- Pennsylvania Consumer Data Privacy Act –
In following the national trend, in 2023, lawmakers proposed a data
privacy law that would allow Pennsylvanians to opt out of having
their personal data subject to certain data processes activities.
While the bill's likelihood of passage into law is uncertain,
the proposed legislation emphasizes the country-wide movement
towards state-level consumer data protections. Pennsylvania House Bill
1201 also proposes codifying the consumer right to (1) confirm
whether a business is processing or accessing their data; (2)
access a copy of their personal data, and (3) correct inaccuracies
in their personal data. Should HB 1201 pass, it is anticipated to
have a sizable effect on the health care industry, especially
health information organizations, as it creates numerous new
patient rights. There are several types of data that are currently
exempt from the scope of HB 1201, including protected health
information as defined by HIPAA. Notably, HB 1201 lacks a private
right to action, meaning only the Pennsylvania Attorney
General's Office could enforce this law – and 2023 saw
such increased enforcement by the office against potential consumer
privacy violations. It is expected that 2024 likely will see a
continued trend of governmental scrutiny on data privacy.
- Artificial Intelligence in Health Insurance
– In 2023, Pennsylvania lawmakers introduced House Bill 1663,
which would require health insurance companies to disclose when
artificial intelligence and machine learning (AI/ML) algorithms are
used in the process of claim evaluations. Similar to the consumer
data privacy law discussed above, this bill's survival and
passage remain unclear, but, demonstrate a state-level focus on
transparency on the use of AI in health care. Regulated insurers
would be required to disclose whether the organization uses or
plans to use AI/ML in the claims evaluations process. AI Regulated
organizations would also be required to submit AI/ML algorithms and
datasets used in the utilization review process to
Pennsylvania's Department of Insurance for evaluation of biases
and ethical concerns in the datasets. Any violations of this law
would be deemed unfair deceptive acts or unfair methods of
competition in violation of state law. Although there is no private
cause of action, consumers can file complaints with the
Pennsylvania Insurance Department. An increased focus on the ethics
of AI/ML use in health care operations – including insurance
and website optimization – is likely to occur in 2024.
- Increased Attorney General Activity – In
light of the proposed data privacy legislation and AI/ML disclosure
law, 2024 will likely bring with it continued action by the
Pennsylvania Attorney General's Office to address issues
related to data mining and data tracking on health care entity
websites. The proposed laws discussed above indicate a heightened
governmental enforcement focus on the ethical use of AI/ML and the
transparency of use of consumer data.
- Pennsylvania Payor Updates – Gov. Josh
Shapiro's administration has announced new 2024 individual
health insurance rates, which are intended to expand access,
through, for example, the availability of new stand-alone plans for
purchase. It's expected that 2024 likely will see an increased
focus on health care accessibility for Medicaid-eligible
populations.
- Mental Health, Behavioral Health, and Substance-Use Disorders (SUDs) Services – There has been an increased focus on mental health, behavioral health, and SUD treatment, with an emphasis on providing access to these services to adolescents and in school settings. On Dec. 19, 2023, Pennsylvania launched its Behavioral Health Council to help state officials address any gaps in access, affordability, and access to care for behavioral health and SUDs. Pennsylvania also passed a major bipartisan law that, in part, funds student mental health programs in Pennsylvania. The law has allocated $100 million solely to promoting adolescent-focused school mental health programs to better address adolescent mental health, behavioral health, and SUD concerns. In 2024, the trend of increasing governmental focus on and support for behavioral health programs and initiatives likely will continue, especially those targeting adolescents and other disadvantaged communities.
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