#HealthierPA Accomplishments Since 2011 Key Points: • For a #HealthierPA, House Republican members are acting to ensure every Pennsylvania resident, no matter where he or she lives, has access to a family doctor or health care provider. • House Republican members continue to work toward preserving the doctor/patient relationship with minimal government interference. • House Republicans have enacted measures to allow health care providers to improve the health and well-being of patients. • House Republican members have supported and advanced scientific innovations without undermining the ethical principles that have guided physicians and licensed professionals. Health Care Laws Enacted Taking Care of Those Who Take Care of Others Family Caregiver Support Act (Act 112 of 2011): Changes the name of the law to the Pennsylvania Caregiver Support Act, addresses approved out-of-pocket expenses incurred by caregivers, allows reimbursement of non-relative caregivers and adult family members and makes other changes. Cancer as Occupational Disease for Firefighters (Act 46 of 2011): Designates cancer as an occupational disease for firefighters for the purposes of workers’ compensation. Civil Immunity for Epinephrine Administration (Act 2 of 2017): Applies civil immunities to school bus drivers or crossing guards who administer an epinephrine auto-injector to a student. Access to Epinephrine (Act 93 of 2018): Permits authorized entities with properly trained employees to maintain a supply of epinephrine auto-injectors and provide or administer them. Ensuring Safe Health Care Facilities Long-Term Care Nursing Facility Independent Informal Dispute Resolution Act (Act 128 of 2011): Establishes an independent informal dispute resolution process for long-term care nursing facilities to dispute Department of Health survey deficiencies; and provides for the powers and duties of the Department of Health. Hospital Licensure (Act 60 of 2013): Amends the Health Care Facilities Act to utilize national accrediting standards for hospital licensure. Ambulatory Surgery Center (Act 70 of 2017): Amends the Health Care Facilities Act to change the length of stay in a licensed Ambulatory Surgery Center (ASC) to comport with that of other states and federal Centers for Medicare and Medicaid Services (CMS) guidelines. Reauthorization of Assessments (Act 19 of 2019): Reauthorizes current human services-related assessments and adds studies on two programs with potential fiscal impacts. Trauma Centers (Act 54 of 2019): Addresses declining outcomes and inequitable funding formulas for trauma centers. Improving Health Outcomes Through Education and Raising Awareness Management of Sport-Related Concussions (Act 101 of 2011): Raises awareness of the danger of concussions by calling for the removal from play of an athlete who shows symptoms of a concussion, such as confusion, headache, nausea, blurred vision or memory loss. The athlete would not be eligible to return to action until examined and cleared by a doctor. Under the Safety in Youth Sports Act, student athletes and parents are required to read and sign a concussion awareness sheet annually before the student is allowed to participate in a sport, including cheerleading and club sports like rugby and hockey. In addition, coaches must complete a concussion certification course every year. Primary Stroke Center Recognition Act (Act 54 of 2012): Establishes a statewide stroke system of care by recognizing primary stroke centers and directing the creation of emergency medical services training and transport protocol. o Stroke is the third-leading cause of death in the nation and in Pennsylvania. It is also one of the leading causes of long-term disability. Rapid response can save lives and minimize the long-term effects of stroke. Sudden Cardiac Arrest Prevention Act (Act 59 of 2012): Requires the Departments of Health and Education to provide educational materials regarding the risk, nature and warning signs of sudden cardiac arrest (SCA). Also, a student who exhibits signs or symptoms of sudden cardiac arrest during athletic participation must immediately be removed from the activity and cannot return to participation until cleared by an appropriate medical professional. o SCA occurs when the heart stops beating suddenly and unexpectedly. Warning signs include fainting, shortness of breath, unexplained family death and a family history of abnormal heart or seizures. o SCA is the No. 1 killer of student athletes and is responsible for up to 30 percent of all sudden infant deaths. It affects an estimated 5,000 to 7,000 children annually. Lyme Disease Task Force (Act 83 of 2014): Directs the Department of Health to establish a task force that will investigate and make recommendations to the department regarding the education, prevention and treatment of Lyme disease and related tick-borne diseases. Suicide Prevention Education (Act 74 of 2016): Requires the State Board of Psychology and the State Board of Social Workers, Marriage and Family Therapists and Professional Counselors to have at least one hour of continuing education in the assessment, treatment and management of suicide risks. Improving Care for Stroke Victims (Act 4 of 2017): Adds acute stroke-ready hospitals and comprehensive stroke center designations to the state’s Stroke System of Care Act. The system is designed to improve health outcomes for stroke victims. Taking Steps to Beat Cancer Breast Density Notification Act (Act 86 of 2013): Requires mammography facilities certified by the Food and Drug Administration to provide patients with information regarding their breast density. Breast Cancer Treatment (Act 3 of 2014): Aims to ease anxiety for breast cancer patients by repealing Act 213 of 1984, which mandates an additional medical consent form from patients for treatment of breast disease. Prostate Cancer (Act 66 of 2015): Directs the Department of Health to establish a task force for the purpose of investigating, raising awareness and making recommendations concerning prostate cancer and related prostate cancer conditions. Coverage for Oral Cancer Treatments (Act 73 of 2016): Prohibits health insurers from providing coverage or imposing cost sharing for a prescribed, orally administered chemotherapy medication on a less favorable basis than the coverage it provides or cost sharing it imposes for intravenously administered or injected chemotherapy medications. Supporting Pediatric Cancer Research (Act 39 of 2017): Creates an opportunity for taxpayers to donate to pediatric cancer research via their Pennsylvania tax returns. Pediatric Cancer Research Funding (Act 73 of 2018): Requires the Pennsylvania Department of Transportation to establish a method to accept $5 contributions for the Pediatric Cancer Research Fund from persons renewing licenses, identification cards and registrations through web-based online transactions. Dental Care for Better Health and Well-Being Dental Volunteers (Act 7 of 2014): Creates a temporary volunteer dental license for out-of-state dentists to volunteer at charitable dental clinics. Dental School Instructors (Act 89 of 2014): Allows licensed dentists from other states to obtain a restricted faculty license to teach in dental schools in Pennsylvania. Dental Licensing and Training (Act 60 of 2015): Allows dentists from other states and countries to attend continuing education courses taught in dental schools located in the Commonwealth and allows licensed dentists from other countries to obtain restricted faculty licenses authorizing them to teach in Pennsylvania dental schools. It also allows dental hygiene practitioners to practice in non-institutional settings, such as providing services for homebound patients. Improving Access to Quality Health Care PACE/PACENET (Act 21 of 2011): Ensures PACE and PACENET recipients remain eligible for the prescription drug benefit despite a minimal increase in their Social Security income that may put them just above the income limits for the programs. The law ensures nearly 30,000 senior citizens retain their benefits. CHIP Extension (Act 74 of 2013): Extends the Children’s Health Insurance Program (CHIP) through Dec. 31, 2015. Health Care Navigators (Act 7 of 2015): Establishes a state registration process with the Pennsylvania Insurance Department to clarify the proper role of health care navigators and assisters who enroll individuals in health insurance exchanges. CHIP (Act 84 of 2015): Reauthorizes the Pennsylvania Children’s Health Insurance Program through Dec. 31, 2017, and moves the program from the Insurance Department to the Department of Human Services. Human Services Funding (Act 153 of 2016): Expands the Human Services Development Block Grant program by making it available to all 67 counties on a voluntary basis. The block grant program is designed to give counties more flexibility to meet human service needs. CHIP Extension (Act 58 of 2017): Reauthorizes the Children’s Health Insurance Program (CHIP) until Dec. 31, 2019. CHIP provides insurance coverage to uninsured children and teens (up to age 19) whose families earn too much to qualify for Medical Assistance, but who cannot afford to purchase private insurance. State Based Exchange and Reinsurance Program (Act 42 of 2019): Creates a PA state-based health insurance exchange and a reinsurance program. Improving Treatment and Care Through Professional Oversight Access to Diabetic Shoes (Act 104 of 2014): Exempts pharmacists, podiatrists and physicians from licensure with respect to dispensing durable medical equipment and allows persons currently selling/dispensing diabetic shoes and inserts to receive a prosthetic, orthotic, pedorthotic, or orthotic fitter license without examination. Audiology Updates (Act 106 of 2014): Updates the provisions regulating audiologists and speech-language pathologists, and eliminates the licensure requirement for teachers of the hearing impaired. Acupuncture Treatment Access (Act 134 of 2014): Enables acupuncturists to treat patients seeking routine wellness treatments without the requirement of a physician’s diagnosis. Psychologist Practice Update (Act 53 of 2016): Amends the Professional Psychologists Practice Act to update licensure and practice provisions. Marriage and Family Therapists (Act 54 of 2016): Restricts the use of the title “Licensed Marriage and Family Therapist” to only those who are licensed as such and amends the composition of the State Board of Social Workers, Marriage and Family Therapists and Professional Counselors. Sports Team Physicians (Act 73 and Act 74 of 2015): Allows visiting sports team physicians to provide medical care to their players and coaches while in Pennsylvania without obtaining a temporary or full Pennsylvania medical license. Interstate Medical Licensure Compact (Act 112 of 2016): Establishes the Interstate Medical Licensure Compact to allow for the practice of medicine across state boarders by creating a pathway for licensure. The compact would help increase medical access to Pennsylvanians in underserved areas and connect individuals with serious illnesses to specialists in the field. Naturopathic Doctor Registration Act (Act 128 of 2016): Establishes the Naturopathic Doctor Registration Act to require naturopathic doctors to hold an active registration with the State Board of Medicine. Paramedic Blood Draws (Act 142 of 2016): Allows paramedics to conduct blood draws on behalf of municipal police departments in alleged driving under the influence (DUI) cases. Death Certificates (Act 17 of 2017): Allows a physician assistant (PA) to sign a death certificate for a patient under his or her care. Psychiatric Supervision (Act 25 of 2018): Changes the number of hours of psychiatric supervision required at outpatient psychiatric clinics to help meet growing demand and address the shortage of psychiatric time in Pennsylvania. The legislation will allow licensed prescribing professionals to work within their scope of practice as is the case in the physical health care arena. Chiropractic Students (Act 67 of 2018): Authorizes students in chiropractic schools to perform, under the direct, immediate and personal supervision of a licensed chiropractor, chiropractic activities as part of their clinical training. Ensuring Better Treatment (Act 76 of 2018): Amends the Social Workers, Marriage and Family Therapists and Professional Counselors Act to require individuals who engage in the independent practice of clinical social work, marriage and family therapy or professional counseling to be licensed. Physician Designee (Act 68 of 2019): Allows a physician to appoint a designee to assist with the input of information relating to written agreements into the Department of State’s new online PALS licensing system as it relates to the medical practice act. Physician Designee (Act 69 of 2019): Allows a physician to appoint a designee to assist with the input of information relating to written agreements into the Department of State’s new online PALS licensing system as it relates to the Osteopathic Medical Act. Better Care For PA Patient-Centered Medical Home (PCMH) Advisory Council (Act 198 of 2014): Creates a PCMH Advisory Council for the state’s Medicaid program to improve care and reduce health care costs. The PCMH model basically has a primary care physician or nurse practitioner as the primary point of contact for all medical care having to do with an individual patient. This model of care is especially effective for those who have chronic diseases that require one or more specialists. Doctors, nurses, pharmacists, physical therapists and others are all communicating to ensure the patient is receiving coordinated care, which includes making sure the patient does not undergo duplicative testing, receives important routine exams, and is alerted when immunizations are needed. Fighting Rare Diseases (Act 14 of 2017): Establishes a Rare Disease Advisory Council within the Pennsylvania Department of Health to study the incidence and prevalence of rare diseases in Pennsylvania. Patient Test Results (Act 112 of 2018): Requires the imaging service who performs diagnostic imaging services to directly notify the patient or his/her designee if the entity believes a significant abnormality may exist. Spinal Cord Disability Research Grant Program (Act 126 of 2018): Establishes the Spinal Cord Injury Research Program and allocates funding from the Tobacco Settlement Fund. Preventative Care for Healthy Pregnant Women, Children & Infants Infant Screenings (Act 94 of 2014): Requires a pulse oximetry screening for each newborn baby born in a hospital or freestanding birthing center. Down Syndrome Diagnosis (Act 130 of 2014): Requires health care practitioners to provide complete information to women who receive a prenatal diagnosis for Down Syndrome. Newborn Screenings (Act 148 of 2014): Adds Krabbe, Fabry, Pompe, Niemann-Pick, Gaucher and Hurler Syndrome to the list of genetic diseases that hospitals must screen newborns for in Pennsylvania. Coverage for Infant Formula (Act 158 of 2014): Requires health insurance carriers in Pennsylvania to cover the cost of medically necessary amino acid-based elemental formulas for infants and children. Pertussis Awareness (Act 163 of 2014): Allows health care facilities to provide parents of newborns with educational information about pertussis disease and the availability of a vaccine to protect against pertussis. HepC Screening (Act 87 of 2016): Requires health care providers and hospitals to offer screening tests and treatment for hepatitis C to those born between 1945 and 1965. Maternal Mortality Review (Act 24 of 2018): Establishes the Maternal Mortality Review Committee within the Department of Health to review maternal deaths in the Commonwealth and to develop strategies for the prevention of maternal deaths. Organ Donation as an Option for Consideration Organ Donation Tax Credit (Act 193 of 2014): Permanently extends the organ and bone marrow donation tax credit benefits. The tax credit is available to businesses that grant paid leaves of absence to employees for the purpose of bone marrow or organ donation. Organ Donation Promotion (Act 79 of 2015): Aims to encourage Pennsylvanians to become organ or tissue donors by including the following statement and question on both the application for a driver’s license or identification card and on the organ donor designation at a photo center: “Pennsylvania strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunities. Do you wish to have the organ donor designation printed on your driver’s license?” Donate Life PA Act (Act 90 of 2018): Makes several updates to the state’s organ donation laws. Encouraging Personal Responsibility Achieving a Better Life Experience (ABLE) Act (Act 17 of 2016): Allows a tax-free savings account to be established for use by an individual with disabilities to cover qualified expenses such as education, housing and transportation. The new law allows family members and other persons to make contributions during a taxable year for a designated beneficiary to supplement the costs of qualified disability expenses. Right to Try (Act 33 of 2017): Allows eligible, terminally ill patients to request and use investigational drugs, biological products and medical devices not yet approved by the U.S. Food and Drug Administration. Transparency in Health Care Department of Human Services (Act 131 of 2014): Changes the name of the Department of Public Welfare to the Department of Human Services. Protecting Against Surprise Medical Bills (Act 169 of 2014): Requires hospitals to notify patients of their outpatient status, as well as the billing and insurance implications of that designation, in order to bring transparency to patients and their families. Caregiver Advise, Record and Enable Act (Act 20 of 2016): Requires health care facilities to record the name of the family caregiver when someone is admitted to a hospital, and requires facilities to notify the designated caregiver when the patient is to be discharged to another facility, such as a rehab center, or home. A live explanation or video instruction on the medical tasks necessary to care for the patient would be given by the facility in order to ensure a smoother transition back home and maximize recovery. Health Care Reimbursements (Act 146 of 2016): States that an insurer may only retroactively deny reimbursement to a health care provider during a 24-month period after the date the insurer paid that provider. An insurer that retroactively denies reimbursement shall provide a written statement to the health care provider specifying the basis for the retroactive denial. Flu Vaccine Notice (Act 173 of 2016): Requires each assisted living residence and personal care home in the Commonwealth to post information year-round about the flu vaccine. Pharmacists and Prescription Remedies Prescription Drug Monitoring Program (Act 191 of 2014): Creates the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) Act. Flu Vaccine Access (Act 8 of 2015): Allows authorized pharmacists to administer flu immunizations to children 9 years of age and older with parental consent and allows qualified pharmacy interns to administer injections under supervision of an authorized pharmacist. Medical Cannabis (Act 16 of 2016): Permits the growing, processing and dispensing of medical cannabis to qualified patients in Pennsylvania. The following diseases qualify for the use of medical cannabis: cancer, epilepsy, intractable seizures, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, post-traumatic stress disorder (PTSD), HIV/AIDS, glaucoma, severe chronic or intractable pain of neuropathic origin or severe or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective, damage to the nervous tissue of the spinal cord with objective neurological indicated of intractable spasticity, inflammatory bowel disease (IBS), neuropathies, sickle cell anemia and Huntington’s disease. Fighting Drug Abuse (Act 37 of 2016): Allows the Department of Health to promptly add chemicals used to manufacture illegal drugs to the list of “precursor substances” under the Drug Act. Biologic Medications (Act 95 of 2016): Amends the Generic Equivalent Drug Law to provide for the substitution of an interchangeable biological product for a brand name biologic. Pharmacy Benefit Managers (Act 169 of 2016): Establishes a framework for pharmacy benefits managers and other entities to conduct audits within a pharmacy. ABC-MAP Changes (Act 79 of 2017): Amends the Achieving Better Care by Monitoring All Prescriptions Program to exempt prescribers from the requirement to query the database when non-narcotic Schedule V drugs are prescribed to treat epilepsy or a seizure disorder. Prescription Refills (Act 8 of 2018): Permits pharmacists to dispense emergency prescription refills for up to 30 days pursuant to certain restrictions and allows for refills of medications which are not dispensed or sold in 72-hour supplies. Electronic Prescription Requirements for Controlled Substances (Act 96 of 2018): Requires electronic prescriptions of a Schedule II, III and IV controlled substance, and establishes exceptions. Medication Synchronization (Act 46 of 2019): Allows patients to synchronize their medications in order to receive them on the same day each month, instead of having to make multiple visits to the pharmacy.