PENNSYLVANIA

Overview

Pennsylvania has a robust set of healthcare inspection and transparency laws. Notwithstanding, initiatives to adopt other measures, including a most favored nations clause ban for healthcare contracts, a certificate of needs program, and a state-run health exchange have not gained traction in the legislature. In the 2017-2018 term, the Pennsylvania legislature introduced many bills affecting price transparency, prescription drug costs, and health care markets and competition. However, none were passed or signed into law, with the exception of a resolution to enact legislation that would allow states to regulate air ambulance billing and pricing practices.

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates. 

LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.

 

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© 2018-2019 The SLIHCQ Database. Initial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Download User Guide
© 2018-2019 The SLIHCQ Database. Initial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
Filter by Key Issue

Additional Resources

LEGISLATIVE CALENDAR

Pennsylvania’s current legislative session runs from 1/1/2019 – 12/31/2019. Bills from 2019 will carry over to 2020 as part of the 2019-2020 legislative term.

FY 2018 BUDGET

Pennsylvania’s budget operates on a twelve month cycle beginning July 1 and ending June 30 of the following calendar year. Pennsylvania enacted its FY 2018 Budget during the regular legislative session. To view Pennsylvania’s FY 2018 Budget, click here.

REGULATION & ENFORCEMENT

  • In October 2013, Attorney General Kathleen G. Kane announced that her office had reached an agreement with Geisinger Health System Foundation over antitrust concerns that the acquisition of Lewistown Hospital and its employed physician group may have substantially lessened or eliminated competition in the region.  The eight-year agreement placed several conditions on the merger.
  • Pennsylvania was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.
  • Enforcement Actions, Market Conduct Actions and Market Surveillance reports conducted by the Department of Insurance can be found here.

KEY RESOURCES

 

Coverage

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