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Pa. legislators say it’s time to require insurers pay for virtual health care

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Pa. legislators say it’s time to require insurers pay for virtual health care


In Pennsylvania, non-public insurance coverage corporations don’t need to pay for a affected person’s digital examine up with their very own doctor, or cowl any well being care providers offered with out an in-person go to.

The state is one in all simply seven that doesn’t require insurers to cowl telehealth, based on the Nationwide Consortium of Telehealth Useful resource Facilities, a set of nationwide and regional useful resource teams centered on increasing entry to telehealth.

Twice earlier than the pandemic, and as soon as throughout, the state Basic Meeting did not cross payments requiring non-public insurers to cowl digital care. Now three years of widespread telemedicine use throughout the pandemic, and a brand new Democrat majority within the Home, have legislators hopeful.

“Telemedicine is just too handy and too efficient to disregard as a software at this level,” mentioned State Rep. Michael Schlossberg, an Allentown Democrat who has advocated for telehealth for psychological well being care.

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Republican State Sen. Elder Vogel sponsored payments in 2016, 2018, and 2021 requiring non-public insurers to pay for telehealth providers. A brand new draft is now circulating, and he expects to introduce it within the coming weeks.

“The pandemic hit, and we realized how essential this actually was,” Vogel mentioned.

» READ MORE: Lack of telehealth legislation in Pennsylvania a serious headache for sufferers who want it most

Telehealth entry is altering

When a affected person and a well being care supplier work together by way of dwell video or seek the advice of by cellphone, that’s telemedicine, mentioned Kathy Hsu Wibberly, director of the Mid-Atlantic Telehealth Useful resource Heart, one of many regional facilities taking part within the nationwide coalition. It might additionally embrace distant monitoring of well being circumstances.

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Most insurers already present complete telehealth protection, mentioned Jonathan Greer, president of the Insurance coverage Federation of Pennsylvania, a state commerce group.

“We don’t oppose any legislative involvement on this, as long as it doesn’t intrude with what we’re doing now and doesn’t unintentionally impede its progress sooner or later,” Greer mentioned.

Over the previous three years, the pandemic made digital visits routine. Nationally, 28% of Medicare recipients had at the very least one telehealth go to in 2021, in comparison with 1% in 2019.

Earlier than COVID, docs with Jefferson Well being carried out roughly 50 telemedicine appointments each day. That skyrocketed to three,000 each day on the peak of the pandemic.

Immediately, digital visits nonetheless are occurring at the very least thrice extra usually than occurred pre-pandemic, mentioned Judd Hollander, an emergency care doctor who began and runs the hospital telehealth portal, JeffConnect.

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“In case your readers take into consideration the variety of occasions they went to their physician however [their doctor] didn’t actually contact them, these are nice issues to make use of telemedicine for,” Hollander mentioned.

Most business insurers voluntarily coated telemedicine for a lot of the pandemic, recognizing some sufferers feared publicity to COVID and needed to keep away from in-person appointments, well being care suppliers mentioned. Different states have reported insurers scaling again reimbursements, mentioned Kate Slatt, vice chairman of revolutionary fee and care supply with the Hospital Affiliation of Pennsylvania, and the dearth of authorized pointers from Harrisburg means the identical might occur right here.

“What we’re seeing nationwide and in different states is payers pulling again on that reimbursement they offered,” Slatt mentioned.

With out legislative motion, insurers could possibly be selective about what kinds of telemedicine visits they may pay for, or make telemedicine appointments obtainable solely although sure docs, reasonably than a affected person’s common doctor.

“It truly is sadly a giant unknown at this level, or it’s extraordinarily variable,” mentioned Shari Erickson, chief advocacy officer for the American Faculty of Physicians.

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Nonetheless, Pennsylvania’s insurance coverage commerce group says there are occasions when telemedicine isn’t applicable. Greer cited for example a dermatologist who doesn’t have a video digital camera with the standard ranges wanted to correctly diagnose a regarding blemish.

“There could also be an excellent motive why we impose sure circumstances on sure suppliers and sure procedures,” Greer mentioned.

Folks counting on Medicare and Medicaid, the federal government’s insurance coverage applications for seniors and low-income households, aren’t affected by the non-public insurance coverage debate, consultants famous. Medicare will reimburse recipients for telehealth service for behavioral and psychological well being care indefinitely, and for different medical providers by way of the tip of 2024. State guidelines permits Medicaid to pay for telehealth visits when clinically applicable, based on the state Division of Human Providers.

The nationwide COVID-19 emergency declarations are because of expire Could 11, which has spurred dialog about telehealth entry, although they by no means required insurers to cowl telehealth.

» READ MORE: What does the tip of the pandemic public well being emergency imply for you

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The advantages of telehealth

Entry to telehealth has meant fewer skipped appointments for psychological well being care, mentioned Christine Michaels, govt director of the Nationwide Alliance on Psychological Sickness Keystone Pennsylvania, a state chapter of the psychological well being advocacy non-profit. Many sufferers valued the way it allowed for higher privateness.

“It acquired folks into therapy that may not have gone as a result of they didn’t wish to go right into a clinic or they didn’t wish to be seen going to a psychiatrist’s workplace,” she mentioned.

Telehealth additionally expanded entry to medical care exterior of larger cities. As a lawmaker representing rural Pennsylvania, Vogel mentioned folks in his district might need to drive greater than an hour spherical journey for follow-up appointments in Pittsburgh hospitals.

Vogel’s previous efforts to cross laws guaranteeing protection for telehealth providers acquired blocked when Home Republicans raised considerations about telemedicine visits getting used to prescribe abortion-inducing medication. With Democrats now controlling the Home by a slim majority, many imagine Senate Republicans is not going to be an impediment to altering the legislation.

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“The framework was already there,” mentioned State Rep. Dan Miller, a Pittsburgh Democrat. “We don’t want 4 months to resolve actually the right way to do it.”



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Pennsylvania

Fire breaks out overnight in Quakertown

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Fire breaks out overnight in Quakertown


We’re following a developing story out of Quakertown.

Crews have been on the scene of a fire in Bucks County.

The fire was reported around midnight at the 100 block of Pacific Drive in Quakertown.

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The fire is reported to have broken out inside a commercial building.

Dispatchers say firefighters from multiple companies were working on putting out hotspots once the bulk of the fire was out.

We are working to learn more details on what caused the fire and if there are any injuries. 

This is a developing story and will be updated. 

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Pa. Consumer Advocate resigns, claiming utilities lobbied for his ouster

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Pa. Consumer Advocate resigns, claiming utilities lobbied for his ouster


Talk of lobbying against Cicero by utilities

The investor publication speculated Sunday’s win would likely mean a move to a “more moderate” Consumer Advocate.

“We view this as an indicator of the water industry’s strong political influence in Pennsylvania, which is a key factor that has enabled the state to consistently rank among the most attractive states for water utilities to do business,” Northcoast Research wrote.

The letter of support for Cicero includes signatures by the Pennsylvania Municipal Authorities Association, which represents more than 700 municipal authorities statewide, the publicly owned Chester Water Authority, the Pennsylvania Utility Law Project, Community Legal Services and several housing, health and environmental organizations.

In his resignation letter, Cicero said the “utilities’ actions” and Sunday’s decision to open the position to other candidates “cannot be separated.”

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“Collectively, they challenge the integrity and independence of the office and erode the public trust in the impartiality of the regulatory process and signal a concerning shift, where public accountability and consumer protection are subordinate to corporate interests,” Cicero wrote.

Sunday’s statement did not directly address these allegations, but said his administration will prioritize “having a capable, unbiased and apolitical” Consumer Advocate to protect the interests of consumers.

“Its work is vital to all Pennsylvanians, especially the most vulnerable among us,” Sunday said. “I look forward to an open and transparent process that includes feedback from all interested parties and individuals.”

A spokesperson for Sunday’s transition team declined to answer questions about whether utilities had asked Sunday to replace Cicero.

Several utilities are represented on Sunday’s transition committee. Members include David Kralle, a registered lobbyist for Peoples Gas, Aqua Pennsylvania and parent company Essential Utilities; David Fisfis, general counsel and vice president of energy policy at Duquesne Light Company; and Carolina DiGiorgio, vice president of government and external relations at PECO.

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Sunday is also inviting consumer advocacy organizations to join the transition committee and seeking feedback on what to look for in the next Consumer Advocate, he said in his statement.

PECO and Duquesne Light did not respond to a request for comment.

Aqua America declined to comment on Cicero’s resignation as well as on Kralle’s participation in Sunday’s transition committee.

In a statement, American Water said it was not involved in the process.

“Pennsylvania American Water is committed to transparency and maintaining the trust of our customers and stakeholders,” spokesperson Gary Lobaugh said in an email. “Pennsylvania American Water has not been involved in any efforts to influence the selection or retention of the Consumer Advocate. Our focus remains on providing reliable and high-quality service to our customers, and we respect the independent processes that govern the appointment of the Consumer Advocate.”

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A Consumer Advocate who scrutinized the water sale process

Acquisitions of aging municipal water supplies by investor-owned utilities are increasing across the United States and in Pennsylvania as some municipalities struggle to upgrade infrastructure to meet new drinking water standards.

But purchases of municipal systems by companies often come with a higher cost to consumers — something Cicero has not been quiet about. Several states, including Pennsylvania, have passed fair market value laws, which allow companies to factor in the potential future value of a utility when purchasing it, pay above the price and essentially recover the cost of inflated acquisition prices through rate increases.

A Cornell University study of the 500 largest community water systems in the U.S. found that Pennsylvania has some of the highest utility bills following privatization.

Investor-owned utilities often argue privatization is necessary to “save” struggling municipal-owned systems. Though Cicero does not oppose privatization when necessary, he has argued Pennsylvania’s fair market value law allows companies to purchase “perfectly viable” systems for the sake of making more money.

“We are not anti-privatization, and we are not against well-thought-out consolidation and regionalization,” he said during a 2023 state House committee hearing on legislation aiming to amend the state’s fair market value laws. “What we oppose is privatization for its own sake — and privatization and consolidation at any cost or regardless of the cost to consumers.”

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On a number of occasions, Cicero has pointed to dramatically increasing water and wastewater costs in Pennsylvania. In fact, fair market value laws have cost consumers more than $85 million more each year than they would have paid without the law.

Cicero’s Office of Consumer Advocate has settled several privatization cases before the PUC, essentially agreeing to allow them to go forward. But he has thrown a wrench in at least two.

In 2023, the Pennsylvania Commonwealth Court sided with Cicero and reversed the Pennsylvania Public Utility Commission’s approval of Aqua Pennsylvania’s purchase of East Whiteland Township’s sewer system for nearly $55 million. Cicero argued the PUC failed to prove the acquisition would provide a public benefit, and that it would raise wastewater costs for thousands of ratepayers.

Early last year, when Pennsylvania American Water applied to the PUC to buy the borough of Brentwood’s sewer system, Cicero urged the commission to approve the application only if it would provide “substantial, affirmative benefits to the public.” He argued PA American had not met its burden of proof that the acquisition would benefit the public interest. The PUC ultimately denied PA American’s acquisition request.

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Body camera video shows Pennsylvania police officers rescue 2 dogs trapped in frozen pond

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Body camera video shows Pennsylvania police officers rescue 2 dogs trapped in frozen pond


Police in Easttown Township, Pennsylvania, are being called heroes after body camera video captured them saving two dogs from an icy pond.

The daring rescue happened Friday around 3 p.m. on Waynesbrooke Road. 

In the video, you can hear the sad sound of one of the dogs whimpering as the officers spring into action to rescue the animals from the freezing water.

Officers say when they got to the scene they found two black labs. One of them was not far from the bank, they say, but the other needed to be rescued first after swimming to a much deeper end of the pond.

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“If they weren’t able to get themselves out, they may have drowned,” said Charles Burdsall, one of the responding officers. 

Burdsall says it was the first call they ever received for a water rescue in Easttown Township. He says their hearts were racing the entire time but they didn’t think twice, knowing every second mattered to save the dogs.

“The only goal at the time was to get the dog out of the pond,” Burdsall said. 

Their focus was not only to get the dogs out but to do so without breaking the ice. Luckily, the officers say neighbors were able to give them a ladder and a pole that proved to be exactly what they needed to pull the dogs out.

“[The dog’s] neck was touching the ice. [Burdsall] couldn’t get too close to the dog. We figured the ice was thinner there and we didn’t want him falling in. It was a pretty amped up situation,” Kevin Oreskovich with Easttown Township Police said. 

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The dogs are doing fine and were reunited with their owner, the officers said. 

The officers are now being celebrated as heroes.

“It was rewarding. It felt good,” Oreskovich said.

“Being able to help them when they were in distress,” Burdsall said, “that was big for me.”

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