Overview
Pennsylvania has a robust set of healthcare inspection and transparency laws. However, 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. Although Pennsylvania introduced several bills affecting price transparency, health care markets and costs, none were signed into law. Stay tuned for what action Pennsylvania will take this session.
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. We currently cover bills from the 2017-2018 legislative term and key statutes from each state. Search the database for specific bills, statutes or cases by using keyword, key issue category, and/or jurisdiction.
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SB 1166 – Pennsylvania
Introduced/Considered: 2018 Status: In Process
An Act amending the act of November 21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit Integrity and Transparency Act, adding provisions relating to public contracting for pharmacy benefits management. No public pharmacy benefits management …
HB 2211 – Pennsylvania
Introduced/Considered: 2018 Status: In Process
CONSUMER PRESCRIPTION DRUG PRICING DISCLOSURE ACT. Neither a pharmacy, a pharmacist nor its contracting agent shall be prohibited from or penalized by a pharmacy benefits manager for discussing the information under subsection (a), disclosing the …
SB 1014 (see companion bill HB 1688) – Pennsylvania
Introduced/Considered: 2018 Status: In Process
An Act providing for a Statewide comprehensive health care system; establishing the Pennsylvania Health Care Plan and providing for eligibility, services, coverages, subrogation, participating and nonparticipating providers, cost containment, quality assurance and for transitional support …
SB 637 – Pennsylvania
Introduced/Considered: 2017 Status: In Process
This bill would establish the “Pharmaceutical Transparency Commission.” It would require pharmaceutical manufacturers to report annually to the commission for each of the following: the total costs derived in the production of the prescription including: …
HB 1293 – Pennsylvania
Introduced/Considered: 2017 Status: Inactive / Dead
An Act providing for preauthorizations conducted by utilization review entities relating to health care services.
Next | See all Legislation Records
Introduced/Considered: 2018 Status: In Process
An Act amending the act of November 21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit Integrity and Transparency Act, adding provisions relating to public contracting for pharmacy benefits management. No public pharmacy benefits management …
HB 2211 – Pennsylvania
Introduced/Considered: 2018 Status: In Process
CONSUMER PRESCRIPTION DRUG PRICING DISCLOSURE ACT. Neither a pharmacy, a pharmacist nor its contracting agent shall be prohibited from or penalized by a pharmacy benefits manager for discussing the information under subsection (a), disclosing the …
SB 1014 (see companion bill HB 1688) – Pennsylvania
Introduced/Considered: 2018 Status: In Process
An Act providing for a Statewide comprehensive health care system; establishing the Pennsylvania Health Care Plan and providing for eligibility, services, coverages, subrogation, participating and nonparticipating providers, cost containment, quality assurance and for transitional support …
SB 637 – Pennsylvania
Introduced/Considered: 2017 Status: In Process
This bill would establish the “Pharmaceutical Transparency Commission.” It would require pharmaceutical manufacturers to report annually to the commission for each of the following: the total costs derived in the production of the prescription including: …
HB 1293 – Pennsylvania
Introduced/Considered: 2017 Status: Inactive / Dead
An Act providing for preauthorizations conducted by utilization review entities relating to health care services.
Next | See all Legislation Records
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40 Pa. Cons. Stat. §§ 323.1-323.8 – Pennsylvania
Introduced/Considered: Status: Enacted
Authorized the Insurance Department to inspect the books, records, accounts, papers, computers, property, assets, business and affairs of an insurance company as often as the commissioner deems necessary to determine regulatory compliance. The Department shifts …
35 Pa. Cons. Stat. §§ 449.1-449.19 – Pennsylvania
Introduced/Considered: Status: Enacted
The “Health Care Cost Containment Act,” implements a number of cost containment, transparency, and health care reform measures designed to study and increase consumer access to quality and affordable care. The Act was set to …
35 Pa. Cons. Stat. §§ 449.4-449.5 – Pennsylvania
Introduced/Considered: Status: Enacted
Creates the Pennsylvania Health Care Cost Containment Council (PHC4), an independent state agency charged with increasing access to health care and reducing costs. The Council is comprised of representatives from the business community, organized labor, …
35 Pa. Cons. Stat. § 449.6 – Pennsylvania
Introduced/Considered: Status: Enacted
Authorizes the PHC4 to collect data on provider quality and provider services under the Uniform Claims and Billing Form that the PHC4 maintains. The Council is required to collect, among other things, patient demographic information, …
35 Pa. Cons. Stat. § 449.7 – Pennsylvania
Introduced/Considered: Status: Enacted
Requires that the PHC4 issue certain public reports (see here) using the data collected under § 449.6 (see above). The reports must contain information on provider quality and service effectiveness ranked against performance and cost …
Next | See all Legislation Records
Introduced/Considered: Status: Enacted
Authorized the Insurance Department to inspect the books, records, accounts, papers, computers, property, assets, business and affairs of an insurance company as often as the commissioner deems necessary to determine regulatory compliance. The Department shifts …
35 Pa. Cons. Stat. §§ 449.1-449.19 – Pennsylvania
Introduced/Considered: Status: Enacted
The “Health Care Cost Containment Act,” implements a number of cost containment, transparency, and health care reform measures designed to study and increase consumer access to quality and affordable care. The Act was set to …
35 Pa. Cons. Stat. §§ 449.4-449.5 – Pennsylvania
Introduced/Considered: Status: Enacted
Creates the Pennsylvania Health Care Cost Containment Council (PHC4), an independent state agency charged with increasing access to health care and reducing costs. The Council is comprised of representatives from the business community, organized labor, …
35 Pa. Cons. Stat. § 449.6 – Pennsylvania
Introduced/Considered: Status: Enacted
Authorizes the PHC4 to collect data on provider quality and provider services under the Uniform Claims and Billing Form that the PHC4 maintains. The Council is required to collect, among other things, patient demographic information, …
35 Pa. Cons. Stat. § 449.7 – Pennsylvania
Introduced/Considered: Status: Enacted
Requires that the PHC4 issue certain public reports (see here) using the data collected under § 449.6 (see above). The reports must contain information on provider quality and service effectiveness ranked against performance and cost …
Next | See all Legislation Records
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In re: Flonase Antitrust Litigation – Pennsylvania
District Court: Eastern District of Pennsylvania Status: Pending
The U.S. Court of Appeals for the Third Circuit ruled that an antitrust suit filed by Louisiana’s Attorney General against GlaxoSmithKline (GSK) isn’t barred by …
State of Wisconsin, et al. v. Indivior Incl, et al. – Pennsylvania
District Court: E.D. Pennsylvania Status: Pending
In September 2016, the New York Attorney General joined with 34 other states and the District of Columbia and sued pharmaceutical manufacturer Indivior, alleging that …
In re Generic Pharm. Pricing Antitrust Litig – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from over 40 states, Puerto Rico, and the District of Columbia that filed an antitrust enforcement action against six pharmaceutical manufacturers …
Federal Trade Commission v. AbbVie Inc. et al. – Pennsylvania
District Court: Eastern District of Pennsylvania Status: Decided
FTC alleged AbbVie sued generic companies for patent infringement over their proposed generic version of the testosterone gel, AndroGel, without justifiable grounds but merely to …
Royal Mile Company, Inc. et al v. UPMC et al. – Pennsylvania
District Court: W.D. Pennsylvania Status: Pending
In February 2016, provider UPMC agreed to pay $12.5 million to settle its involvement in a long-running antitrust lawsuit, with Cole’s Wexford Hotel Inc., the only …
Next | See all Litigation Records
District Court: Eastern District of Pennsylvania Status: Pending
The U.S. Court of Appeals for the Third Circuit ruled that an antitrust suit filed by Louisiana’s Attorney General against GlaxoSmithKline (GSK) isn’t barred by …
State of Wisconsin, et al. v. Indivior Incl, et al. – Pennsylvania
District Court: E.D. Pennsylvania Status: Pending
In September 2016, the New York Attorney General joined with 34 other states and the District of Columbia and sued pharmaceutical manufacturer Indivior, alleging that …
In re Generic Pharm. Pricing Antitrust Litig – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from over 40 states, Puerto Rico, and the District of Columbia that filed an antitrust enforcement action against six pharmaceutical manufacturers …
Federal Trade Commission v. AbbVie Inc. et al. – Pennsylvania
District Court: Eastern District of Pennsylvania Status: Decided
FTC alleged AbbVie sued generic companies for patent infringement over their proposed generic version of the testosterone gel, AndroGel, without justifiable grounds but merely to …
Royal Mile Company, Inc. et al v. UPMC et al. – Pennsylvania
District Court: W.D. Pennsylvania Status: Pending
In February 2016, provider UPMC agreed to pay $12.5 million to settle its involvement in a long-running antitrust lawsuit, with Cole’s Wexford Hotel Inc., the only …
Next | See all Litigation Records
Additional Resources
LEGISLATIVE CALENDAR
Pennsylvania’s current regular legislative session runs from 1/2/2018– 11/30/2018. Bills from 2017 were carried over to 2018 for the 2017-2018 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.KEY RESOURCES
Coverage
September 3, 2018
August 12, 2018
August 6, 2018
July 17, 2018
July 17, 2018