This is a summary of those bills that have been introduced and enacted during the 2009-2010 legislative session. This information will be updated on a periodic basis.

Health Care Bills Signed into Law—Governor Ed Rendell has signed the following bills:

State Budget - House Bill 1416 (General Appropriations Act 10 of 2009) includes spending amounts for fiscal year 2009-2010. All of the hospital supplemental payments received restorations. While the restorations were improved over various legislative budget proposals, they are still at an amount lower than was spent in fiscal year 2008-2009.

Fiscal Code - House Bill 1614 (Act 50 of 2009). In passing this year’s state budget, the General Assembly put forward changes in the state’s fiscal code and tax code to: transfer $708 million from the HCPRA to the General Fund and transfer an additional $100 million from the Mcare Fund to the General Fund. Creates on-going funding for the state’s General Fund by redirecting the cigarette tax revenues ($170 million per year) from the HCPRA to the General Fund and redirecting the Auto CAT Fund surcharge ($44 million per year) from the Mcare Fund to the General Fund.

Emergency Medical Services - Senate Bill 240 (Act 37 of 2009), which updates the Emergency Medical Services System Act, requires the Department of Health to plan, guide, and coordinate programs to promote effective and efficient operation of statewide and regional EMS systems. HAP supported the bill because it better reflects current practices.

Health Insurance for the Unemployed - House Bill 1089 (Act 2 of 2009) extends COBRA health benefits to companies with between two and 19 employees. HAP supported the bill.

Health Insurance for Dependent Adults - Senate Bill 189 (Act 4 of 2009) allows some dependent adults to receive health insurance benefits through their parents’ plans until they are age 30. HAP supported the bill.

Preventable Serious Adverse Events - House Bill 84 (Act 1 of 2009) prohibits a health care provider from seeking payment for a preventable serious adverse event. HAP supported the bill.

PHC4 - Senate Bill 89 (Act 3 of 2009) reauthorizes the Pennsylvania Health Care Cost Containment Council (PHC4) through June 30, 2014. Key provisions of the law include the removal of the single-vendor requirement for reporting of quality data as well as measures providing for greater oversight and accountability of PHC4’s actions. HAP supported the bill.

Unemployment Compensation - House Bill 1770 (Act 30 of 2009) extends unemployment compensation benefits by seven weeks for those who have exhausted the current 72-week availability. The measure allows Pennsylvania to collect $145 million in stimulus money to aid in the payments. Costs for private businesses are covered using funds from the federal stimulus package, but state and municipal governments will be responsible for millions in benefits for their former employees. According to state officials, more than 17,000 Pennsylvanians exhausted their unemployment benefits as of July 21. HAP supported the bill.

Other bills that are pending include the following:

Health Information Technology

Health Information Technology - Representative Rick Taylor (D-Montgomery) introduced House Bill 2106 , the Health Information Technology Act. The bill establishes the Pennsylvania Health Information Exchange to promote the expansion of and use of health information technology. HAP supports the bill.

Health Information Technology Act - The Senate Public Health and Welfare Committee approved Senate Bill 700 , sponsored by Senator Rob Wonderling (R-Montgomery), which provides a framework for use of the federal stimulus funds directed at health information technology. It also requires the Department of Public Welfare to make payments to health care providers for the purchase or enhancement of health information technology. HAP supports the bill.

Electronic Prescriptions - The House Health and Human Services Committee approved House Bill 825 , sponsored by Representative Matt Baker (R-Tioga). The bill requires adoption of electronic prescriptions in health care facilities and provides incentive payments for adoption of health information technology. While HAP has some concerns with the bill, HAP supports the overall intent of the legislation.

Insurance

adultBasic Expansion - The House approved House Bill 1 , sponsored by Representative Todd Eachus (D-Luzerne). The bill modifies and expands the adultBasic health insurance program by adding new benefits and increasing enrollment from 46,000 adults to 130,000 adults. Funding would come from matching federal funds, the Health Care Provider Retention Account, existing adultBasic health insurance funding, a premium tax on nonprofit health plans, and a change in the escheat law from five to four years. The House added several amendments to the bill, including HAP-supported amendments to prohibit use of Medicaid rates in determining provider payment rates and to establish a physician medical school loan forgiveness program. A spokesman for the Senate Majority Leader said that the Senate will not likely vote on the legislation because the bill lacks sustainable funding, and the state should wait to see how the federal health reform initiative develops. HAP supports expanded health insurance coverage to the uninsured. However, this bill has serious funding issues, especially in light of the commonwealth’s fiscal crisis. With health care reform becoming more of a reality at the federal level, this is not the best time for the commonwealth to embark on a new program.

Small Group Reform - The House passed House Bill 746 , sponsored by Representative Tony DeLuca (D-Allegheny), which would prohibit insurance companies from using demographic or pre-existing condition information to price their plans. The Senate has no immediate plans to consider the bill.

Hospital Plan and Professional Health Service Corporations - Representative Phyllis Mundy (D-Luzerne) introduced House Bill 354 , which requires that hospital plan corporations and professional health service corporations maintain reserves in such form and amount as the Insurance Department may determine, and would require that such plans return any excess reserves to reduce health insurance premiums. HAP is reviewing the bill.

False Claims - House Bill 1679 introduced by Representative Mike Gerber (D-Montgomery) would provide for liability for false claims, for treble damages, costs and civil penalties, for powers of the Attorney General, and for qui tam actions. HAP opposes the bill as drafted.

Physician Credentialing - Representative Flo Fabrizio (D-Erie) introduced House Bill 1912 , the Physician Credentialing Act. The bill provides for the credentialing of physicians with health insurers and provides requirements for physician payment during the credentialing process. Senator Michael O’Pake (D-Berks) introduced Senate Bill 1046 , the same bill in the Senate. HAP supports the bill since it follows national standards.

Pharmacy Audits - Representative Mark Cohen (D-Philadelphia) introduced House Bill 882 , the Pharmacy Audit Integrity Act. The bill establishes minimum and uniform standards and criteria for the audit of pharmacy records. The bill outlines procedures for conducting and reporting an audit and requires a written report on the audit to be provided to the pharmacy. The bill also provides for an appeals process, third party resources, prohibits the accounting practice of extrapolation in calculating recoupment’s or penalties for audits, and outlines standards for determining fraud. HAP supports the bill.

Market Conduct

Certificate of Need - Representative Phyllis Mundy (D-Luzerne) introduced House Bill 247 , which reenacts the certificate of need program for health care facilities under the Department of Health. HAP opposes the bill since it would restrict local decision-making and increase health care costs.

Self–Referral - Representative Tony DeLuca (D-Allegheny) introduced House Bill 1405 , which prohibits certain referrals of patients by health care providers for health care services. HAP supports the bill.

Medicaid

Critical Access Hospitals - Senator Lisa Baker (R-Susquehanna) introduced Senate Bill 417 , which requires the Department of Public Welfare to reimburse critical access hospitals at 101 percent of Medical Assistance allowable costs. Representative Matt Baker (R-Tioga) introduced House Bill 1130 , the same bill in the House. HAP supports the bill since it will help to preserve access to health care in rural areas.

Hospital Medicaid Payments - Representative Matt Baker (R-Tioga) introduced House Bill 417 . The bill provides that Medicaid hospital payment rates be adequate to provide incentives for provider efficiency, to facilitate beneficiaries’ access to high-quality care, and to offer cost-effective care. HAP worked with Rep. Baker on the development of the bill.

Rural Hospitals - Senator Don White (R-Indiana) introduced Senate Bill 981 , the Rural Community Hospital Act. The bill requires the Department of Public Welfare to reimburse certain rural community hospitals at 101 percent of the Medical Assistance allowable costs for inpatient hospital and outpatient hospital services provided to a Medical Assistance recipient. The bill complements Senate Bill 417 , which requires the Department of Public Welfare to reimburse a critical access hospital which is qualified to participate under Title XIX of the Social Security Act at 101 percent of Medical Assistance allowable costs. HAP supports the bill since it will help to preserve access to health care in rural areas.

Medicaid Managed Care - Senator Jane Orie (R-Allegheny) introduced Senate Bill 995 , which allows Medicaid managed care organizations to customize benefit packages for Medicaid recipients over the age of 21 or who are pregnant. HAP is reviewing the bill.

Medical Liability

Mcare Fund - Representative Nick Micozzie (R-Delaware) introduced House Bill 1913 , which retires the Mcare Fund. The bill is similar to Senate Bill 1018 , introduced by Senator Ted Erickson (R-Delaware). The bill uses existing public funds to retire the estimated $1.66 billion in unfunded liabilities of the Mcare Fund, and it minimizes the financial impact on participating health care providers. HAP and the Pennsylvania Medical Society support the bills.

Apologies/Benevolent Gesture - Representative Dan Frankel (D-Allegheny) introduced House Bill 1804 which would make any benevolent gesture made prior to the start of a medical liability action by a health care provider inadmissible as evidence of liability or an admission of guilt. The language in this bill is identical to Senate Bill 208 , sponsored by Senator Pat Vance (R-Cumberland). HAP supports the bill as a means of reducing medical liability lawsuits.

Limits on Non-economic Damages - Representative Bob Godshall (R-Montgomery) introduced House Bill 199 , which amends the Pennsylvania constitution to allow the General Assembly to enact laws limiting the amount of recovery for non-economic damages and punitive damages in medical liability actions. HAP supports the bill as a means to reduce medical liability costs.

Bad Faith - Senate Bill 746 , introduced by Senator John Rafferty (R-Berks), provides physicians with civil immunity when reporting to law enforcement authorities information regarding a patient who is using a controlled drug for illicit purposes. The bill includes an amendment on “bad faith” actions that is unrelated to the purpose of the bill. Pennsylvania’s “bad faith” law imposes interest, attorney fees, and punitive damages on insurers where the judge finds the insurer has acted in bad faith toward the insured. The amendment gives this determination to juries rather than judges. Bad faith claims are generally mixed questions of fact and law, and as such, are best left to judges with greater experience in the law than juries. Moving these cases from judges to juries will create less predictability and will lead to higher settlements and costs. HAP opposes the bill, as amended.

Patient Care

Sudden Infant Death Syndrome - The House approved House Bill 47 , sponsored by Representative Larry Curry (D-Montgomery). The bill promotes awareness and education relating to SIDS and SUDI and safe sleeping practices for newborns and infants. HAP opposes the bill since it would create additional administrative burdens and possibly increase liability exposure. A similar bill, Senate Bill 577 , was introduced by Senator John Pippy (R-Allegheny).

Hemophilia Care - The House approved House Bill 620 , sponsored by Representative Larry Curry (D-Montgomery). The Hemophilia Standards of Care Act mandates certain protocols for care. HAP opposes the bill since it mandates specific treatment protocols, rather than allowing clinical flexibility.

Health Clinics - Representative John Pallone (D-Westmoreland) introduced House Bill 1846 , which would create the Community-Based Health Care Program. The program would require the Department of Health to make grants and the Department of Public Welfare to offer payments to community-based health care clinics, which would be used to expand and improve health care access and services such as preventive care; chronic care and disease management; prenatal, obstetric, postpartum and newborn care; dental treatment; and behavioral health and pharmacy services. HAP is reviewing the bill.

Heart Disease and Stroke Care - The House Health & Human Services Committee approved House Bill 816 , sponsored by Representative Ed Pashinski (D-Luzerne). The bill provides for the Department of Health (DOH) to expand the heart disease and stroke program by establishing an advisory committee to raise awareness of the public on the prevention of heart disease and the risk factors for stroke. The advisory committee would evaluate data and evidence-based practice to promote disease prevention strategies. Funds appropriated by the General Assembly would be used by DOH to provide grants to entities who voluntarily participate in data collection, evaluation of clinical outcomes, and subsequent analysis. HAP supports the bill.

Radiologic Test Results - The House Health and Human Services Committee approved House Bill 1358 , sponsored by Representative Marguerite Quinn (R-Bucks). The bill requires the results of all diagnostic imaging tests to be sent to the patient by the entity that performs the test. HAP expressed concerns about sharing of test results without interpretation by a physician and the cost of notifying all patients. The bill is intended to ensure that patients are informed about test results, and the bill was developed in response to several situations where a physician failed to communicate with the patient about a positive test result. Members of the Committee urged The Radiological Society of Pennsylvania, the Pennsylvania Medical Society and HAP to work with the bill’s sponsor to further refine the bill.

Whistleblower Protection - House Bill 521 , introduced by Representative Tony DeLuca (D-Allegheny) amends the Medical Care Availability and Reduction of Error Act further providing for patient safety definitions, for powers and duties of the Patient Safety Authority to establish whistleblower protection for health care practitioners and a reporting system for medical errors; for powers and duties of the Department of Health; including imposing administrative penalties of up to $5,000 upon health care facilities for acts or omissions which impair patient safety or the quality of patient care. HAP opposes the bill.

Trauma Centers 

Trauma Stabilization Act - The House Health & Human Services Committee approved House Bill 978 , introduced by Representative Todd Eachus (D-Luzerne) which amends the Pennsylvania Trauma Systems Stabilization Act. The bill further provides for accreditation of Level III trauma centers and for payment calculation of funding of trauma centers located in a third to eighth-class county by establishing a 25 mile radius from existing Level I and II trauma centers to qualify for accreditation. The legislation also authorizes the foundation to determine progression towards accreditation as outlined by the foundation for up to four years for those hospitals seeking to be qualified as Level III trauma centers. HAP supports the bill.

Workforce

Staffing Requirements - Senator Daylin Leach (D-Montgomery) introduced Senate Bill 742 , the Hospital Patient Protection Act. The bill mandates the adoption of specific registered nurse-to-patient staffing ratios in hospitals. Similar legislation, House Bill 147 , was introduced by Representative Tim Solobay (D-Washington). House Bill 1033 , introduced by Representative Bill Adolph (R-Delaware), requires a health care facility to develop and implement a professional nurse safe staffing plan based on patient acuity. HAP opposes the bills since they would impose new administrative burdens on hospitals while reducing the ability of hospitals to adjust staffing to meet changing patient needs.

Physician Loan Forgiveness - Representative Matt Baker (R-Tioga) introduced House Bill 891 , the Physician Retention Loan Forgiveness Act. HAP supports the bill since it will help to address physician shortages. Senator Ted Erickson (R-Delaware) introduced a similar bill, Senate Bill 527 .

Pharmacy Technician Registration - House Bill 528 introduced by Representative Tony De Luca (D-Allegheny) requires state registration for pharmacy technicians. The bill establishes continuity of educational programs approved by the Board of Pharmacy and requires national certification or passage of a board examination to be registered in Pennsylvania. There is a two year grandfather clause to accommodate those individuals currently practicing who do not meet the new criteria. The board would prepare regulations for the enforcement of the act. HAP supports the bill.

Professional Nursing - House Bill 1922 introduced by Representative Jaret Gibbons (D-Beaver). The bill establishes a scope of practice for mental health clinical nurse specialists. Currently the designation “clinical nurse specialist” is not defined in statute. HAP is reviewing the bill.  

Prosthetists and Orthotists - House Bill  255 introduced by Representative Mario Scavella (R-Monroe) and Senate Bill 630 , introduced by Senator Jeffrey Piccola (R-Dauphin) establishes national certification requirements for the licensure of prosthetists, orthotists, pedorthists and orthotic fitters. The bills define scope of practice, require continuing education and allow for a two year grandfather clause if certain requirements are met. Hospitals, that have in-house practitioners currently performing services for three years immediately preceding application for licensure, would be covered by the grandfather clause. HAP does not oppose the bill.

Circulating Nurses - The House approved House Bill 1641 , sponsored by Representative Mauree Gingrich (R-Lebanon). The bill provides for registered nurses to function as circulating nurses in operating rooms of hospitals and Class C ambulatory surgical centers. HAP supports the bill.