2023 Pennsylvania Consolidated & Unconsolidated Statutes › Title 35 - HEALTH AND SAFETY › Chapter 33 - Health Care Cost Containment › Section 3303 - Health Care Cost Containment Council

§ 3303. Health Care Cost Containment Council.
(a) Establishment.--
The Health Care Cost Containment Council is established as an independent council.
(b) Composition.--
The council shall consist of voting members, composed of and appointed in accordance with the following:
(1) The Secretary of Health.
(2) The Secretary of Human Services.
(3) The Insurance Commissioner.
(4) Six representatives of the business community, at least one of whom represents small business, who are purchasers of health care, none of which is primarily involved in the provision of health care or health insurance, three of which shall be appointed by the President pro tempore of the Senate and three of which shall be appointed by the Speaker of the House of Representatives from a list of 12 qualified persons recommended by the Pennsylvania Chamber of Business and Industry. Three nominees shall be representatives of small business.
(5) Six representatives of organized labor, three of which shall be appointed by the President pro tempore of the Senate and three of which shall be appointed by the Speaker of the House of Representatives from a list of 12 qualified persons recommended by the Pennsylvania AFL-CIO.
(6) One representative of consumers who is not primarily involved in the provision of health care or health care insurance, appointed by the Governor from a list of three qualified persons recommended jointly by the President pro tempore of the Senate and the Speaker of the House of Representatives.
(7) Two representatives of hospitals, appointed by the Governor from a list of five qualified hospital representatives recommended by the Hospital and Health System Association of Pennsylvania one of whom shall be a representative of rural hospitals. Each representative under this paragraph may appoint two additional delegates to act for the representative only at meetings of committees, as provided for in subsection (f).
(8) Two representatives of physicians, appointed by the Governor from a list of five qualified physician representatives recommended jointly by the Pennsylvania Medical Society and the Pennsylvania Osteopathic Medical Society. The representative under this paragraph may appoint two additional delegates to act for the representative only at meetings of committees, as provided for in subsection (f).
(8.1) An individual appointed by the Governor who has expertise in the application of continuous quality improvement methods in hospitals.
(8.2) One representative of nurses, appointed by the Governor from a list of three qualified representatives recommended by the Pennsylvania State Nurses Association.
(9) One representative of the Blue Cross and Blue Shield plans of Pennsylvania, appointed by the Governor from a list of three qualified persons recommended jointly by the Blue Cross and Blue Shield plans of Pennsylvania.
(10) One representative of commercial insurance carriers, appointed by the Governor from a list of three qualified persons recommended by the Insurance Federation of Pennsylvania, Inc.
(11) Two individuals appointed by the Governor who have expertise in health economics and outcomes research.
(12) Representatives from the General Assembly as follows:
(i) One Senator appointed by the President pro tempore of the Senate.
(ii) One Senator appointed by the Minority Leader of the Senate.
(iii) One member of the House of Representatives appointed by the Speaker of the House of Representatives.
(iv) One member of the House of Representatives appointed by the Minority Leader of the House of Representatives.
(13) In the case of each appointment to be made from a list supplied by a specified organization, it is incumbent upon that organization to consult with and provide a list which reflects the input of other equivalent organizations representing similar interests. Each appointing authority will have the discretion to request additions to the list originally submitted. Additional names will be provided not later than 15 days after such request. Appointments shall be made by the appointing authority no later than 90 days after receipt of the original list. If, for any reason, any specified organization supplying a list should cease to exist, then the respective appointing authority shall specify an equivalent organization to fulfill the responsibilities set forth in this chapter.
(c) Chairperson and vice chairperson.--
The members shall annually elect, by a majority vote of the members, a chairperson and a vice chairperson of the council from the business and labor members of the council.
(d) Quorum.--
The council shall establish in the council's bylaws the number of members necessary to constitute a quorum.
(e) Meetings.--
All meetings of the council shall be advertised and conducted under 65 Pa.C.S. Ch. 7 (relating to open meetings), unless otherwise provided in this section. The following apply:
(1) The council shall meet at least once every two months and may provide for special meetings as it deems necessary. Meeting dates shall be set by a majority vote of the members of the council or by the call of the chairperson upon seven days' notice to council members. Attendance at the meeting may be accomplished by electronic means so long as each council member attending via electronic means can communicate in real time with the other members of the council and the public.
(2) All meetings of the council shall be publicly advertised, as provided for in this subsection, and shall be open to the public, except that the council, through its bylaws, may provide for executive sessions of the council on subjects permitted to be discussed in such sessions under 65 Pa.C.S. Ch. 7. No act of the council shall be taken in an executive session.
(3) The council shall publish a schedule of its meetings in the Pennsylvania Bulletin, on its publicly accessible Internet website and as provided under 65 Pa.C.S. Ch. 7. The notice shall be published at least once in each calendar quarter and shall list the schedule of meetings of the council to be held in the subsequent calendar quarter. The notice shall specify the date, time and place of the meeting and shall state that the council's meetings are open to the general public, except that no notice shall be required for executive sessions of the council.
(4) All action taken by the council shall be taken in open public session, and action of the council shall not be taken except upon the affirmative vote of a majority of the members of the council present during meetings at which a quorum is present.
(f) Bylaws.--
The council shall adopt bylaws, not inconsistent with this chapter, and may appoint such committees or elect such officers subordinate to those provided for in subsection (c) as it deems advisable.
(g) Technical advisory group.--
(1) The council shall appoint a technical advisory group which shall, on an ad hoc basis, respond to issues presented to it by the council or committees of the council and shall make recommendations to the council. The technical advisory group shall include:
(i) Physicians.
(ii) Researchers.
(iii) Biostatisticians.
(iv) One representative of the Hospital and Healthsystem Association of Pennsylvania.
(v) One representative of the Pennsylvania Medical Society.
(2) The Hospital and Healthsystem Association of Pennsylvania and the Pennsylvania Medical Society representatives shall not be subject to executive committee approval. In appointing other physicians, researchers and biostatisticians to the technical advisory group, the council shall consult with and take nominations from the representatives of:
(i) the Hospital Association of Pennsylvania;
(ii) the Pennsylvania Medical Society;
(iii) the Pennsylvania Osteopathic Medical Society; or
(iv) other like organizations.
(3) At its discretion and in accordance with this section, nominations shall be approved by the executive committee of the council. If the subject matter of any project exceeds the expertise of the technical advisory group, physicians in appropriate specialties who possess current knowledge of the issue under study may be consulted. The technical advisory group shall also review the availability and reliability of severity of illness measurements as they relate to small hospitals and psychiatric, rehabilitation and children's hospitals and shall make recommendations to the council based upon this review. Meetings of the technical advisory group shall be open to the general public.
(h) Payment data advisory group.--
(1) In order to assure the technical appropriateness and accuracy of payment data, the council shall establish a payment data advisory group to produce recommendations surrounding the collection of payment data, the analysis and manipulation of payment data and the public reporting of payment data. The payment data advisory group shall include technical experts and individuals knowledgeable in payment systems and claims data. The advisory group shall consist of the following members appointed by the council:
(i) One member representing each plan under 40 Pa.C.S. Chs. 61 (relating to hospital plan corporations) and 63 (relating to professional health services plan corporations).
(ii) Two members representing commercial insurance carriers.
(iii) Three members representing health care facilities.
(iv) Three members representing physicians.
(2) The payment data advisory group shall meet at least four times a year and may provide for special meetings as may be necessary.
(3) The payment data advisory group shall review and concur with the technical appropriateness of the use and presentation of data and report its findings to the council prior to any vote to publicly release reports. If the council elects to release a report without addressing the technical concerns of the advisory group, it shall prominently disclose this in the public report and include the comments of the advisory group in the public report.
(4) The payment data advisory group shall exercise all powers necessary and appropriate to carry out its duties, including advising the council on the following:
(i) Collection of payment data by the council.
(ii) Manipulation, adjustments and methods used with payment data.
(iii) Public reporting of payment data by the council.
(i) Compensation and expenses.--
The members of the council and any member of an advisory group appointed by the council shall not receive a salary or per diem allowance for serving as members or advisors of the council, but shall be reimbursed for actual and necessary expenses incurred in the performance of their duties. The expenses may include reimbursement of travel and living expenses while engaged in council business.
(j) Terms of council members.--
(1) The terms of the Secretary of Health, the Secretary of Human Services, the Insurance Commissioner and the legislative representatives shall be concurrent with their holding of public office. The council members under subsection (b)(4), (5), (6), (7), (8), (8.1), (8.2), (9), (10), (11) and (12) shall each serve for a term of four years and shall continue to serve thereafter until their successors are appointed.
(2) Vacancies on the council shall be filled in the manner designated under subsection (b), within 60 days of the vacancy, except that, when vacancies occur among the representatives of business or organized labor, two nominations shall be submitted by the organization specified in subsection (b) for each vacancy on the council. If the officer required in subsection (b) to make appointments to the council fails to act within 60 days of the vacancy, the council chairperson may appoint one of the persons recommended for the vacancy until the appointing authority makes the appointment.
(3) Except for the Secretary of Health, the Secretary of Human Services, the Insurance Commissioner and the legislative representatives, a member may be removed for just cause by the appointing authority after recommendation by a vote of at least 14 members of the council.
(4) No appointed member under subsection (b)(4), (5), (6), (7), (8), (8.1), (8.2), (9), (10), (11) and (12) shall be eligible to serve more than three full consecutive terms of four years beginning on the effective date of this paragraph.
(k) Subsequent appointments.--
Submission of lists of recommended persons and appointments of council members for succeeding terms shall be made in the same manner as prescribed in subsection (b), except that:
(1) Organizations required under subsection (b) to submit lists of recommended persons shall do so at least 60 days prior to expiration of the council members' terms.
(2) The officer required under subsection (b) to make appointments to the council shall make the appointments at least 30 days prior to expiration of the council members' terms. If the appointments are not made within the specified time, the council chairperson may make interim appointments from the lists of recommended individuals. An interim appointment shall be valid only until the appropriate officer under subsection (b) makes the required appointment. Whether the appointment is by the required officer or by the chairperson of the council, the appointment shall become effective immediately upon expiration of the incumbent member's term.
Special Provisions in Appendix.
See section 2(2) of Act 15 of 2020 in the appendix to this title for special provisions relating to applicability.
Cross References.
Section 3303 is referred to in sections 3304, 3314 of this title.