State Advocacy for Family Medicine
PAFP 2023-24 State Legislative Agenda
The PAFP advocates on state government matters of importance on behalf of our members and the patients they serve.
Download the PAFP 2023-24 State Legislative Agenda
Administrative Burden Reform
Act 146 of 2022,
supported by the PAFP, represents the Commonwealth’s most meaningful health
insurance reform measure in more than two decades. While this was a crucial
step toward bringing transparency and consistency to the prior authorization
process, there is still work to be done to ensure timely patient care. Other
administrative hurdles, such as credentialing processes imposed on physicians
by health insurance providers, take physician time away from patients, delaying
access to quality health care. The PAFP supports legislation that would streamline
health insurer credentialing processes and address other administrative hurdles
to ensure timelier patient care.
Scope of Practice
Expansion
Health care providers, such as Certified
Registered Nurse Practitioners (CRNPs) and Physician Assistants (PAs), are
integral, valuable members of the health care team, held in the highest regard
by family physicians. However, patients are best served when a physician-led,
highly coordinated team provides care. During the 2021-22 session, the PAFP
supported legislation allowing pharmacists to administer influenza and COVID
vaccinations to children ages 5 and above; however, medications, biologics, routine
childhood immunizations, and diagnostic tests should be prescribed and
administered by a member of the patient’s physician-led health care team to
ensure proper diagnosis and treatment. The PAFP opposes legislation that would
expand non-physician providers’ scope of practice beyond their education and
training, eliminate collaborative agreements with physicians, and allow
pharmacists to conduct diagnostic testing and administer routine childhood
immunizations.
Family Physician Workforce
Development
The PAFP, through a grant from the Pennsylvania Department
of Health, administers the Family Medicine Residency Expansion program, which
seeks to generate family physician residency graduates for the state’s primary
care workforce. As part of the 2022-23 fiscal year budget, the program received
an increase to further expand its impact on communities across the
Commonwealth. A PAFP-supported study in 2021 by the Joint State Government
Committee on the efforts of Pennsylvania’s medical schools to promote family
medicine called for greater investment in and expansion of the state’s
existing primary care pipeline programs, which aligns with the PAFP’s work to
advance the specialty of family medicine within the Commonwealth. The
PAFP further supports policies, such as eliminating non-compete clauses in
physician employment contracts, that would help expand the Commonwealth’s
primary care physician workforce and increase access to family physicians for
all Pennsylvanians.
Telemedicine Services
and Reimbursement
Telemedicine has become an increasingly common form of
health care, especially given the recent COVID-19 pandemic; however,
reimbursement rates for telemedicine services continue to fall short of those
for in-person health care visits. The PAFP supports legislation enabling parity
with in-person visits in the service of and payment for telehealth care.
Specifically, the PAFP encourages the inclusion of the following provisions in
any telemedicine policy: requires scope of practice and payment parity for all
telehealth services on par with in-person office visits; requires reimbursement
for telehealth audio-only visits at parity with in-person office visits;
ensures that primary care telehealth services be conducted within the context
of an existing, comprehensive primary care relationship; does not contain carve
outs for the prescription of certain medications or treatment, including
buprenorphine and opioids; permits interstate licensing for the practice of
telemedicine; and standardizes home and work settings as eligible sites of
service across all insurance providers to decrease regulatory burden of all
telehealth services and provide high quality, safe and timely patient care.
Access to Health
Care for all Pennsylvanians
The PAFP
recognizes the varying personal, religious, and moral beliefs of our members
and the scope of health care services they choose to provide. The PAFP supports
the evidence-based practice of medicine and access to safe, medically-sound
health care services, including reproductive and maternity health services, for
all Pennsylvanians. Additionally, the PAFP opposes the criminalization of
evidence-based medicine; government infringement on the confidential
relationship between physicians and their patients; legislation that regulates
the content or scope of information exchanged between a patient and physician;
and legislative limitations on patient autonomy in making decisions about their
health care.
Prescribing and
Treatment Mandates for Opioid Use Disorder
Given the ongoing opioid crisis in Pennsylvania, access to care for
patients suffering from substance use disorder is more critical than ever.
State regulations that would place additional barriers on providers already
federally approved to prescribe buprenorphine for Medically Assisted Treatment
(MAT) for opioid use disorder could jeopardize patient access to office-based
opioid treatment. The PAFP opposes legislation that would create additional
hurdles at the state level for prescribers of buprenorphine and other MAT
options who have already been approved to prescribe such medications by the
federal Drug Enforcement Agency.
Primary Care Spending and Alternative Health Care
Payment Models
Evidence shows
that high quality, accessible primary care helps keep populations healthier
longer and lowers the overall costs of health care. Yet, Pennsylvania lags
behind other states in investing in primary care services. The PAFP supports
measures that prioritize shifting more health care dollars to primary care,
strengthening the Commonwealth’s health care infrastructure. Additionally, the
PAFP supports alternative health care practice and payment models, such as Direct
primary care (DPC) and value-based payment, to increase access to quality,
affordable primary health care and improve population health.
Prescription Drug
Costs and Transparency
The PAFP supports legislation that
would ensure the availability of effective, safe, and affordable medications
through governmental authority to promote competition and availability,
transparency, patient-centric pricing, drug price negotiation and review.
Public Health and
Health in All Policies
The PAFP supports legislation and policies that would help ensure the
increased health, safety, and quality of life of all Pennsylvanians through
collaboration with state agencies, the Pennsylvania General Assembly, and the
Administration. Health in All Policies (HiAP) is a collaborative
approach that integrates health considerations into policymaking across state
government to improve the health of all communities and people. The PAFP
supports the adoption of a HiAP strategy to
help address social determinants of health and health disparities and assist
the Commonwealth in developing the most effective and achievable means
for improving the health and well-being of all Pennsylvanians.
PAFP’s State Legislative Agenda is crafted through the Government and Practice Advocacy Committee with position decisions made by the Board of Directors.
Questions/Comments? Please contact Jennifer Reis, Chief Government Affairs Officer at jreis@pafp.com.
GOVERNMENT & PRACTICE ADVOCACY COMMITTEE
This committee guides our policy positions on health care legislation and regulations. PAFP members interested in joining, please visit our PAFP Leadership page.
GRASSROOTS ADVOCACY: TIPS & GUIDELINES
One of the ways primary care professionals can effect change is to personally engage those individuals who write and pass legislation on the state level. Physicians and medical students are well-respected members of the community and having their voices heard makes a difference. The PAFP has put together a brief primer to help you get involved.
