Healthcare is always a hot topic, and so it was in Pennsylvania in 2018. Initiatives came from both the legislature and the administration the last year, all with the intent to increase access to and improve the quality of healthcare in the Commonwealth. Hot issues included the opioid epidemic and medical marijuana, as well as pharmacy issues, PACE/PACENET and human services.

Human Services Code

As is the case each year, the General Assembly put forth an omnibus Human Services Code bill during the 2018 budget season. This year’s bill, Act 40/H.B. 1677 (Ortitay, R-Allegheny) included the following highlights:

  • Extending the statewide quality care assessment for all inpatient acute care and rehabilitation hospitals through 2023;
  • Changes to non-emergency medical transportation services provided through the Medical Assistance Transportation Program (MATP);
  • Development of educational materials related to the Living Independence for the Elderly (LIFE) Program;
  • Established a pilot program in the City of Philadelphia for the coordinated delivery of education and human services to students and their families; and
  • Authorized a Medicaid Outcome-Based program through hospitals and Managed Care Organizations (MCO’s).

Opioids

In January, Governor Wolf declared the heroin and opioid epidemic a statewide disaster emergency. The first-of-its-kind disaster declaration addressed 13 key initiatives that were organized in three categories: (1) enhancing coordination and data collection to bolster state and local response; (2) improving tools for families, first responders and others to save lives; and (3) speeding up and expanding access to treatment.

In conjunction with the declaration, funding streams to assist in the effort were announced throughout the year, including:

  • $55.9 million from the federal Substance Abuse and Mental Health Services Administration to focus on prevention, treatment, recovery, education and training;
  • $10 million from Bloomberg Philanthropies targeted in the areas of staffing, technical assistance and data collection;
  • $5.1 million from the Centers for Disease Control and Prevention as part of a cooperative agreement for emergency response; and
  • $5 million from the National Health Emergency Dislocated Worker Demonstration Grant program to provide career services for individuals impacted by the opioid epidemic.

Along with the executive-level solutions, the legislature also adopted measures to combat the opioid epidemic, including:

  • Act 8/S.B. 542 (Browne, R-Lehigh), which allows for emergency refills of medications that are not dispensed or sold in 72-hour supplies;
  • Act 47/H.B. 17 (Hahn, R-Northampton), which allows a parent or legal guardian to give consent over the objection of the minor for medical care or counseling related to diagnosis or treatment of substance abuse;
  • Act 69/S.B. 978 (Baker, R-Luzerne), which authorizes home health and hospice agencies to properly dispose of unused medications following a patient’s discharge or death;
  • Act 93/H.B. 126 (Warner, R-Fayette), which adds exceptions for prescribing opioids to minors; and
  • Act 98/H.B. 353 (Nesbit, R-Erie), which requires electronic prescriptions for Schedule II, III and IV controlled substances.

Medical Marijuana

2018 was another busy year from Pennsylvania’s burgeoning medical marijuana industry. Act 43/H.B. 2477 (Watson, R-Bucks), clarified the Chapter 20 program by addressing Academic Clinical Research Centers (ACRC’s) and Clinical Registrants (CR’s). After this legislative enactment, eight medical schools were certified as ACRC’s. However, the Department of Health did not issue any CR permits yet, stating that no applicants had met department standards. A second round of applications for the medical marijuana research program will open in early 2019.

In other medical marijuana-related news, 13 “Phase II” grower/processor permits were awarded, bringing the total number of grower/processors in the state to 25. Phase II dispensary permits are expected to be announced at the end of 2018 or early 2019.

Other Healthcare News

As medicine and technology continue to advance, and as the cost of healthcare and research continue to rise, the General Assembly must act to keep up with the times. In light of that, we saw a few additional enactments over the course of the last year:

  • Act 24/H.B. 1869 (Mackenzie, R-Lehigh), which established the Maternal Mortality Review Committee to review maternal deaths in the Commonwealth;
  • Act 24/H.B. 478 (Pickett, R-Bradford), which specified the number of hours that psychiatrists and other advanced practice professionals must be on site at an outpatient psychiatric clinic;
  • Act 73/S.B. 1091 (Martin, R-Lancaster), which provides the option to contribute $5 towards the Pediatric Cancer Research Fund from people renewing licenses, ID cards and registrations;
  • Act 87/H.B. 270 (Farry, R-Bucks), which increased the Pharmaceutical Assistance Contract for the Elderly Needs Enhancement Tier (PACENET) income eligibility limits and provided for medication synchronization in the PACE/PACENET Program;
  • Act 90/S.B. 180 (Greenleaf, R-Montgomery), which updated the Donate Life PA Act to provide a comprehensive framework for facilitating organ and tissue donations;
  • Act 103/H.B. 1013 (Barrar, R-Delaware), which requires emergency medical services agencies be reimbursed for services provided even if transport to a hospital does not take place;
  • Act 106/H.B. 1233 (Murt, R-Montgomery) which established a new standard for assisted outpatient treatment for seriously mentally ill individuals;
  • Act 112/H.B. 1884 (Quinn, M., R-Bucks), which requires notification of specific radiological test results be sent directly to the patient or their designee when a significant abnormality exists; and
  • Act 126/S.B. 31 (Scavello, R-Monroe), which allows Tobacco Settlement dollars to be used to fund the Spinal Cord Injury Research Program.

Looking Forward

It’s hard to say at the outset of the legislative session what to expect over the next two years. We may see advancement of a telemedicine bill that didn’t quite make it to the Governor’s desk this year, or possibly legislation increasing the oversight of pharmacy benefit managers in response to a report by the Auditor General. Opioids are likely to continue to be a hot topic, and the state’s medical marijuana program may make additional advances.

Whatever the issues, expect new leadership at the helm of the relevant standing committees. The House Democratic Caucus will appoint a new Minority Chair of the House Heath Committee, filling the shoes of Rep. Flo Fabrizio (D-Erie), who passed away this year. We’ll also have a new Chairman of the House Professional Licensure Committee due to the retirement of Rep. Mark Mustio (R-Allegheny). Changes in leadership in both chambers could trickle down to changes in committee chairmanships as well. However, as the new session unfolds, we’ll be sure to keep you posted on all the latest developments.