The Milbank Memorial Fund recently released a report, the Effectiveness of Policies to Improve Primary Care Access for Underserved Populations. This report reviews the evidence base for policies to improve primary care access, including around increasing the availability of primary care clinicians, removing financial barriers to primary care, and bringing outpatient clinics to the community.

On December 14, 2021, the Centers for Medicare and Medicaid Services (CMS) unexpectedly issued a letter to U.S. Senator Ron Widen (D-OR) indicating that CMS plans to use its “administrative authority to issue proposed rulemaking” addressing price concessions and direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) have increasingly charged to specialty and retail pharmacy providers in Medicare and other pharmacy benefit programs in recent years. The proposed regulation was issued on January 12.

The MidAtlantic AIDS Education and Training Center (AETC) has created several new pocket guides by Dr. Linda Frank and their regional partners which are available for download on their website. The new topics are:

• Rapid Initiation of HIV Treatment
• HIV and Medication Assisted Treatment Centers (MAT)
• Differential Diagnosis of HIV and SARS-COV-2
• Best Practices & Tips for Clinicians Providing Care for Patients with HIV via Telehealth
• Integrating Geriatric Principles into an HIV Clinic
• Workplace Burnout Guide for Health Professionals
• Addressing Social Determinants of Health and Persons with HIV

You can also find all their other pocket guides and clinical tools here.

A new report by a Pennsylvania legislative research agency offers many recommendations to help Pennsylvania’s nine medical schools take more steps to ease a shortage of primary care doctors in the state. The report by the Joint State Government Commission looks at the training needed to become a primary care doctor and efforts by the medical schools to promote primary care as a career choice. It examines a host of issues believed to contribute to the shortage in that practice, including student debt burden, doctor burnout and low public investment in primary care. Read the report, Medical School Impact on the Primary Care Physician Shortage.

In October, the state Senate passed SB 705 authorizing the regulation of telemedicine by professional licensing boards and providing for insurance coverage of telemedicine. Sponsored by Senator Vogel, SB 705 is now with the House of Representatives for their consideration. The bill has language that was in the previous version of the bill that led to Governor Wolf vetoing the bill last session. PACHC is not aware that any progress has been made between the House of Representatives and the Governor’s office to address the issues from last session. At this time, the House is not expected to act on this legislation. This creates a conundrum when reviewing the OMAP Telehealth Bulletin, which notes that telehealth is allowed “if permitted according to their scope of practice, licensure, or certification.” Nothing in the practice acts “permits” telehealth. The current waiver allowing for telehealth expires on March 31, 2022. There have been rumors of a possible extension of some of the waivers, such as telehealth, beyond the March 31 deadline. PACHC is working with the legislature and the administration, along with other provider groups, to try and get clarification on the future of telehealth amidst these political issues.