Legislation and Advocacy​

The mission of PAAA includes advocacy for patients with allergic, asthmatic, and  ​imm​​​unologic disorders in the Commonwealth of Pennsylvania. As one of the major specialties represented in the Specialty Leadership Cabinet of the Pennsylvania Medical Society (PAMED), PAAA has a strong voice in Harrisburg. Also, through the Federation of Regional, State, and Loc​​al Allergy, Asthma & Immunologic Societies (RSLAAIS), PAAA communicates issues to and from our national organizations who have representatives that monitor federal issues ​​and speak with legislators in Washington on behalf of allergists.
Through collaboration with other medical societies and communication between local, state, and regional allergy societies, PAAA has advocated for newborn infants with Primary Immunodeficiency, students with food allergy, and patients who require expensive specialty pharmacy drugs. Listed below are some of PAAA’s legislative and regulatory priorities. The Association is dedicated to monitoring and addressing issues that affect our specialty and our patients.

Current Issues

Quarterly Legislative Report
​April 2019
Originally printed by Pennsylvania Medical Society

Venue Rule
Background
  • On Dec. 22, 2018, the Pa. Supreme Court Civil Procedural Rules Committee (Committee) published a proposed rule change in the Pennsylvania Bulletin, which would revise the venue rule (the county in which a case may be filed) for medical liability cases.
  • By allowing venue in counties with little to no relation to the underlying cause of action, claimants could shop for verdict-friendly venues in which to file their suits.
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  • The Pennsylvania Medical Society (PAMED) mobilized a movement through stakeholder involvement to flood the Committee with comments. PAMED formed a coalition of 42 state-based organizations who oppose the proposed venue rule changes.
  • There is strength in numbers - 2,560 physicians, patients, and other stakeholders submitted comments directly to the Committee through PAMED’s online form. PAMED thanks all physicians who submitted personal comments. 
  • Senate Resolution 20 was approved by the Pa. Senate on Feb. 5, 2019. It calls for a study to  review several aspects and impact of previous medical liability reforms, which will enable a more measured approach to any future changes to rules governing venue in medical liability actions.
Current Status
  • The Pa. Supreme Court has agreed to accept the recommendations of Senate Resolution 20 and delay its decision on the proposal in order to await further study by the Pa. Legislative Budget and Finance Committee (LBFC) of potential effects of venue rule changes. The report is due no later than Jan. 1, 2020.
Next Steps
  • All physicians are encouraged to meet with legislators to discuss how the proposed venue rule changes would affect medicine and specifically their practice. Personal stories will help to keep this issue front of mind for legislators while the LBFC drafts its report. Find your local legislators and resources for a legislative visit at www.pamedsoc.org/VenueRule.
  • On March 22, 2019, PAMED met with the LBFC. PAMED shared our comments that were submitted to the Court's committee and offered our help with its study. PAMED also plans to testify at an upcoming LBFC hearing.

Prior Authorization Reform
Background
  • PAMED is seeking a legislative fix to the prior authorization process to address patient care issues, such as delays in needed treatment. Our efforts are supported by a coalition of more than 50 patient and medical advocacy groups and is recognized as a national issue by the American Medical Association (AMA).
Current Status
  • Lobbyists for physician stakeholders met in February 2019 to outline a plan for bill introduction, discuss bill language, and strategize a plan for the 2019-2020 legislative session.
Next Steps
  • The stakeholder group will identify a bill sponsor that will lead to the circulation of a co-sponsorship memo and the bill’s introduction within the Pa. House of Representatives.
 
Team-Based Care and Scope of Practice
Background
  • Some things are just better together, and physicians and health care team members are no different. PAMED strongly opposes any legislation that does not keep physicians as the leader of the health care team.
  • Currently, Pa. law requires certified registered nurse practitioners (CRNPs) to have a collaborative agreement with a physician. As organizations representing CRNPs pursue policy changes that would give these practitioners the authority to practice without a collaborative agreement with a physician, PAMED remains committed to opposing this legislation.
Current Status
  • In a letter sent to members of the Pa. Senate Consumer Protection and Professional Licensure Committee on March 25, 2019, PAMED expressed our strong opposition to
    SB 25, which passed out of committee on March 27, 2019. Senators Mike Regan and John Gordner opposed this bill. If you are in their district, please thank them for their support. You can read the letter PAMED sent to the Senate committee here.
  • In a letter sent to Pa. House members on Feb. 11, 2019, PAMED expressed our strong opposition to Rep. Jesse Topper’s proposal (HCO 854) . The Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Academy of Family Physicians, and Pennsylvania Osteopathic Medical Association signed on to our letter and joined PAMED in opposing this effort. Read the letter here.
Next Steps
  • The Senate will return to session on April 8, 2019. It is uncertain when the Senate will consider SB 25.
  • We encourage physicians to reach out to their legislators to meet with them on this issue and educate them as to why this is a bad idea for patient care in Pennsylvania. Get your legislators' contact information here.
  • The PAMED government relations team continues to educate legislators and the public regarding our concerns with this legislation.

Narrow Networks/Any Willing Provider/Out-of-Network Balance Billing
Background
  • PAMED believes that patient protections from “surprise” and other out-of-network health care billings should begin by addressing the root cause of the problem – tiered and narrow health insurance provider networks as well as a lack of insurance product transparency.
  • An informational meeting took place on Feb. 5, 2019, within the Pa. House Insurance Committee. The Pennsylvania College of Emergency Physicians and the Pennsylvania Society of Anesthesiologists submitted testimony.
Current Status
  • PAMED continues to participate in monthly Provider Coalition meetings to advance legislation and strengthen communications between stakeholders.
Next Steps
  • There have been many changes in insurance coverage and health delivery over the past 20 years. The Provider Coalition strongly encourages the Pa. House Insurance Committee to hold a future hearing on network adequacy requirements and potential updates to the law.
 
Maintenance of Certification (MOC)
Background
  • While physicians are committed to lifelong learning, the current MOC process is burdensome for physicians.
  • The American Board of Medical Specialties’ (ABMS) Vision for the Future Commission on MOC reform released its final report and recommendations in February 2019. PAMED Past President Charles Cutler, MD, MACP, is one of 26 members who participated in the Vision Commission.
  • The report offers recommendations that the ABMS and ABMS Boards should consider implementing in the near-term (i.e. one to two years) or within an intermediate timeframe (i.e. less than five years). Of note is the recommendation that ABMS must encourage hospitals, health systems, payers, and other health care organizations not to deny credentialing or privileging to a physician solely on the basis of certification status.
  • On March 12, 2019, the ABMS Board announced a plan to begin implementing the Vision Commission’s suggestions.
Current Status
  • On a webinar hosted by AAMSE on April 1, 2019, Dr. Richard Hawkins of ABMS shared that all 24 ABMS Boards have committed to identifying alternatives to the high stakes exams and having alternatives identified by the end of 2019 so that the alternative options are in place by 2020. 
Next Steps
  • PAMED continues to explore possible legislative solutions to ensure that the MOC process is fair for all physicians.
 Stay up to date at www.pamedsoc.org/MOC.

Physician Wellness
Background
  • PAMED believes in improving the practice environment for physicians in Pennsylvania. State legislators can help by recognizing the factors that often lead to “physician burnout” and work to resolve them, or at the very least, lessen their impact.
Current Status
  • On March 12, 2019, PAMED President Danae Powers, MD, provided written and oral testimony with state Representatives at a Pa. House Health Committee hearing on barriers to employment in the health care field. In her testimony, Dr. Powers encouraged policymakers to learn what happens behind the scenes in physician offices, hospitals, and operating rooms, working with physicians to better understand some of the barriers that make practicing medicine difficult. Read Dr. Powers’ written testimony here.
Next Steps
  • PAMED will continue to ask legislators to support proposals that seek to return clinical autonomy to physicians so that they can do what is right for patients.
 
The Foundation of the Pennsylvania Medical Society invites physicians to attend its Physician Resiliency Summit on June 5, 2019, at the Eden Resort in Lancaster, Pa. There is something for everyone! Physicians will hear from nationally regarded speakers in the field of physician wellness, addressing concerns affecting physicians at all career stages. Learn more and register at www.foundationpamedsoc.org/summit.
 
Let Your Voice Be Heard by Attending Advocacy Day
  • PAMED members are encouraged to join us for our annual Advocacy Day on April 29, 2019, from 8:30 a.m. to 1:30 p.m. at the State Capitol in Harrisburg. Let your voice be heard – don’t be indifferent, be the difference! Learn more and register to attend by April 15 at www.pamedsoc.org/AdvocacyDay.
 
A Look Ahead
  • ASC Tax: We can expect that the budget will take up a great deal of legislative time during the session between now and June 30. Gov. Tom Wolf’s 2019-2020 state budget proposes a provider tax on ambulatory surgery centers (ASCs) and endoscopy centers to generate $12.5 million on an annual basis. PAMED supports specialty societies in opposing this tax by urging members to contact lawmakers to oppose, stating that this tax will drive up health care costs and put surgery centers at risk of closing. Read a coalition letter sent to state legislators on March 29, 2019 here.
  • PAMED’s Bill Tracker: Our new Bill Tracker/Legislative Update page allows members to stay up to date. You can access it at www.pamedsoc.org/BillTracker. You can also stay up to date via PAMED’s Bills on the Hill Blog at www.pamedsoc.org/BillsontheHill.
  • Register to Vote: April 22, 2019 is the last day to register to vote before Pennsylvania's Primary Election on May 21, 2019. Visit www.votespa.com for additional information, including applications for absentee ballot, polling place location, and voter registration. Voting is important to help ensure that your voice as a constituent, and as a physician, is heard.

PAAA has donated to the following lay organizations:

Allergy and Anaphylaxis Network Mothers of Asthmatics (AANMA)
Food Allergy Research Education (FARE)
Immune Deficiency Foundation (IDF)
Kids with Food Allergies (KFA)