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Bill Summary

IMPROVING HEALTH CARE ACCESS

Community-Based Health Care Program - Senate Bill 5 (Senator Ted Erickson)

Establishes a program under which the Department of Health will provide grants to community-based health care clinics that provide "medical homes" for the uninsured.  The program will be funded in part through an EITC-type credit for businesses which would receive tax credits for supporting community clinics.

Approximately $50 million would be allocated to expand services to 175,000 new patients to provide integrated care to uninsured low-income individuals.

Community-based health care clinics provide the uninsured with a medical home that emphasizes a partnership among the patient, physician, nurses, and clinic staff. These health clinics become the place where patients are known, recognized, supported, and where they find a centralized base for medical care and connection to other medical and supportive community services.

Many health clinics embrace this comprehensive approach to health care and share a commitment to the community as well as ensuring quality care for the underserved.

Health clinics provide high-quality and cost-effective health care regardless of patients' insurance status or ability to pay.  They also help to reduce the use of costly hospital emergency visits, and avoidable hospital admissions. 

Specialty Physicians Network - Senate Bill 314 (Senator Mike Brubaker)

Creates a physician, hospital and ancillary partner volunteer program, known as Project Access, through which an additional 159,000 uninsured patients would be assigned to a primary or specialty care physician, with access to free specialty care, labs and inpatient hospital care. The program would be administered by the Department of Health, and funded at $4 million.

The physician volunteer program, modeled after the national Project Access model, would provide a system of healthcare for low income uninsured patients in a particular region that uses an organized physician volunteer component to leverage alignment of existing healthcare and related resources in the community.

Participating physicians, hospitals, or other partners who sign up would determine their level of participation by agreeing to donate their services to see a set number of patients per year.  The average caseload would be 10 – 20 patients per group.

Patients would be required to utilize all current resources (Medical Assistance, Medication Plans, etc.) prior to enrollment in the program. 

Continuing Medical Education Credits - Senate Bill 464 (Senator Pat Browne)

Provides continuing education credits for health care providers who volunteer at health clinics and in their communities for uninsured and low-income residents.  Health care providers would include doctors, nurses, nurse practitioners, physician assistants and dentists. 

Physician Loan Forgiveness Program - Senate Bill 527 (Senator Ted Erickson)

Establishes a Physician Loan Forgiveness Program in the Pennsylvania Higher Education Assistance Agency to increase efforts aimed at the recruitment and retention of physicians in the Commonwealth.

$10 million annually has been designated for the program.  Physicians must practice in Pennsylvania for at least seven years to be eligible for up to $75,000 of loan forgiveness. This will assist up to 1500 new doctors and dentists to stay in PA.

Full and part-time medical and osteopathic doctors as well as dentists are eligible for loans.  The program is based upon a loan repayment of 10% in the first year of medical service and 15% per year for the following six years. 

Preference for acceptance into the loan forgiveness program will be given to those physicians who have completed their training in the Commonwealth and agree to practice in a medically underserved area or in a primary care health professional shortage area.

Low-Cost Prescription Drugs - Senate Bill 603 (Senator Pat Vance)

Eliminates predatory pricing provisions to allow for the sale of low-cost prescription drugs at retail establishment pharmacies. 

This would permit a pharmacy to sell certain prescription drugs for a minimal amount such as $4.  Only 9 states currently do not permit prescriptions to be sold below cost. 

Free Drug Registry Program - Senate Bill 335 (Senate Chuck McIlhinney)

Creates an internet program in the Department of Health to assist low-income uninsured individuals in accessing prescription assistance programs.  Staff would assist persons with completion of the applications and required documentation for submission. This would apply to long-term medications.

In addition, the State Board of Pharmacy would create a drug registry of free and low-cost pharmaceuticals donated by drug manufacturers and pharmacies and made available in the Commonwealth for dispensing by physicians and clinics to low-income, uninsured patients.

$1 million would be designated for funding these programs.

Cancer Drug Repository - Act 14 of 2008

Establishes a cancer drug repository in Pennsylvania to help uninsured patients and those in need gain access to safe, unused cancer medications. Cancer patients who are uninsured or underinsured can now access these medications through a network of participating pharmacies and medical clinics.

Under this new law, only medications maintained by a health care facility are currently able to be donated to a participating health care facility, medical clinic or pharmacy. Only medications in their original, sealed, and tamper-resistant packaging can be accepted and dispensed.

Donations must also be accompanied by a cancer drug repository donor form that is signed by the donor or that person's authorized representative. Medication used for pain, anxiety, and sleep cannot be donated according to federal law. 

MAKING HEALTH CARE MORE AFFORDABLE 

Electronic Medical Records - Senate Bill 700 (Senator Rob Wonderling)

Creates the Medical Safety Automation Fund (M-SAF) Act, which would provide grants to health care providers and regional health information organizations to implement medical safety automation systems.  This would be funded with $10 million that would assist and enable hospital and physician office conversion to the use of electronic medical records, including incentives for the use of evidence-based diagnosis and treatment protocols.

Telemedicine Expansion - Senate Bill 467 (Senator John Pippy)

Creates the Telemedicine Act to permit physicians licensed in another jurisdiction to receive medical data and radiology images for a patient located in Pennsylvania for purposes of interpreting the data to consult, diagnose or treat that patient.

Nonpayment for Medical Errors - Senate Bill 443 (Senator Don White)

Permits health insurers to withhold payment to providers in the event of a preventable serious adverse event.  A preventable serious adverse event is described as a negative consequence of care that results in unintended injury or illness that could have been anticipated and prepared for, but that occurs because of an error and results in the patient's death, loss of a body part, disability, or loss of bodily function.

Healthy Living Discounts - Senate Bill 526 (Senator Ted Erickson)

Allows employers to establish a "Healthy Living Committee" (HLC) to help employees live longer and healthier lives; promote health and wellness; and reduce premium costs. The Insurance Department would establish qualifications and certify HLCs.  Group health insurers would provide a 5 percent discount on premium rates to employers with HLCs.

Reducing Health Care-Associated Infections - Budget Item

Provides $10 million to fund electronic surveillance systems designed to eliminate the occurrence of health-care associated infections, as outlined in Act 52 of 2007. Requires hospitals, nursing homes and ambulatory surgical facilities to implement internal infection control plans that will improve the health and safety of patients and healthcare workers.

EXPANDING COVERAGE

Mini-Cobra Coverage for Employers with 2 to 19 Employees - Senate Bill 442 (Senator Don White)

Extends continuation of a group health insurance policy for former employees and their dependents who are no longer eligible for the small group policy. This will make this option available to approximately 150,000 individuals who work for employers with 2 to 19 employees and who change jobs.

Extending the Insurance Option for Adult Dependent Children - Senate Bill 189 (Senator Jake Corman)

Offers parents the option to purchase insurance coverage for dependent individuals up to the age of 30. At the option of the policyholder, coverage could be extended to dependent individuals who are not married, have no dependents, are residents of the Commonwealth or enrolled as a full-time student at an institution of higher education, and are not provided insurance coverage or eligible for government benefits. Insurers would be able to determine increases in the premium to cover this additional benefit. This would apply to new contracts and contract renewals 90 days after the immediate effective date of this act. Having such an option could assist approximately 15,000 young adults. Nearly half of uninsured Pennsylvanians are age 18 to 34.

High-Risk Insurance Pools - Senate Bill 507 (Senator Mike Folmer)

Creates a High-Risk Pool as an alternative for individuals with severe health conditions to obtain affordable health insurance. Establishes a governing board to be appointed by the Governor and General Assembly, which would include insurers, health care experts, the business community, and members of the general public.  Requires the Pennsylvania Health Insurance Pool (PHIP) Board to hire an administering insurer - through competitive bid - to manage the pool.

Allows an individual (and their dependents) who are not otherwise eligible for Medicaid or other government programs to participate in PHIP if they have been refused coverage from at least two health insurers or have been offered coverage from at least two health insurers at rates higher than that offered by PHIP.  Directs the Insurance Department to annually determine an individual standard rate for health insurance premiums in the Commonwealth.  Caps individual premiums at a maximum of 150 percent of the individual standard rate. Allocates $10 million annually to PHIP to fund the cost of coverage beyond the individual premium. Any excess funds would be held in escrow to offset future premium costs. Directs PHIP to offer various benefit plans that include a 'mandate free' policy as well as a high deductible policy compatible with Health Savings Accounts.  It is estimated that a high risk pools could assist approximately 8000 individuals.

Small Business Health Plans - Senate Bill 686 (Senator Lisa Baker)

Permits a group of two or more small businesses with fewer than 50 employees to join together for the purpose of negotiating lower group health insurance rates.  Currently in Pennsylvania, groups of employers are not permitted to pool together solely for insurance purposes.

State Tax Credits for Health Savings Accounts - Senate Bill 506 (Senator Mike Folmer)

Provides $5 million in state tax credits for small businesses that contribute to employee Heath Savings Accounts.   HSAs are similar to 401(k) retirement plans, but rather than allowing people to save for future retirement expenses, they allow people to save for future medical expenses.

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