Gearing Up for a Busy Fall at the State Capitol – State Budget, Medical Marijuana, Liability Issues

State legislators will soon return to the Capitol, and we’re expecting a very busy legislative session during the next few months.

On Sept. 9, 2015, the Pennsylvania Medical Society (PAMED) held a media call-in to discuss some of the important health care-related issues on tap this fall.

As you can imagine, there’s a wealth of items on our fall agenda. Among the items discussed were the state budget, medical marijuana, liability protections for physicians, liability/negligence standard in the emergency department, credentialing, physician-led, team-based care, and telemedicine.

Over the next several days, we’ll dive deeper into these items.

First up: What’s up with the state budget? And, find out what Scot Chadwick, PAMED’s legislative counsel, says about several issues that are likely to see action this fall, including medical marijuana, liability protections for physicians, and the liability/negligence standard in the emergency department. The recordings of their talks during the media call-in also are available on our website.

State Budget
Mike Fraser, PhD, CAE, Executive Vice President of PAMED, and Larry Light, Senior Vice President of Physician Advocacy & Political Affairs at PAMED, talked about the items that PAMED is closely watching throughout the budget process, included funding for the controlled substances database, increased funding for residency slots and student loan forgiveness, and continued funding for chronic care programs, research, and preventive health, among others.

Medical Marijuana
In May 2015, the state Senate passed a broad-ranging bill (Senate Bill 3) to legalize medical marijuana in Pennsylvania and sent it to House. While there’s been no further formal action on the bill, there’s been a lot of behind-the-scenes work over the summer by a variety of stakeholders. We’re expecting the House to consider some sort of work product this fall, but it’s too premature to speculate what that might be.

PAMED opposes this legislation. However, it’s important to note that “just saying we’re opposed may to a degree mischaracterize where we stand on the issue because to just say that we’re opposed infers or suggests that we think medical marijuana has no value,” said Chadwick. “Actually, we’d like it to have value and we hope that someday it’s demonstrated that it does. Physicians are healers and they’d very much love to have powerful new medicines in their arsenal. However, until very fundamental questions of safety and efficacy can be answered through the FDA approval process, we think legalization is premature, and that’s why we oppose legalization at this point.”

Liability Protection for Physicians
There are a number of free clinics around the state, but the lack of immunity for physicians who volunteer is often a barrier to them volunteering their time to provide services at these clinics.

“Recruiting physicians to volunteer at those clinics would not be that difficult but for the fact that in many cases they don’t have liability protections,” Chadwick said. “They volunteer their services for free but they could conceivably be sued for services they provide in those free clinics.”

Chadwick said that under the Federal Tort Claims Act there are some clinics at which physicians do have liability protection, but in order for them to have that protection they have to work at a federally qualified health center (FQHC), and those clinics require federal approval, which is often a burdensome process.

Rep. Warren Kampf recently introduced House Bill 1483, strongly supported by PAMED, which would give the state the opportunity to create a second pathway for clinics that are not FQHCs to grant that immunity protection and make it easier for physicians to donate their time at these clinics to serve the poor and underserved.

Improving access to care is another continued priority for PAMED.

Liability/Negligence Standard in the Emergency Department
Providers in an emergency setting must make immediate lifesaving decisions without the benefit of a prior relationship to the patient and often without any knowledge of the patient’s medical history

Among PAMED’s medical liability reform priorities is House bill 1064 – legislation that would raise the standard of negligence for emergency room providers from simple negligence to gross negligence and require that the negligence be required by clear and convincing evidence.

Part 2 will cover PAMED’s efforts related to streamlining the credentialing process and promoting physician-led team-based care in Pennsylvania