PRIOR PRINTER'S NOS. 2275, 2791, 2869
PRINTER'S NO. 4226
THE GENERAL ASSEMBLY OF PENNSYLVANIA
INTRODUCED BY BAKER, PICKETT, AUMENT, FRANKEL, GINGRICH, C. HARRIS, DENLINGER, HESS, MILNE, EVERETT, COHEN, MURT, QUINN, CLYMER, HARHART, GABLER AND CUTLER, AUGUST 26, 2013
SENATOR VANCE, PUBLIC HEALTH AND WELFARE, IN SENATE, AS AMENDED, OCTOBER 6, 2014
1Establishing the Patient-Centered Medical Home Advisory Council;
2providing powers and duties of the council, the Department of
3Public Welfare Human Services<-; and providing for development
4of a plan to implement a Statewide medical home model.
7Section 1. Short title.
10Section 2. Definitions.
17"Council." The Patient-Centered Medical Home Advisory
1Council established by this act.
4"Health care professional." A person who is licensed,
5certified or otherwise authorized or permitted by the law of
6this Commonwealth to administer health care in the ordinary
7course of business or in the practice of a profession.
10(1) is physician-led, led by a nurse practitioner
11practicing under a collaborative agreement as required by the
12act of May 22, 1951 (P.L.317, No.69), known as The
13Professional Nursing Law or led by a physician assistant
14practicing under the supervision and direction of a physician
15as required by the act of December 20, 1985 (P.L.457,
16No.112), known as the Medical Practice Act of 1985;
17(2) originates in a primary care setting;
27"Primary care." Health care that emphasizes a patient's
28general health needs and utilizes collaboration with other
29health care professionals and consultation or referral as
30appropriate to meet the needs identified.
3(1) a physician who is a family or general practitioner;
4(2) a pediatrician;
5(3) an internist;
6(4) an obstetrician; or
7(5) a gynecologist.
13Section 3. Patient-Centered Medical Home Advisory Council.
14(a) Establishment.--The Patient-Centered Medical Home
15Advisory Council is established. The council shall advise the
16department on how Pennsylvania's Medicaid program can increase
17the quality of care while containing costs through the following
18Patient-Centered Medical Home model approaches:
1Act (Public Law 111-148, 42 U.S.C. § 299b-35(c)).
2(5) Promote strong and effective medical management,
3including, but not limited to, planning treatment strategies,
4monitoring health outcomes and resource use, sharing
5information and organizing care to avoid duplication of
6services, including the use of electronic medical records. In
7sharing information, the protection of the privacy of
8individuals and of the <-individual's individuals' information
9shall be priorities. In addition to any and all other Federal
10and State provisions for the confidentiality of health care
11information, any information-sharing required by a medical
12home system shall be subject to written consent of the
14(6) Provide comprehensive care management to patients to
15align and assist with treatment strategies, health outcomes,
16resource utilization and organization of care and address
17determinants of health impeding goals of care.
18(7) Emphasize patient and provider accountability.
22(9) Establish a baseline for medical home goals and
23establish performance measures that indicate a patient has an
24established and effective medical home. These goals and
25performance measures may include, but need not be limited to,
26childhood immunization rates, well-child care utilization
27rates, care management for chronic illnesses and emergency
1the Senate, the Majority Leader of the Senate, the Minority
2Leader of the Senate, the Speaker of the House of
3Representatives, the Majority Leader of the House of
4Representatives and the Minority Leader of the House of
5Representatives, <-who shall consist of the following:
6(1) The secretary, or a designee.
5(1) Family physicians.
6(2) Obstetricians and gynecologists.
7(3) Nurse practitioners.
11(7) Hospital and health systems.
12(8) Patient-centered medical homes.
13(9) Mental health care providers.
14(10) Community health centers.
17(12) Physician assistants.
29Section 4. Duties of the council.
30(a) Organizational model.--The council shall recommend to
1the department an organizational model for the patient-centered
2medical home system in this Commonwealth, including possible
3Medicaid pilot projects. The organizational model shall provide
4a strategy to coordinate health care services and provide for
5monitoring and data collection on patient-centered medical
6homes, for training and education to health care professionals
7and families and for transition of children to the adult medical
8care system. The organizational model may also include the use
9of telemedicine resources and may provide for partnering with
10pediatric and family practice residency programs to improve
11access to preventive care for children. The organizational
12structure shall also address the need to organize and provide
13health care to increase accessibility for patients, including
14using venues more accessible to patients and having hours of
15operation that are conducive to the population served.
17(1) The council shall recommend to the department
18standards and a process to certify patient-centered medical
19homes based on standards developed by a number of
20nongovernmental accrediting entities <-such as the National
21Committee for Quality Assurance and Accreditation Association
22for Ambulatory Health Care. The certification process and
23standards shall provide mechanisms to monitor performance and
24to evaluate, promote and improve the quality of health of,
25and health care delivered to, patients through a patient-
26centered medical home. The standards and process shall also
27include a mechanism for other ancillary service providers to
28become affiliated with a certified patient-centered medical
30(2) The council shall recommend to the department
4(c) Reimbursement methodology.--The council shall recommend
5to the department a reimbursement methodology and incentives for
6participation in the patient-centered medical home system
7sufficient to ensure that providers enter and remain
8participating in the system and to promote wellness, prevention,
9chronic care management, immunizations, health care management
10and the use of electronic health records and other pertinent
11concerns. In developing the recommendations, the council shall
12consider the feasibility of all of the following:
<-3Section 5. Expiration.
4This act shall expire June 30, 2020.
5Section <-5 6. Effective date.
6This act shall take effect immediately.