SENATE AMENDED PRIOR PRINTER'S NO. 350 PRINTER'S NO. 4020
No. 304 Session of 2003
INTRODUCED BY MAITLAND, NICKOL, FLEAGLE, R. MILLER, ADOLPH, BAKER, CAPPELLI, CAUSER, CORRIGAN, CREIGHTON, CURRY, DeWEESE, EGOLF, FRANKEL, GEORGE, GINGRICH, HARHAI, HARRIS, HORSEY, MACKERETH, MAHER, McILHATTAN, MUNDY, PICKETT, ROSS, RUBLEY, SATHER, SCRIMENTI, SEMMEL, B. SMITH, SOLOBAY, TANGRETTI, E. Z. TAYLOR, THOMAS, TIGUE, VANCE, YOUNGBLOOD, MYERS, JAMES, HARPER AND WASHINGTON, FEBRUARY 18, 2003
AS AMENDED ON THIRD CONSIDERATION, IN SENATE, JUNE 8, 2004
AN ACT 1 Amending the act of December 20, 1985 (P.L.457, No.112), 2 entitled "An act relating to the right to practice medicine 3 and surgery and the right to practice medically related acts; 4 reestablishing the State Board of Medical Education and 5 Licensure as the State Board of Medicine and providing for 6 its composition, powers and duties; providing for the 7 issuance of licenses and certificates and the suspension and 8 revocation of licenses and certificates; providing penalties; 9 and making repeals," defining "home health care agency"; and 10 providing for home health care services ordered by physicians 11 from another state. 12 The General Assembly finds and declares as follows: 13 (1) Home health care agencies are widely accepted by the 14 general public because they allow people to age in place, 15 maintain their independence and exercise decision making and 16 personal choice. 17 (2) Pennsylvanians have the right to seek out the 18 medical care they feel is most appropriate to meet their 19 needs.
1 (3) Nationally, 72% of home health care SERVICES <-- 2 recipients on average are elderly. Pennsylvania has the 3 second oldest population in the nation, and it is expected <-- 4 WHICH IS PROJECTED to grow from 16% to 25% over the next 20 <-- 5 years. 6 (4) Pennsylvania's home health care agencies provided 7 care directly DIRECT SERVICES in the homes of nearly 500,000 <-- 8 Pennsylvania residents in 1999 alone. 9 (5) It is expected that the need for home health care 10 services by Pennsylvania residents will continue to 11 dramatically increase in the coming years. <-- 12 (6) An increasing number of SOME Pennsylvanians have <-- 13 been denied access to home health care SERVICES because their <-- 14 out-of-State physicians are not authorized to write ORDERS <-- 15 FOR THE DELIVERY OF home health care orders to be <-- 16 administered inside Pennsylvania. 17 (7) Out-of-State physicians choose not to be licensed in 18 Pennsylvania due to skyrocketing costs for medical 19 malpractice insurance. Home health care agencies are required 20 to accept orders from only licensed Pennsylvania physicians 21 who must assume liability when signing orders written by out- 22 of-State physicians. Pennsylvania citizens are denied needed 23 access to home health care services because of statutory and 24 regulatory constraints. SERVICES WITHIN PENNSYLVANIA. <-- 25 (8) (7) It is in the best interest of all Pennsylvanians <-- 26 that the Commonwealth allow duly licensed out-of-State 27 physicians to order home health care services to be delivered 28 by licensed Pennsylvania agencies in the Commonwealth. 29 The General Assembly of the Commonwealth of Pennsylvania 30 hereby enacts as follows: 20030H0304B4020 - 2 -
1 Section 1. Section 2 of the act of December 20, 1985 2 (P.L.457, No.112), known as the Medical Practice Act of 1985, is 3 amended by adding a definition to read: 4 Section 2. Definitions. 5 The following words and phrases when used in this act shall 6 have the meanings given to them in this section unless the 7 context clearly indicates otherwise: 8 * * * 9 Home health care agency." An organization or part thereof, 10 licensed by the Department of Health under the act of July 19, 11 1979 (P.L.130, No.48), known as the Health Care Facilities Act, 12 staffed and equipped to provide nursing and at least one 13 therapeutic service to persons who are disabled, aged, injured 14 or sick in their place of residence. The agency may also provide 15 other health-related services to protect and maintain persons in 16 their own home. 17 * * * 18 Section 2. The act is amended by adding a section to read: 19 Section 36.2. Home health care services ordered by physicians <-- 20 from another state. 21 (a) General rule.--A physician from another state shall be 22 authorized to order home care services to be delivered by a 23 licensed home health agency if the physician shows, upon request 24 by the board, or the home health agency that will deliver the 25 home care services shows that the physician: 26 (1) Holds a license in good standing conferred by the 27 medical board or other medical licensing authority in another 28 state, as shown by a photocopy or facsimile of their valid 29 license submitted to the home health care agencies. 30 (2) Conducts 50% or less of the physician's health care 20030H0304B4020 - 3 -
1 practice within this Commonwealth. 2 (3) Prescribed home health care services pursuant to an 3 in-person physical examination of the patient. 4 SECTION 36.2. HOME HEALTH CARE SERVICES ORDERED BY PHYSICIANS. <-- 5 (A) GENERAL RULE.--A HOME HEALTH CARE AGENCY MAY DELIVER 6 HOME HEALTH CARE SERVICES TO A PATIENT WHO RESIDES IN THIS 7 COMMONWEALTH BASED UPON AN ORDER FROM A PHYSICIAN FROM ANOTHER 8 STATE WHO MEETS ALL OF THE FOLLOWING REQUIREMENTS: 9 (1) HOLDS A LICENSE IN GOOD STANDING CONFERRED BY THE 10 MEDICAL BOARD OR OTHER MEDICAL LICENSING AUTHORITY IN ANOTHER 11 STATE, AS SHOWN BY A PHOTOCOPY OR FACSIMILE OF THE 12 PHYSICIAN'S VALID LICENSE SUBMITTED TO THE HOME HEALTH CARE 13 AGENCY, AND AVAILABLE UPON REQUEST BY THE BOARD OR THE 14 DEPARTMENT. 15 (2) PRESCRIBES HOME HEALTH CARE SERVICES PURSUANT TO AN 16 IN-PERSON PHYSICAL EXAMINATION OF THE PATIENT PERFORMED 17 WITHIN THE JURISDICTIONAL BOUNDARIES OF THE STATE IN WHICH 18 THE PHYSICIAN IS LICENSED. 19 (b) Duties of referring physician from another state.--A 20 referring physician from another state shall ask the patient if 21 the patient has a primary care physician in this Commonwealth. 22 If so, the referring physician shall contact the primary care 23 physician and obtain the concurrence of that individual for 24 ordering home health care services. The referring physician 25 shall make a notation of such contact in the patient's medical 26 record. 27 Section 3. This act shall take effect in 60 days. A21L63DMS/20030H0304B4020 - 4 -