09-29-2015

Pennsylvania Issues

• H.B. 883: Exemptions for Immunizations: The Commonwealth of Pennsylvania allows for medical, religious and philosophical exemptions to vaccinations for school age children. Pennsylvania is one of only 20 states offering a philosophical exception and is one of the top five states with children not vaccinated for measles, mumps and rubella. The state approved 3,300 philosophical exceptions during the 2013-2014 school year, and, as a result, the state’s overall kindergarten immunization rate dropped to 87%. On April 6, 2015, State Representatives Becky Corbin (R-Chester) and Michael Schlossberg (DLehigh) introduced legislation that would eliminate the philosophical exemption, which is the most commonly requested exemption in Pennsylvania. Representative Schlossberg decided to introduce the bill following the recent nationwide measles outbreak that sickened more than 100 people. Representatives Robert Freeman (D-Northampton), Steve Samuelson (D-Northampton), Dan McNeill (D-Lehigh, Northampton) and Peter Schweyer (D-Lehigh) serve as co-sponsors of the bill, which has been assigned to the House Health Committee. The Hospital & Healthsystem Association of Pennsylvania (HAP) and the Pennsylvania Medical Society (PMS) support the bill. Dr. Jennifer Janco, Chief of Pediatrics for St. Luke’s University Health Network, recently participated in a television interview with Representative Schlossberg to discuss the benefits of vaccinations and to support passage of the bill. Opponents to the bill argue that certain vaccines are unsafe for some children and that the philosophical exemption is needed to protect parental and civil rights.


• H.B. 1233: Patient Test Result Information Act. On May 18, 2015, Representative Marguerite Quinn (R-Bucks) reintroduced legislation requiring that significantly abnormal diagnostic test results be sent directly to patients by the entity performing the service within 20 days after the results are sent to the ordering physician. The PMS and the Pennsylvania Radiological Society oppose the bill, since they believe that test results are best delivered by the ordering physician who can explain and discuss the results. The groups also object to government interfering with the relationship between a physician and a patient. Representative McNeill serves as a co-sponsor of the bill, which has been assigned to the House Health Committee. During the prior legislative session, the bill was passed unanimously by the House of Representatives, but it was not considered by the Senate before the session concluded.

• Legislative Visit On May 27, 2015, State Representative Craig Staats (R-Bucks) toured St. Luke’s Hospital – Quakertown Campus and met with John Sylvia and Jane George to discuss issues relevant to the district. Representative Staats is serving his first term in office. He succeeds Representative Paul Clymer, who served the district for over 34 years. Representative Staats serves as a member of the House Committees on Aging & Older Adult Services, Commerce, Education and Human Services.


• Three-Dimensional Mammography: Three-dimensional mammography, also known as tomosynthesis, was approved in the United States in 2011 for use in combination with standard twodimensional imaging. Research has demonstrated that the technology increases breast cancer detection while reducing false alarms. On October 5, 2015, Governor Wolf (D) announced a new policy requiring that insurers must cover all screening mammograms, including three-dimensional mammography, at no out-of-pocket cost to consumers, effective January 1, 2016. On October 16, 2015, St. Luke’s University Health Network announced that it would waive any additional fees charged for three-dimensional mammograms, effective immediately. St. Luke’s installed a low-dose three-dimensional mammography unit within a sensory suite at St. Luke’s West End Medical Center in Allentown earlier this year. A three-dimensional mammography unit was also installed at St. Luke’s Upper Perkiomen Outpatient Health Center in Pennsburg earlier this month.

New Jersey Issues

• OMNIA Health Alliance: On September 10, 2015, Horizon Blue Cross Blue Shield of New Jersey (Horizon), New Jersey’s largest health insurer, announced that it would offer tiered insurance policies to consumers through the formation of the OMNIA Health Alliance. Beginning in 2016, OMNIA Health Alliance will offer lower premiums, deductibles and co-pays for care provided at 34 selected Tier 1 health systems. St. Luke’s Hospital – Warren Campus (SLW) is one of 13 hospitals or health systems not included within the Tier 1 provider network. On October 5, 2015, the State Senate Commerce and Health, Human Services Committee and the State Senior Citizens Committee held a special joint hearing to investigate the criteria used to develop the health alliance and its impact to non-Tier 1 providers. Representatives from Horizon defended the OMNIA Health Alliance selection process by claiming that six broad categories were used to identify providers with a demonstrated commitment to population health management. Horizon representatives testified that only about 250,000 of its 3.8 million customers are expected to subscribe to the tiered plan. Critics of the OMNIA Health Alliance, including certain State Senators without Tier 1 providers in their districts, criticized Horizon and the selection process. These opponents argued that Horizon was unfairly manipulating the health care market. Senate Commerce Chair Nia Gill (D-Essex, Passaic) and Senate Health Chair Joseph Vitale (D-Middlesex) asked the New Jersey Attorney General’s Office to investigate whether Horizon violated anti-trust and false advertising laws in developing the proposed health plan.

Federal Issues

• Radiologist Assistants: Advanced practice radiologic technologists, known as Radiologist Assistants (RAs), work under the supervision of a radiologist. The primary role of RAs is to enhance patient care by assisting radiologists with patient assessment, patient management and radiological procedures. While they do not prescribe medications or therapies, or diagnose or interpret medical images, RAs perform certain procedures and patient assessments that increase patient access to critical radiology services. The Centers for Medicare & Medicaid Services (CMS) does not reimburse providers for procedures performed by RAs. However, several members of Congress are drafting a bill for consideration during the 114th Congress which would require CMS to pay for these services. On September 1, 2015, Carol McGee, Interventional Radiology Supervisor at St. Luke’s, and Jane George met with staff members from the office of Senator Pat Toomey (R-PA) to request the Senator’s support for the proposed legislation. Similar advocacy efforts occurred with Senator Bob Casey (D-PA). Both offices agreed to review and consider the request.

• House Speaker: On September 25, 2015, House Speaker John Boehner (R-8-OH) announced that he would resign from Congress and relinquish his position as Speaker of the House. The Speaker of the House serves as the presiding officer and the leader of the majority political party in the chamber. The Speaker of the House is also second in succession for the Presidency, following the Vice President. On October 22, 2015, Congressman Paul Ryan (R-1-WI) announced his candidacy for the position. Congressman Ryan currently serves as the Chair of the House Ways and Means Committee and was the Republican nominee for Vice President in the 2012 election. The vote for the next Speaker will be held on October 29, 2015. A candidate needs 218 votes to win the election.