Post Session Report :: Tuesday, July 9, 2024

SB 698, PN 1808 (Robinson) – This bill amends Title 34 (Game) to require the PA Game Commission to issue Military Event License Exemptions and Permits to provide for armed services veterans and disabled veterans’ rehabilitation and/or eligible event. A vote of 49-0 was recorded.

HB 1032, PN 3415 (Fiedler) – An Act establishing the Solar for Schools Grant Program; and providing for powers and duties of the Department of Community and Economic Development.

Amendment A05418 (Laughlin) – This amendment provides that:

1. DCED shall develop a financial risk and savings report for use by eligible applicants. This report shall be updated periodically to track project costs; energy and cost savings; solar credit sales; and operations and maintenance costs.
2. An approved applicant shall use the contracting procedure under either the Separations Act or the Guaranteed Energy Savings Act for any grant received, provided that if an applicant uses the Guaranteed Energy Savings Act contracting procedure the project shall be exempt from the Separations Act requirements.
3. In the event of the sale, transfer or conveyance of a school facility having received a solar grant, the new owner shall reimburse DCED

• 80% of the grant amount for any grant awarded less than 5 years;
• 60% of the grant amount if awarded more than 5 but less than 10 years;
• 40% if between 10 and 15 years;
• 20 if between 15 and 20 years

The amendment passed by a vote of 44-5 and the bill was re-referred to the Appropriations Committee.

SB 1232, PN 1809 (Pennycuick) – The bill requires direct deposit for workers compensation payments.

Amendment A5501 (Pittman) – The amendment would amend the Bill, page 4, line 28, by striking out “under section 307”

The amendment was agreed to by a voice vote and the bill went over in its order as amended.

SB 1242, PN 1701 (J. Ward) – This bill amends Title 63 (Professional and Occupations (State Licensed)) to provide for a continuing education tracking system. A vote of 46-3 was recorded.

HB 1466, PN 3487 (Bizzaro) – The bill creates the Uniform Public Expression Act by amending Title 42 (Judiciary and Judicial Procedure) to grant civil immunity based on protected public expression. A vote of 49-0 was recorded.

HB 1540, PN 2278 (Parker) – The bill changes the due date for the annual report of the Commission for Agricultural Education Excellence and addresses the way vacancies are filled.

Amendment A05463 (K. Ward) – The amendment establishes the new commission membership to begin October 1, 2024 and changes the membership and the process of appointment of the members of the commission.

The membership in the commission includes the Secretaries of Education and Agriculture and other appointed members.

The amendment specifies the new appointment method and members as follow:

2 members appointed by the Sec. of Education

• A school district teacher in career and technical agriculture
• A CTE teacher in career and technical agriculture

2 members appointed by the Sec. of Agriculture

• An agriculture marketing industry representative
• A higher education faculty of agricultural sciences

2 members appointed by the President pro temp

• A farmer
• An agriculture processing industry representative

2 members appointed by the Minority Leader of the Senate

• A school district occupational advisory committee member
• A member of the business community with agriculture education knowledge

2 members appointed by the Speaker of the House

• A farmer
• A PSU College of Agricultural Science faculty member

2 members appointed by the Minority Leader of the House

• A member of the business community with agriculture education knowledge
• An individual with a background in agricultural education

The amendment adds the new members shall draw lots to stagger the terms. The term is three years once the staggering is set.

If by October 1, 2024 any member hasn’t been appointed, the Sectaries of Education and Agriculture are required to jointly appoint a qualified individual to fill the vacancy.

The amendment was agreed to by a voice vote and the bill went over in its order as amended.

HB 2182, PN 3145 (Marshall) – This bill authorizes the use of green flashing or revolving lights on highway construction and maintenance vehicles. A vote of 49-0 was recorded.

HB 1993, PN 2833 (Benham) – The bill amends the Pharmacy Audit Integrity and Transparency Act to provide for the oversight of pharmacy benefit manager contracts in the Commonwealth.

Amendment A05498 (J.Ward) – This amendment is a gut and replace A05498 amends the Pharmacy Integrity and Transparency Act to as follows:

Changes the name to the Pharmacy Benefit Reform Act

Applies to any contract between a pharmacy or a PBM and a health insurer or a health benefit plan, or a contract between a pharmacy and a PBM on behalf of a health insurer or health benefit plan. Except for the Chapter 5- it does not apply to self-insured health benefit plan subject to ERISA or exempted from ERISA under section 4b.

• Defines the terms and phrases as applied within the act
• Authorizes PID to promulgate regulations as necessary to carry out the act
• Requires a PSAO to register with the Commonwealth
• States that the licensing fee may not exceed $10,000 for a PBM or auditing entity and not more than $500 for a PSAO

PBM Contract Provisions

A PBM registered in the Commonwealth may not:

• Reimburse a retail pharmacy an amount less than it reimburses a PBM affiliated retail pharmacy providing the same pharmacist services.
• Reimburse a federally qualified health center, health care facility or other entity participating in the 340B program, an amount lesser than similar entities not participating in the program.
• Authorize the PBM to unilaterally alter the terms of a participation contract beyond the terms and conditions of the original contract agreed to by PSAO or pharmacy with a PBM beyond the terms and conditions of the original contract agreed to by the pharmacy or PSAO with a PBM.
• Designate a prescription drug as a specialty drug or require prescription drug to be dispensed exclusively at specialty pharmacy unless it meets the criteria in section 103 of the act.
• Requires PBMs to pass through to the health benefit plans no less than 95% of any prescription drug manufacturer rebate obtained by the PBM on behalf of a health insurer client if the health benefit plan delegates negotiations of the rebate to the PBM.
• Requires PBM contracts to provide information to pharmacists, pharmacy or PSAO pertaining to the participation in the PBM’s network
• Prohibits patient steering, further they may not:
• Require a covered individual, as a condition of payment or reimbursement, to purchase pharmacist services, including, but not limited to, prescription drugs, exclusively through a mail-order pharmacy or PBM affiliate.
• Prohibit or limit a covered individual from selecting an in-network pharmacy or in-network pharmacist of the covered individual’s choice if that pharmacy or pharmacist meets and agrees to the terms and conditions, including reimbursements, in the PBM’s contract.
• Require a covered individual to use an a PBM-affiliated retail pharmacy.
• Transfer a covered individual’s prescriptions from an in-network pharmacy to another pharmacy unless requested by the covered individual.
• Use financial incentives, including, but not limited to, adjustments in cost sharing obligations of a covered individual, to the exclusive benefit of a PBM-affiliated retail pharmacy.
• Auto-enroll a covered individual in mail-order pharmacy services subject to exceptions
• A PBM, health benefit plan or health insurer may require a covered individual to use an approved specialty pharmacy operating in the PBM’s network.
• A PBM, health benefit plan or health insurer may auto-enroll a covered individual in mail order services for maintenance medication, provided it does not occur the first 90 days of a new maintenance medication and the individual has the ability to opt-out at any time.

Prohibits Clawbacks

A pharmacist, pharmacy intern, or technician may not charge a patient an amount for a covered prescription drug that exceeds the lesser of:

• The net reimbursement paid to the pharmacy for the prescription drug by the health benefit plan, health insurer or PBM contracting with a health benefit plan or health insurer.
• The amount an individual would pay for the prescription drug if the prescription drug were purchased without coverage under a health benefit plan.

A health benefit plan, health insurer or PBM contracting with a health benefit plan or health insurer, may not collect from the member any difference in cost sharing the member pays to the pharmacy and the member’s cost sharing defined in the members benefit plan.

Network Adequacy

PBM are required to establish reasonably adequate and accessible retail pharmacy network for the provision of prescription drugs under a health benefit plan that shall provide for convenient patient access to pharmacies within a reasonable distance from a patient’s residence in accordance with the following requirements:

• The network may not be limited to affiliated pharmacies only.
• The network shall meet or exceed the requirements of 42 CFR 423.120 a or a successor regulation. If a PBM fails to comply with the requirements, it shall not be considered a violation if the PBM contracts with all retail pharmacies within the network distance standards of the health benefit plan participants.

Beginning April 1, 2026, PBM shall file and annual report with the department describing the PBM network and the PBM network’s accessibility. The reports shall be posted on the department’s publicly accessible Internet website.

PBM Transparency Reporting

Provides for transparency reporting beginning on July 1, 2026, and annually thereafter, each licensed PBM shall submit a transparency report containing data from the prior calendar year to the department.

The transparency report shall contain the following information:

• The aggregate amount of all rebates that the PBM received from all pharmaceutical manufacturers for all health benefit plan and health insurer clients and for each health benefit plan or health insurer client.
• The aggregate administrative fees that the PBM received from all manufacturers for all health benefit plan and health insurer clients and for each health benefit plan or health insurer client.
• The aggregate retained rebates that the PBM received from all pharmaceutical manufacturers and did not pass through to health benefit plan or health insurer clients.
• The highest, lowest and mean aggregate retained rebate percentage for all health benefit plan or health insurer clients and for each health benefit plan or health insurer client.
• For a PBM that controls or is affiliated with a pharmacy, a description of any differences between what the PBM reimburses or charges affiliated and nonaffiliated pharmacies.

Within 60 days of receipt, the department shall publish the transparency report under this section on the department’s website in a form that does not disclose the name of the PBM, does not directly or indirectly disclose the identity of a specific health insurer client or present information in a manner that can be extrapolated to identify a specific health insurer client, foes not list the prices charged for specific drugs or classes of drugs or the amount of any rebates provided for specific drugs or classes of drugs.

Additionally, PID may, by regulation, direct PBMs to include additional categories for aggregated data from health benefit plan or health insurer clients in the annual transparency report submitted.

Provides for the confidentiality of the information submitted to PID in accordance with the transparency report shall be privileged and subject to the confidentiality provisions within the act,

PSAO Reporting

Requires a PSAO to provide the following information to PID for each pharmacy that iti has contracted pharmacy services:

• Changes in the PSAO’s ownership, including a parent company or subsidiary of the PSAO, no later than five days prior to the change in ownership of the PSAO, the parent company of a PSAO or a subsidiary of the PSAO.
• Whether the change in ownership includes a company or organization that provides pharmaceutical, prescription drug or device services.
• Whether the change in ownership includes a company that sells or manufacturers prescription drugs, biologics or medical devices.

Scope of Enforcement Authority

PID may investigate and enforce the provisions of the act only insofar as it relates to prescription drug coverage under a health insurance benefit.

Examination and Access to Records

The department may order a PBM, a health insurer and a PBM’s affiliates to produce records, books or other information as reasonably necessary to ascertain compliance with this act. The department may retain an expert as reasonably necessary to conduct an analysis of PBM business practices. The cost for the expert shall be paid by the PBM, within 30 days of PBM’s receipt of a bill for the services. This analysis includes impact of steering and spreadprivng cost of prescription drugs to consumers and pharmacy access. The impact to consumers by requiring a health benefit plan or PBM to reimburse a pharmacy utilizing the national average drug acquisition cost and a professional dispensing fee of 10.49. PID may examine or audit the books and records of a PBM, health insurer and a PBM’s affiliates to ascertain compliance with the act.

Review of Specialty Drugs

PID shall establish an efficient process by which a pharmacy may refer for designation of a drug as a specialty drug by a PBM that does not meet the criteria. No later than 60 days following the effective date of this subsection, PID shall publish guidance to effectuate the subsection including a list of prescription drugs classified as a specialty drug under MA- fee-for service. This list shall not be considered exclusive.

Penalties

Upon the determination, after notice and hearing, that this act has been violated, the commissioner may impose the following penalties:

• Suspension or revocation of the licensee’s license, authorization to operate or registration.
• Refusal to issue or renew a license, authorization to operate or registration.
• A cease and desist order.
• Order reimbursement to an insured, pharmacy or dispenser that has incurred a monetary loss as a result of a violation of this act.
• For each violation of this act that a licensee knew or reasonably should have known was a violation, a penalty of not more than $100,000, not to exceed an aggregate penalty of $1,000,000 in a single calendar year.
• For each violation of this act that a licensee did not know nor reasonably should have known was a violation, a penalty of not more than $50,000, not to exceed an aggregate penalty of $500,000 in a single calendar year.
• Additional remedies may be imposed under any other applicable law including the Unfair Insurance Practice

The administrative procedures shall be subject to Pa. C.S. Ch. 5 Subch. A practices and procedures of this Commonwealth and the party whom the penalties are assessed may appeal to Commonwealth Court.

Pharmacy Services- Scope of Practice

Defines the Practice of Pharmacy and outlines the provisions for the administration of injectable medications, biologicals and immunizations.

Requires the board of Pharmacy to establish by regulation practice guidelines pursuant to which pharmacists shall be authorized to administer injectable medications, biologicals and immunizations to persons 8 years of age and older and influence and COVID-19 injectables to persons 5 years of age and older. The guidelines shall include but not be limited to:

1. Satisfactory completion of an academic and practical curriculum approved by the board that includes the current guidelines and recommendations of the Centers for Disease Control and Prevention in the Public Health Service of the United States Department of Health and Human Services, the American Council on Pharmaceutical Education or a similar health authority or professional body and includes, but is not limited to, disease epidemiology, vaccine characteristics, injection technique, emergency response to adverse events and related topics.
2. Maintenance of a current cardiopulmonary resuscitation (CPR) certificate acceptable to the board.
3. That the administration of injectable medications, biologicals and immunizations be in accordance with a definitive set of treatment guidelines established by a physician and the Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices guidelines or another competent authority approved by the board.
4. That a minimum of two hours of the 30-hour requirement for continuing education for license renewal be dedicated to administering injectable medications, biologicals and immunizations.
5. For individuals under 18 years of age, that parental consent be obtained prior to administration.
6. Maintenance of a level of professional liability insurance coverage in the minimum amount of $1,000,000 per occurrence or claims made. Failure to maintain insurance coverage as required shall subject the licensees to disciplinary proceedings. The board shall accept as satisfactory evidence of insurance coverage any of the following:

• personally purchased liability insurance;
• professional liability insurance coverage
• provided by the individual licensee’s employer; or
• similar insurance coverage acceptable to the board.

7) Notification of the individual’s primary care provider, if known, within 48 hours of administration. Pharmacist authority shall not be delegated to any other individual except as provided under this act. A pharmacy intern who has completed a course of education and training which meets the requirements under this subsection and maintains liability insurance in the amounts specified under subsection may administer injectable medications, biologicals and immunizations, to individuals who are eight years of age or older and influenza and COVID-19 individuals five years of age or older only under the direct, immediate and personal supervision of a pharmacist holding the authority to administer them.

Report of administration- A supervising pharmacist shall report the administration of immunizations under this section to the immunization registry maintained by the Department of Health within 72 hours of immunization administration and to the individual’s primary care provider in accordance.

A pharmacist, pharmacy intern or pharmacist technician who administers an influenza or COVID-19 immunization to an individual under 18 years of age shall inform the parent or adult caregiver of the importance of a well-child visit with a pediatrician or other licensed primary care provider and refer the patient as appropriate.

Delegation of authority-A pharmacist who holds the authority to administer injectable medications, biologicals and immunizations may delegate the authority to administer: (1) Influenza and COVID-19 immunizations to a certified registered nurse practitioner, physician assistant, registered nurse or licensed practical nurse; or (2) COVID-19 immunizations that are authorized or that are licensed by the FDA to individuals 13 years of age or older or childhood influenza vaccinations that are recommended by the Advisory Committee on Immunization Practices to individuals 13 years of age or older to a pharmacy technician if:

(i) The pharmacy technician:

1. Until the board promulgates final regulations implementing registration of pharmacy technicians, holds a national certification from the Pharmacy Technician Certification Board or the National Healthcareer Association; or
2. After the board promulgates final regulations implementing registration of pharmacy technicians, is registered with the board.

(ii) The following conditions are met:

1. The supervising qualified pharmacist is providing direct, immediate and personal supervision to the qualified pharmacy technician who is administering the immunizations or vaccinations.
2. The qualified pharmacy technician has completed a practical training program that is approved by the Accreditation Council for Pharmacy Education and that includes hands-on injection technique and the recognition and treatment of emergency reactions to vaccines.
3. The qualified pharmacy technician has a current certificate in basic cardiopulmonary resuscitation.
4. The qualified pharmacy technician has obtained liability insurance as required under subsection (a)(6) through the qualified pharmacy technician’s employer.
5. Administration of a COVID-19 immunization or childhood influenza vaccinations shall be in keeping with the requirements under subsection (a)(3).

Section 1003. Clinical laboratory certificate.

(a) Certificate – If a pharmacy holds a valid certificate of waiver issued by the Centers for Medicare and Medicaid Services, a pharmacy or pharmacist may order and perform laboratory

examinations and procedures for COVID-19, influenza, respiratory syncytial virus and streptococcal infections authorized or approved by the United States Food and Drug Administration under the Clinical Laboratory Improvement Amendments of 1988 and shall be exempt from the requirements under section 3 of The Clinical Laboratory Act.

A pharmacist may designate the administration of a test under subsection (a) to a pharmacy intern or pharmacy technician if the designation by the pharmacist to a pharmacy intern or pharmacy technician and the administration of the test is in keeping with nationally recognized clinical practice guidelines that have not been disapproved by the Department of Health through transmission to LRB for publication in the next available issue of the Pennsylvania Bulletin.

Report on Pharmacy-Administered Vaccines

(a) Report–The Department of Health shall, in consultation with the board, report to the President pro tempore of the Senate, the Majority Leader and the Minority Leader of the Senate, the Speaker of the House of Representatives and the Majority Leader and the Minority Leader of the House of Representatives information concerning pharmacist activities authorized under this chapter, including:

• The number of injectable medications, biologicals and immunizations administered to individuals under 18 years of age broken down by age.
• The number of injectable medications, biologicals and immunizations administered to individuals under 18 years of age broken down by type of injectable medications, biologicals and immunizations.
• Subject to information being made available, an assessment on whether there is a change in the number of well visits for children with their primary pediatric care provider attributable pharmacist services authorized under this chapter
• Beginning from the effective date of this section, changes in the pharmacy immunization rates for individuals under 18 years of age.

(b) DOH shall review data available for injectable medications, biologicals and immunizations administered by a pharmacist, pharmacy intern or technician in this Commonwealth. The Department of Health shall also review data available from other state governments which have authorized pharmacists to provide similar pharmacy services as authorized under this chapter.

(c) DOH shall report its findings no later than five years following the effective date of this subsection and include recommendations for changes in the laws of this Commonwealth.

(d) Upon completion of the report and transmission of the report under, DOH shall publish the report on its website.

Repeals

Repeals the following:

The General Assembly declares that the repeal under

paragraph the following repeals are necessary to effectuate the addition of section 1002 of the act.

• Sections 9.2 and 9.5 of the Pharmacy Act, are repealed.

The addition of section 1002 of the act is a continuation of sections 9.2 and 9.5 of the Pharmacy Act. Except as otherwise provided in section 1002 of the act, all activities initiated under sections 9.2 and 9.5 of the Pharmacy Act shall continue and remain in full force and effect and may be completed under section 1002 of the act. Orders, regulations, rules and decisions which were made under sections 9.2 and 9.5 of the Pharmacy Act and which are in effect on the effective date of section 12(2) of this act shall remain in full force and effect until revoked, vacated or modified under section 1002 of the act. Contracts, obligations and collective bargaining agreements entered into under sections 9.2 and 9.5 of the Pharmacy Act are not affected nor impaired by the repeal of sections 9.2 and 9.5 of the Pharmacy Act.

Applicability

(1) The addition of Chapter 6 and section 703.1 of the act shall apply to a contract issued, renewed or amended after the effective date of this section.

(2) The following shall apply:

• For a health insurance policy for which either
• rates or forms are required to be filed with the Federal
• Government or the Insurance Department, this act shall apply to the health insurance policy for which a form or rate is first approved on or after the effective date of this paragraph.
• For a health insurance policy for which neither rates nor forms are required to be filed with the Federal Government or the Insurance Department, this act shall apply to the health insurance policy issued or renewed on or after 180 days after the effective date of this paragraph.

Effective Date

(1) Section 14 of this act shall take effect in 90 days.

(2) This section shall take effect immediately.

(3) The remainder of this act shall take effect in 120 days.

Makes other technical changes to carry out the provisions of the Act.

The amendment passed by a vote of 49-0 and the bill was re-referred to the Appropriations Committee.

HB 2216, PN 3493 (Briggs) – Making various land conveyances in the Commonwealth.

Amendment A05491 (Pittman) – This amendment includes the following conveyances and Project 70 releases:

• Releases Project 70 restrictions on a portion of Fayfield Park in Springettsbury Township, York County, and authorizes a transfer of ownership to PennDOT (Sen. Phillips-Hill’s district)
• Authorizes DGS to convey a permanent easement from the Western Pennsylvania Psychiatric Institute in Pittsburgh to the University of Pittsburgh for construction, use, repair and replacement of improvements made by the University for $1 (Sen. Costa’s district)
• Authorizes the Pa. Historical and Museum Commission to convey to New Freedom Theatre, Inc. a deed to land that was originally conveyed by New Freedom Theatre to the Commission in 1992, for $1 (Sen. Street’s district)
• Authorizes the State Armory Board to enter into agreements to exchange with the U.S. Army Reserve the right to occupy and use the Johnstown Walters Avenue Readiness Center and a hangar facility owned by the Johnstown-Cambria County Airport Authority and currently leased to the Army Reserve (Sen. Langerholc’s district)

The amendment passed by a vote of 48-1 and the bill went over in its order as amended.

HB 1086, PN 1303 (Takac) – The bill amends Title 51 (Military Affairs) to allow the Pennsylvania Department of Military and Veterans Affairs (DMVA) to transmit information collected under the voluntary veteran’s registry to veteran and community outreach partners who participate in community outreach under the PA VETConnect program. A vote of 48-1 was recorded.