights of interest follow:
Patricia Allan, DHS
CHIP director, provided an update on the Children’s Health Insurance Program (CHIP) and the State Health official
letter, “Extending Federal Funding for Chip.” Congress reauthorized the program
for 10 years. The letter outlines key impacts of the reauthorization
legislation and was sent October 5, 2018. There are no direct impacts on
optometric care. Any members wishing to know the details are encouraged to
contact Dr. Rich Christoph.
Joseph Glinka of Gateway Health pointed to a declining enrollment in Medical Assistance (MA) and asked if the department is looking see where those people are going. Allan stated CHIP enrollment was climbing to almost 182,000 early this year, but then it dropped to 178,000 in May. She found that the drop was due in part to fears of the expiration of the program. Regarding the overall MA program, Kozak confirmed there have been some decreases in recent months, but she could not say if that is a trend yet. She said it is being monitored.
Joseph Glinka of Gateway Health pointed to a declining enrollment in Medical Assistance (MA) and asked if the department is looking see where those people are going. Allan stated CHIP enrollment was climbing to almost 182,000 early this year, but then it dropped to 178,000 in May. She found that the drop was due in part to fears of the expiration of the program. Regarding the overall MA program, Kozak confirmed there have been some decreases in recent months, but she could not say if that is a trend yet. She said it is being monitored.
Managed Care Delivery
System Subcommittee: The committee will prepare information to reduce
confusion due to changes in the law that haven't been implemented by
regulations. The also discussed Medicaid expansion numbers and quality
measures. Questions were raised about how to keep individuals enrolled in
Medicaid so they are not unnecessarily dis-enrolled. Glinka reported the new
credentialing notice will be for all providers, not just dental providers.
The following bills of interest to the POA
were introduced or acted upon in the past month:
HB
353 RE: Electronic Prescription Requirements for Controlled
Substances
(by Rep. Tedd Nesbit, et al)
(by Rep. Tedd Nesbit, et al)
Amends the Controlled Substance, Drug, Device and Cosmetic
Act further providing for definitions and for professional prescription,
administration, and dispensing by requiring electronic prescriptions for
Schedule II, III, and IV controlled substances, except in situations as
prescribed by regulation. The bill allows exceptions for veterinarians,
circumstances when an electronic prescription is not available due to temporary
technological or electrical failure by providing a practitioner shall within 72
hours correct any cause for the failure, when dispensed by a pharmacy outside
Pennsylvania, lack of internet access or an electronic health record system,
where an electronic prescription would cause an untimely delay in an emergency
department, patients enrolled in a hospice program or residing in a nursing
home or residential health care facility, controlled substance compounded
prescriptions and prescriptions containing certain elements required by the
food and drug administration not able to be accomplished with electronic
prescribing, a prescription issued pursuant to an established and valid
collaborative practice agreement between a practitioner and a pharmacist, a
standing order or a drug research protocol, a prescription issued in an
emergency situation, circumstances where the pharmacy that receives the
prescription is not set up to process electronic prescriptions, or controlled
substances that are not required to be reported to the prescription drug
monitoring program system. Establishes pharmacist responsibility if there is
belief that a patient may be seeking a monitored prescription drug for a
purpose other than the treatment of an existing medical condition.
Signed in the House and in the Senate, 10/17/2018
Signed in the House and in the Senate, 10/17/2018
Amends Title 18 (Crimes and Offenses), in minors,
establishing the offense of access of minors to dextromethorphan (known as DM
or DXM) and imposing a penalty. A person commits a summary offense if he
knowingly sells or purchases with the intent to sell a finished drug product
containing any quantity of dextromethorphan to a person who is less than 18
years of age. Similarly, a person commits a summary offense if he falsely
represents himself to be 18 years of age or older to another for the purpose of
procuring a finished drug product containing any quantity of dextromethorphan.
Read third time, and
passed Senate, 10-17-18 (49-0)
Approved by the
Governor, 10/24/2018 (Act No. 116 of 2018)
Amends the Optometric Practice and Licensure Act amending
the definition of "practice of optometry" to include health care
services related to the eye and vision care services including the supply and
preparation of eyeglasses. Further provides the practice of optometry includes
the administration and prescription of drugs approved by the Food and Drug
Administration for the treatment of diseases and conditions of the eye. Allows
an optometrist to order an imaging test appropriate for diagnosis and treatment
of a disease or condition of the human visual system. Clarifies that
optometrists may not perform surgery and that any insurance procedure and
billing code may not be used to define surgery.
Received in the House
and referred to House Professional Licensure Committee, 10/2/2018
Provides for summaries or copies of patient test results to
be sent directly to a patient or the patient's designee when there is a finding
of a significant abnormality; and provides for duties of the Department of
Health.
Signed in the House
and in the Senate, 10/17/2018
Amends Title 35 (Health and Safety) providing for
reimbursement of patient expenses associated with participation in cancer
clinical trials and for duties of the Department of Health to define and
establish a clear difference between what is considered inducement for a patient
to participate in a clinical trial and direct reimbursement of patient-incurred
expenses for participating in a cancer clinical trial, and establish all
sponsors of cancer clinical trials shall inform potential patient-subjects at
the time of the informed consent process; imposing a penalty; providing for the
use of epinephrine auto-injectors by certain entities and organizations by
establishing a health care practitioner with prescriptive authority may
prescribe epinephrine autoinjectors in the name of an authorized entity for
use; and conferring powers and imposing duties on the Department of Health.
Signed in the House,
10/9/2018 Signed in the Senate, 10/15/2018
Approved by the Governor, 10/24/2018 (Act No. 93 of 2018)
Approved by the Governor, 10/24/2018 (Act No. 93 of 2018)
Amends the act of May 17, 1921 (P.L.682,
No.284), known as The Insurance Company Law of 1921, in quality health care
accountability and protection, further providing for emergency services and
providing for quality eye care for
insured Pennsylvanians. As amended in the Senate, this bill now
contained the agreed-to language that was in SB 257, before the House amended
that bill.
Signed in the House
and in the Senate, 10/17/2018
Provides for telemedicine; authorizes the regulation of
telemedicine by professional licensing boards; and provides for insurance
coverage of telemedicine. The bill authorizes the practice of telemedicine by
health care providers. Requires each licensure board to promulgate regulations
within 24 months of the effective date and provides for the publishing
temporary regulations within 120 days. Further provides for evaluation and
treatment; insurance coverage; and Medicaid program reimbursement. The
provisions regarding insurance coverage and Medicaid program reimbursement
shall take effect in 90 days and the remainder shall take effect immediately.
Amended on House
floor, 10/11/2018
Amends the Achieving Better Care by Monitoring All
Prescriptions Program (ABC-MAP) Act further providing for access to
prescription information adding that authorized users include a Medicaid
managed care organization that is a party to a Medicaid managed care contract
with the Department of Human Services. The Medicaid managed care organization
may query the system to review the requested dispensing or prescribing of a
controlled substance to an individual to whom the organization provides
services under the State's plan for medical assistance under Title XIX of the
Social Security Act. The Medicaid managed care organization shall notify the
Department of Human Services and the Office of Attorney General if the
organization has reason to believe that a controlled substance prescribed or
dispensed to an enrollee under the State's plan for medical assistance under
Title XIX of the Social Security Act is fraudulent.
Read second time, and
rereferred to Senate Appropriations Committee, 10/1/2018
Amends the Workers' Compensation Act, in liability and
compensation, further providing for schedule of compensation, for computation
of benefits and for physical examination or expert interview. Allows employers
to request an Impairment Rating Evaluation after an employee has received total
disability compensation for a period of 104 weeks. Requires the employee to
submit to a medical evaluation which shall be requested by the insurer within
60 days upon the expiration of the 104 weeks to determine the degree of
impairment due to compensable injury. If such determination results in an
impairment rating that meets a threshold impairment rating that is equal to or
greater than 35 per centum impairment, the employee shall be presumed to be
totally disabled and shall continue to receive total disability compensation
benefits. If the determination is less than 35 percent, the employe shall then
receive partial disability benefits provided that no reduction shall be made
until sixty days' notice of modification is given. Further provides for
physical examination or expert interview.
Signed in the House
and Senate, 10/17/2018
State Board of
Optometry Board Meeting Schedule
2019 meeting dates
have not been announced yet
DHS Medical
Assistance Advisory Committee (MAAC)
Remaining 2018
Meeting Dates: December 13
2019 dates have not yet been announced.
For more information check the DHS MAAC website.
Copies of bills
described above can be obtained online at:http://www.legis.state.pa.us/cfdocs/legis/home/session.cfm
Respectfully submitted,
Richard Christoph, O.D.
Chair, POA State and National Education Committee
doctorc@verizon.net
Special thanks to Ted Mowatt, POA Lobbyist, for preparing the content.
Richard Christoph, O.D.
Chair, POA State and National Education Committee
doctorc@verizon.net
Special thanks to Ted Mowatt, POA Lobbyist, for preparing the content.
