PRINTER'S NO. 600
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
537
Session of
2019
INTRODUCED BY STEFANO, MENSCH, K. WARD, FOLMER, BREWSTER,
LANGERHOLC, PHILLIPS-HILL, BARTOLOTTA, KILLION, VOGEL,
J. WARD AND YUDICHAK, APRIL 10, 2019
REFERRED TO HEALTH AND HUMAN SERVICES, APRIL 10, 2019
AN ACT
Amending the act of April 9, 1929 (P.L.177, No.175), entitled
"An act providing for and reorganizing the conduct of the
executive and administrative work of the Commonwealth by the
Executive Department thereof and the administrative
departments, boards, commissions, and officers thereof,
including the boards of trustees of State Normal Schools, or
Teachers Colleges; abolishing, creating, reorganizing or
authorizing the reorganization of certain administrative
departments, boards, and commissions; defining the powers and
duties of the Governor and other executive and administrative
officers, and of the several administrative departments,
boards, commissions, and officers; fixing the salaries of the
Governor, Lieutenant Governor, and certain other executive
and administrative officers; providing for the appointment of
certain administrative officers, and of all deputies and
other assistants and employes in certain departments, boards,
and commissions; providing for judicial administration; and
prescribing the manner in which the number and compensation
of the deputies and all other assistants and employes of
certain departments, boards and commissions shall be
determined," in powers and duties of the Department of Public
Welfare and its departmental administrative and advisory
boards and commissions, further providing for medical
assistance payments and for admissions to drug and alcohol
facilities.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Article XXIII heading and sections 2334 and 2335
of the act of April 9, 1929 (P.L.177, No.175), known as The
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Administrative Code of 1929, are amended to read:
ARTICLE XXIII
POWERS AND DUTIES OF THE DEPARTMENT OF
[PUBLIC WELFARE] HUMAN SERVICES AND ITS DEPARTMENTAL
ADMINISTRATIVE AND ADVISORY BOARDS
AND COMMISSIONS
Section 2334. Medical Assistance Payments.--(a) It is the
general purpose of this section to provide for a continuum of
alcohol and drug detoxification and rehabilitation services to
persons eligible for medical assistance. Facilities serving as
appropriate treatment settings include hospital and nonhospital
drug detoxification and rehabilitation facilities, hospital and
nonhospital alcohol detoxification and rehabilitation
facilities, and hospital and nonhospital drug and alcohol
detoxification and rehabilitation facilities and outpatient
services licensed by the [Office] Department of Drug and Alcohol
Programs [of the Department of Health]. The General Assembly
recognizes that the fluctuating nature of alcohol and drug
dependency, in combination with the associated physical
complications often arising from long-term use of alcohol and
drugs, necessitates that a variety of treatment modalities and
settings be made available to persons eligible for medical
assistance. The availability of a new service in this area is in
no way intended to limit access to or funding of services
available currently.
(b) Consistent with section 2301, the Department of [Public
Welfare] Human Services shall:
(1) Provide, on behalf of persons eligible for medical
assistance, medical assistance coverage for detoxification,
treatment and care in a nonhospital alcohol detoxification
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facility, nonhospital drug detoxification facility, nonhospital
alcohol and drug detoxification facility, or a nonhospital
treatment facility which can provide services for either drug or
alcohol detoxification or treatment or for both, provided that
the facility is licensed by the [Office] Department of Drug and
Alcohol Programs [in the Department of Health].
(2) Use criteria developed by the [Office] Department of
Drug and Alcohol Programs for governing the type, level and
length of care or treatment, including hospital detoxification,
as a basis for the development of standards for services
provided under clause (1).
[(3) Notwithstanding clause (1), provide by regulation for
gradual implementation of medical assistance coverage under this
subsection to client populations which shall be identified in
cooperation with the Department of Health. The regulations shall
provide for full implementation of clause (1) to all medical
assistance eligibles in phases over a period of time not to
exceed five years from the effective date of the regulations.
The program phases shall be structured so as to allow for
independent evaluation of each phase on an ongoing basis.
Initial regulations adopted pursuant to this subsection shall
not be subject to review pursuant to the act of June 25, 1982
(P.L.633, No.181), known as the "Regulatory Review Act," except
that the regulations may be reviewed under section 5(h) of that
act.
(c) The Department of Public Welfare, the Department of
Health and the Office of Drug and Alcohol Programs shall jointly
provide for an independent evaluation of the program authorized
by this section in accordance with specific evaluation criteria,
which shall include, but not be limited to: (i) comparison of
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medical costs before and after program implementation; (ii)
employment history; and (iii) involvement with other programs of
the Department of Health, the Department of Public Welfare, the
Department of Corrections and any other appropriate agencies.
The evaluation shall be conducted in compliance with all
applicable Federal and State confidentiality requirements.]
(4) Include as an access standard in the agreement that each
medical assistance behavioral health managed care organization
administering a provider network for treatment of substance use
disorders maintain a provider network that is geographically
accessible to members. Subject to Federal approval, the access
standard for ambulatory substance use disorder treatment to
which a member travels shall be at least two providers within:
(i) thirty minutes travel time in urban areas; and
(ii) thirty minutes travel time in rural areas if there are
licensed substance use disorder treatment providers located in
the geographic area that meet the managed care organization's
credentialing requirements , otherwise within sixty minutes of
travel time.
(d) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"Ambulatory substance use disorder treatment." Treatment
provided by a facility approved by the Department of Human
Services to participate in the Medical Assistance program and
which is fully or provisionally licensed by the Department of
Drug and Alcohol Programs to provide outpatient services for the
diagnosis and treatment of drug and alcohol abuse and dependence
to eligible medical assistance outpatient beneficiaries who are
not residents of a treatment institution.
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"Rural areas." Territory, persons and housing units in
places which are designated as having less than 2,500 persons as
defined by the United States Census Bureau.
"Urban areas." Territory, persons and housing units in
places which are designated as having 2,500 persons or more as
defined by the United States Census Bureau and which places are
in close geographic proximity to one another.
Section 2335. Admissions to Drug and Alcohol Facilities.--
(a) Drug or alcohol abusers and drug or alcohol dependent
persons shall be admitted to and treated in all facilities
licensed by the Department [of Health and Office] of Drug and
Alcohol Programs, at reasonable rates on the basis of medical or
psychotherapeutic need, and shall not be discriminated against
on the basis of medical assistance eligibility.
(b) As part of its licensure process, the [Office]
Department of Drug and Alcohol Programs shall review each
facility's admission policies for compliance and shall
investigate complaints.
(c) The [Office] Department of Drug and Alcohol Programs may
suspend or revoke the license of any facility which fails to
maintain an admission policy consistent with the requirements of
this section and may impose a fine not to exceed one thousand
dollars ($1,000) for each violation.
(d) Nothing in this section shall require any facility to
accept medical assistance eligible patients for whom payment is
not available pursuant to regulations adopted under former
section 2334(b)(3).
Section 2. This act shall take effect in 60 days.
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