Government Relations Update – March 20, 2012

Pennsylvania Issues

Legislation

S.B. 8: Pennsylvania Health Information Technology Act. On February 13, 2012, Senator Mike Folmer (R- Berks, Chester, Dauphin, Lancaster, Lebanon) introduced legislation to establish the Pennsylvania Health Information Partnership Authority. As proposed by the bill, the Authority would be responsible for developing a sustainable health information exchange for sharing electronic health records and patient information throughout the commonwealth. The Authority would consist of 19 members appointed by the Governor and House and Senate leaders and would be authorized to use the $17 million in federal stimulus funds provided by the American Recovery and Reinvestment Act of 2009 (ARRA) to create the health information exchange. Senator Lisa Boscola (D-Lehigh, Monroe, Northampton) serves as a co-sponsor of the legislation. The Hospital Association of Pennsylvania (HAP) supports the bill, which has been assigned to the Senate Communications and Technology Committee. A committee vote on the bill is expected to occur on March 28, 2012.

H.B. 1400: Primary Stroke Designation Act. On May 24, 2011, Representative Douglas Reichley (R-Berks, Lehigh) introduced legislation directing the Department of Health to designate Primary Stroke Centers (PSCs) for the care and treatment of stroke patients. Pursuant to the bill, emergency medical service providers would be required to transport stroke patients to the closest PSC. Opponents of the bill argue that stroke patients need immediate care by the nearest acute care hospital regardless of designation. On October 31, 2011, the House unanimously passed the bill. On March 14, 2012, the Senate Health & Welfare Committee, which includes Senator Bob Mensch (R-Bucks, Lehigh, Montgomery, Northampton), approved the bill, which will be sent to the Senate for consideration. HAP and the American Heart Association support the bill. St. Luke’s Hospital – Allentown Campus and St. Luke’s University Hospital – Bethlehem Campus were certified as PSCs by the Joint Commission in 2007.

Miscellaneous

Pennsylvania Primary Election: The Pennsylvania Primary election will be held on April 24, 2012. Voters will select party candidates for President, United States Congress and several statewide and local races. A special election between Republican Ryan Mackenzie and Democrat Patrick Slattery will be held on the same date to determine who will serve the remainder of the year in the vacant 134th House District seat. Former Representative Doug Reichley vacated the 134th House District seat when he was elected to the Lehigh County Court of Common Pleas in November 2011. Mr. Mackenzie is a former policy director at the Pennsylvania Department of Labor and Industry. Mr. Slattery is the Director of Business Development for KidsPeace. The 134th House District includes the townships of Lower Macungie, Salisbury, South Whitehall, and Upper Macungie and the boroughs of Alburtis, Emmaus and Macungie. Several St. Luke’s Physician Group practice sites are located in the 134th House District.

New Jersey Issues

Advocacy

Physician Orders for Life-Sustaining Treatment (POLST): POLST programs are designed to create a standardized form for end-of-life health care decisions and are in development in about 30 states throughout the country, including Pennsylvania. POLST differs from an advance directive and a healthcare proxy, because it serves as an actual order from the physician in the patient’s record. POLST can direct care delivered in an ambulance, at a hospital, in a nursing home and in a hospice setting. On February 13, 2012, Governor Christie signed into law legislation creating New Jersey’s POLST program under the leadership of New Jersey Health Commissioner Mary E. O’Dowd. The New Jersey Institute for Quality and Patient Safety at the New Jersey Hospital Association is in the process of developing the POLST form for New Jersey and has been charged with educating health care professionals about its use.

Hospital Charity Care Payments: The State of New Jersey subsidizes hospitals treating uninsured and underinsured patients based on budgeted amounts authorized to be expended through the New Jersey Hospital Relief Subsidy Fund and an associated charity care funding formula. On March 5, 2012, the Christie Administration announced that the aggregate funding would not be reduced during the next fiscal year, although the formula to determine individual hospital payments would be refined. While some New Jersey hospitals will experience a significant reduction in state charity care funding, St. Luke’s Hospital – Warren Campus will experience a $5,565 annual increase, from $1,126,408 in the current fiscal year to $1,131,973 for the next fiscal year.

Federal Issues

Advocacy

Patient Protection and Affordable Care Act: The United State Supreme Court will hear arguments regarding the Patient Protection and Affordable Care Act (PPACA) over a three-day span commencing on March 26, 2012. One hour of argument will be devoted to the question of whether the court is permitted to rule on the constitutionality of PPACA prior to the effectiveness in 2014 of the individual mandate requiring the purchase of health insurance. Two hours are scheduled to consider the constitutionality of the individual mandate. Additional arguments are scheduled to determine whether the remainder of PPACA can be upheld if the individual mandate is stricken. The highly unusual schedule confirms the widely held expectation that the court will issue a ruling this summer during the height of the 2012 presidential campaign.

Health Insurance Exchanges: On March 12, 2012, the United State Department of Health and Human Services (HHS) released its interim final rule to establish state health insurance exchanges under PPACA by January 1, 2014. The exchanges are state-based health insurance markets intended to allow individuals and small employers to compare available private health insurance options on the basis of price, quality and other factors. The interim final rule: (1) establishes the minimum federal standards that states must meet if they elect to establish and operate an exchange, including individual and employer eligibility requirements for enrollment; and (2) outlines minimum standards health insurers must meet to participate in an exchange, including requirements for qualified health plans (QHPs). The final rule provides some flexibility by allowing individual states to determine whether an exchange should be operated by a non-profit organization or a public agency, whether to participate in a regional exchange or a separate state exchange, how to select participating plans, and whether to partner with HHS for certain exchange functions.

Miscellaneous

Congressman Holden Visit: On March 13, 2012, Congressman Tim Holden (PA-17-D) toured St. Luke’s Hospital – Anderson Campus with Rick Anderson, Ed Nawrocki, Dr. Justin Psaila, Darla Frack, Micah Gursky and Jane George. When PPACA was passed on March 23, 2010, Congressman Holden was one of only 34 Democrats who voted against it. During the tour, Congressman Holden explained that he voted against PPACA because it will reduce Medicare and Medicaid funding by more than $500 billion over 10 years, severely disrupt rural hospitals and nursing homes, and lead to taxes on private health care plans.

Congressman Holden also discussed his recent support for extending the current Medicare physician fee schedule until December 31, 2012. If Congress had failed to extend the Medicare physician fee schedule, St. Luke’s Physicians Group would have experienced an annual payment reduction of about $7.4 million.

St. Luke’s Hospital - Miners Campus is within Congressman Holden’s district, which now also includes St. Luke’s Hospital – Anderson Campus and St. Luke’s Wind Gap Medical Center as a result of the 2011 redistricting process.