PA Safety Net Admin, Author at Safety-Net Association of Pennsylvania

PA Health Policy Update for December 13

The following is an update of selected state health policy developments in Pennsylvania December 9 – 13. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate have released their respective 2025 session calendars. Find the House’s calendar here and the Senate’s calendar here.

Department of Human Services

The Department of Human Services (DHS) has announced the addition of doula services to the Medical Assistance (MA) program fee schedule and the submission of a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS). DHS will issue an MA Bulletin to inform providers enrolled in the MA program of the addition of doula services and how to bill for the provision of doula services. Find additional information in this Pennsylvania Bulletin notice.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the Partial Hospitalization Regulatory Compliance Guide. The guidance is intended to help agencies providing partial hospitalization services with the goal of ensuring safe environments and effective services to individuals.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on December 5.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

Department of Health

The Department of Health (DOH) and the Pennsylvania Insurance Department (PID) have reminded Pennsylvanians of the importance of HIV pre-exposure prophylaxis (PrEP) medication for HIV prevention. The Affordable Care Act (ACA) requires that HIV PrEP be covered at zero cost-sharing for insured consumers. Find additional resources and information in this press release.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has released a “Family Members Training Needs Survey.” DDAP has requested feedback from family members and/or significant others of individuals who may be suffering from drug or alcohol use, receiving substance use disorder (SUD) treatment, or in recovery to better understand what would help them navigate SUD services. The survey will remain open until January 6, 2025.

Around the State

The Pittsburgh Post-Gazette has written an article about the expected increase in the number of Pennsylvanians diagnosed with Alzheimer’s Disease in the next 15 years and the challenges the current treatment system will face according to a recent analysis conducted by the Center for Rural Pennsylvania.

The Pennsylvania Capitol-Star published an article about the potential increase in insurance premiums for Pennsylvanians on Pennie, the state’s health insurance marketplace, if federal subsidies expire.

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Board – December 16

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 16 from 2:00 to 3:30 p.m. For connection information or any questions, please contact Megan McDaniel (memcdaniel@pa.gov).

DOH – Health Policy Board – December 19

The Health Policy Board will hold a meeting on Thursday, December 19 at 12:30 p.m. The purpose of the meeting is to consult with the board of the department’s draft proposed hospital regulations. The meeting will be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-12-13T21:47:50+00:00December 13th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for December 6

The following is an update of selected state health policy developments in Pennsylvania November 25 – December 6. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration has held two recent roundtable discussions with maternal health stakeholders to inform the development of the administration’s Maternal Health Strategic Plan, which will address high rates of maternal mortality and ensure pregnant women in Pennsylvania receive necessary prenatal and postpartum care. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate have released their respective 2025 session calendars. Find the House’s calendar here and the Senate’s calendar here.

Department of Human Services

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of October.

Department of Health

The Department of Health (DOH) has released a Respiratory Virus Outbreak Toolkit for long-term care facilities, including personal care homes and assisted living residences. The purpose of the toolkit is to provide recommendations for facilities before and during a respiratory virus outbreak.

DOH has published guidelines and fees that a health care provider or facility may charge in response to a request for production of medical charts or records. Find additional information in this Pennsylvania Bulletin notice. This notice updates the prior notice published on December 9, 2023.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in November, which was $87.2 million, or 2.9 percent, less than anticipated. Fiscal year-to-date General Fund collections total $16.4 billion, which is $9.9 million, or 0.1 percent, below estimate.

Around the State

With the conclusion of the 2023-2024 legislative session, City & State Pennsylvania has published an article highlighting the session’s accomplishments, as well as its unfinished business.

NBC’s local affiliate 21 WFMJ has reported on efforts to keep Sharon Regional Medical Center open.

Spotlight PA has published an article about the range of health care workers who provide maternal care in Pennsylvania and their various roles.

Stakeholder Events

Patient Safety Authority – December 12

The Patient Safety Authority Board will meet on Thursday, December 12 at 1:00 p.m. The meeting will be held virtually. Find details on how to participate here and a draft agenda here.

Department of Aging – Pharmaceutical Assistance Board – December 16

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 16 from 2:00 to 3:30 p.m. For connection information or any questions, please contact Megan McDaniel (memcdaniel@pa.gov).

PA Safety Net Admin2024-12-06T20:21:33+00:00December 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for November 22

The following is an update of selected state health policy developments in Pennsylvania November 18 – 22. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro has signed Executive Order 2024-04 creating the Pennsylvania Permit Fast Track Program to streamline the state’s permitting process for key economic development and critical infrastructure projects. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate have recessed until the call of their respective chair.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Medical Assistance (MA) Program Vaccine Desk Reference. This bulletin applies to all providers enrolled in the MA program that may administer vaccines to MA beneficiaries in the fee-for-service or managed care delivery system.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through December. Find the updated calendar here.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced the publication of the first Pennsylvania Affordable Care Act and Qualified Health Plans (QHP) Summary Report. This report examines how PID reviews health insurance products and enforces laws to ensure a fair insurance market and equitable treatment of consumers. Find more information in this press release.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has announced it received the following final form regulations, which will be considered at its public meeting on December 5, 2024.

State Board of Medicine Opioid Treatment Programs: this final-omitted rulemaking amends the Board of Medicine’s regulations to allow the initial physical examination required for prescribing, administering, and dispensing controlled substances to be done via telehealth under certain conditions.
State Board of Osteopathic Medicine Licensure Requirements: this final rulemaking includes amendments to licensure requirements that are, in part, necessary to reflect the merger of the post-graduate training bodies for osteopathic (DO) and allopathic (MD) medical school graduates into a single accreditation system.

Around the State

The New York Times has written about President Donald Trump’s plan to nominate Pennsylvania resident Dr. Mehmet Oz to serve as the administrator of the Centers for Medicare and Medicaid Services.

WKBN 27 has written an article about the Commonwealth’s continued efforts related to the potential sale of Sharon Regional Medical Center, part of Steward Health Care which filed for bankruptcy in May.

City & State Pennsylvania has published an article about the five bills signed into law by Governor Shapiro this week and his signing of an executive order on permitting.

Stakeholder Events

DHS – Long-Term Services and Supports Subcommittee – December 4

The Long-Term Services and Supports Subcommittee (LTSS) will hold a public meeting on December 4 from 10:00 a.m. to 1:00 p.m. The meeting will be held in person and virtually. Click here for more information.

DHS – Consumer Sub-MAAC – December 4

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 4 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – December 5

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 5 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2024-11-22T22:10:10+00:00November 22nd, 2024|Affordable Care Act, long-term care, Medical Assistance Advisory Committee, Meetings and notices|Comments Off

PA Health Policy Update for November 15

The following is an update of selected state health policy developments in Pennsylvania November 4 – 15. (Some of the language used below is taken directly from state documents).

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it approved an amendment to Pennsylvania’s section 1115 Medicaid demonstration waiver to provide continuous Medicaid eligibility for children until the age of six, and 12 months of continuous eligibility for individuals aged 19 through 64 leaving incarceration, who meet certain high-risk criteria. Find additional information about Pennsylvania’s section 1115 demonstration amendment approval here.

General Assembly

The state House of Representatives and Senate briefly convened for voting session this week to conclude legislative business for the 2023-2024 session and elect caucus leadership for the upcoming 2025-2026 legislative session. Following is the comprehensive list of each caucus’ leadership team.

* Denotes majority party.

Department of Human Services

The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it released an updated Psychiatric Outpatient Clinic Regulatory Compliance Guide (RCG). The changes made were primarily to language and updates based on comments received from stakeholders on the original document issued in 2021. OMHSAS has been working on developing RCGs for each licensed level of care. The RCG is designed to be a tool for providers, OMHSAS staff, and the public to better understand pertinent regulations. The guide is a companion piece to 55 Pa. Code Chapter 5200.

The Department of Human Services (DHS) has issued an updated Pennsylvania Medicaid Managed Care Directory.

DHS has issued a Medical Assistance Bulletin entitled Statewide Preferred Drug List (PDL) Updates – Pharmacy Services.

DHS has issued several Medical Assistance bulletins with updated handbook pages that include the requirements for prior authorization for various pharmacy services. Following is a comprehensive list of prior authorization bulletins recently issued by DHS.

Department of Health

The Department of Health (DOH) has published notice of the Secretary of Health’s decision not to effectuate the recommendation of the Medical Marijuana Advisory Board that certified registered nurse practitioners (CRNPs) and podiatrists be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana. Find the notice regarding CRNPs here and podiatrists here.

Insurance Department

The Pennsylvania Insurance Department (PID) has released a comprehensive study of the accuracy of health insurer provider directories. The report highlights persistent inaccuracies in health insurer provider directories that can delay care, hinder scheduling, or result in surprise out-of-network charges. PID is planning to initiate stakeholder outreach to gather input and develop solutions that reduce inaccuracies in provider directories. Find additional information in this press release.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has released its Economic and Budget Outlooks for FYs 2024-2025 to 2029-2030. This annual fiscal outlook report, which includes projections of state revenues and expenditures, also considers economic and demographic trends that will impact tax revenues and expenditures over the next five fiscal years. Find the IFO’s presentation here and its full report here.

Office of Administration

The Office of Administration has recently announced the launch of a new resource page on PA.gov that makes it easier for residents, businesses, non-profits, and local government entities to find and apply to various grant programs from state agencies. Find additional information in this press release.

Around the State

The Hill has published an article about Governor Shapiro’s national political prospects following the 2024 election.

WHYY has written an article about this year’s open enrollment for health insurance coverage in 2025. The Pittsburgh Post-Gazette has also written about open enrollment and the potential for premiums to increase.

An article published by the Patriot-News highlights the continued partisan split in Harrisburg for the upcoming 2025-2026 legislative session. The Pennsylvania Capital-Star also wrote about this dynamic but noted House Democrats’ hope for greater cooperation with the Republican Senate.

Stakeholder Events

DOH – Newborn Screening Advisory Committee – November 21

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 21 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual conference. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-11-15T20:57:21+00:00November 15th, 2024|Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for November 1

The following is an update of selected state health policy developments in Pennsylvania October 28 – November 1. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro signed the following bills into law this week.

House Bill 1608, now known as Act 115 of 2024, which extends Medicaid coverage to doula services and creates a doula advisory board.
House Bill 2185, now known as Act 117 of 2024, which requires the Department of Health to develop type 1 diabetes informational materials for parents and guardians.
House Bill 2381, now known as Act 119 of 2024, which enables the licensing boards or commissions under Department of State to promulgate one-time, temporary regulations necessary for the implementation of each licensure compact enacted by the General Assembly.
Senate Bill 365, now known as Act 121 of 2024, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage.
Senate Bill 920, now known as Act 122 of 2024, which establishes a statewide sexual assault evidence tracking system.
Senate Bill 267, now known as Act 134 of 2024, which adds urgent care centers to the list of safe haven locations for newborn children.
Senate Bill 1080, now known as Act 137 of 2024, which allows licensed practical nurses to make death pronouncements in the hospice setting.

General Assembly

The state House of Representatives and Senate are currently recessed until after the November 5 General Election.

Department of Human Services

The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2024-2025 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance enrolled, qualifying inpatient general acute care hospitals. DHS does not intend to change the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has published its proposed Psychiatric Residential Treatment regulations in the Pennsylvania Bulletin. These proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

DHS has published a Medical Assistance Bulletin with updates to the PROMISe™ Provider Handbook 837 for Medical Assistance enrolled federally qualified health centers (FQHCs) and rural health clinics (RHCs).

The Office of Medical Assistance Programs (OMAP) has announced it will be hosting several upcoming community health worker (CHW) listening sessions throughout November and December in order to gather information that will help DHS’ strategic plan for CHWs. Find a schedule of the listening sessions as well as details on how to participate here.

DHS has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule and Coding Matrix. This bulletin applies to all providers enrolled in the Medical Assistance program who provide EPSDT screens for Medical Assistance beneficiaries.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on October 24.

Insurance Department

The Pennsylvania Insurance Department has published a notice in the Pennsylvania Bulletin that the Medical Care Availability and Reduction of Error (MCARE) assessment for all basic insurance coverage and self-insured participating health care providers for calendar year 2025 will be 29 percent applied to the prevailing primary premium for each participating health care provider.

Board of Medicine

The State Board of Medicine has published its final-form rulemaking related to licensure by endorsement. The regulations are effective upon publication in the Pennsylvania Bulletin. Find the final-form regulations here.

Office of the Attorney General

The Office of the Attorney General (OAG) has filed a civil suit against Prospect Medical Holdings, which owns Crozer Health System, over breach of contract. OAG has alleged Prospect has broken its 2016 court-approved “asset purchase agreement” by closing facilities and diverting funding from the sale of real estate to shareholders and investors. The lawsuit seeks a preliminary injunction to preserve Crozer’s existing services, and the appointment of a receiver to manage the Crozer Health System until another buyer can be identified. Find additional details in this press release.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate.

Around the State

Spotlight PA has published an article written by Stephen Caruso about a slate of bills to improve maternal health care in Pennsylvania.

WHYY has written an article about Attorney General Michelle Henry’s decision to sue Prospect Medical Holdings over Crozer Health System.

City & State Pennsylvania has published an article about Pennsylvania’s health insurance marketplace, Pennie, as the open enrollment period nears.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – November 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, November 7. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – November 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Planning Committee – November 20

The Statewide HIV Planning Committee will hold public meetings at the Hilton Harrisburg (One North 2nd Street, Harrisburg, PA 17101) on Wednesday, November 20 from 9:00 a.m. to 5:00 p.m. and on Thursday, November 21 from 9:00 a.m. to 4:30 p.m. The meeting will also be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Spinal Cord Research Advisory Committee – November 18

The Spinal Cord Research Advisory Committee will hold a public meeting on Monday, November 18 from 10:30 a.m. to 11:30 a.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-11-01T20:14:07+00:00November 1st, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for October 25

The following is an update of selected state health policy developments in Pennsylvania October 21 – 25. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate convened this week for voting session. The following is an overview of selected health care-related legislative activity.

The House of Representatives passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system and implements the recommendations from Act 70 of 2022. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives voted to concur with the Senate’s amendment to House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill has been presented to Governor Shapiro for his signature.

The Senate voted to concur with the House’s amendments to Senate Bill 267, which adds urgent care centers to the list of safe haven locations for newborn children. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives passed House Bill 2533, which creates a 988 public education campaign.

The House of Representatives passed House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills. The bill will now be sent to the Senate for consideration.

The House Children & Youth Committee met on Tuesday, October 22 and favorably reported House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system. A recording of the hearing is viewable here.

The House Children & Youth Committee also met on Wednesday, October 23 for an informational meeting on the CCAP Complex Case Task Force report and the DHS Blueprint report. A recording of the hearing is viewable here.

The Senate Aging & Youth and Banking & Insurance Committees held a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. A recording of the hearing is viewable here.

This was the last voting session prior to the November 5 General Election. The House and Senate will return to Harrisburg following the election on November 12 and 13, respectively.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through November. Find the updated calendar here.

DHS has published its report on Medicaid managed care enrollment in Pennsylvania for the month of September.

Department of Health

The Department of Health (DOH) has announced it is investing $3.2 million to combat the drug-related overdose epidemic through 13 organizations that will help residents connect with services and care, including receiving overdose prevention and reversal tools, treatment options, drug checking equipment, and educational services. Find additional information in this press release.

DOH has updated the electronic reporting system used to report deaths to the department under the Vital Statistics Law. For information on how to enroll in the new electronic system and frequently asked questions, see this fact sheet.

Around the State

The Pennsylvania Capital-Star has written an article about the waning days of the 2023-2024 legislative session, its accomplishments and unresolved issues.

ABC 27 has reported on bills recently signed into law by Governor Shapiro, including numerous health care bills.

St. Christopher’s Hospital for Children is receiving an additional $30 million in support over two years from a coalition of Philadelphia health care organizations, which was highlighted in an article written by Harold Brubaker for the Philadelphia Inquirer.

Harold Brubaker has also written an article about the rate of insurance denials among plans on the state’s health insurance marketplace, Pennie. Independence Blue Cross had the highest claim denial rate at 20.06 percent.

Stakeholder Events

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – November 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Planning Committee – November 20

The Statewide HIV Planning Committee will hold public meetings at the Hilton Harrisburg (One North 2nd Street, Harrisburg, PA 17101) on Wednesday, November 20 from 9:00 a.m. to 5:00 p.m. and on Thursday, November 21 from 9:00 a.m. to 4:30 p.m. The meeting will also be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-10-25T19:47:48+00:00October 25th, 2024|Advocacy, Governments, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for October 18

The following is an update of selected state health policy developments in Pennsylvania October 14 – 18. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro has signed the following bills into law this week.

House Bill 155, now known as Act 96 of 2024, removes the requirement that direct care workers be interviewed in-person for a position.
House Bill 2084, now known as Act 101 of 2024, establishes a license for prescription drug virtual manufacturers.
House Bill 2127, now known as Act 102 of 2024, allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources.
Senate Bill 668, now known as Act 109 of 2024, permits certified nurse aides to become certified medication aides in long-term care facilities, assisted living residences, and personal care homes.
Senate Bill 840, now known as Act 111 of 2024, creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.

General Assembly

The state House of Representatives and Senate are scheduled to return to Harrisburg on Monday, October 21 for session. This is the last scheduled session week prior to the November 5 General Election.

The House Children & Youth Committee will meet on Tuesday, October 22 at 10:00 a.m. in Room 515 of the Irvis Office Building to consider House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system.

The House Children & Youth Committee will also meet on Wednesday, October 23 at 10:00 a.m. in Room 515 of the Irvis Office Building for an informational meeting the CCAP Complex Case Task Force report and the DHS Blueprint report.

The Senate Aging & Youth and Banking & Insurance Committees will hold a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. The meeting will be held in Hearing Room 1 of the North Office Building.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that DHS will continue the alternative payment methodology and pay the Medical Assistance (MA) program fee schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit.

DHS has shared the agenda for the next Medical Assistance Advisory Committee (MAAC) meeting on Thursday, October 24. Find additional details on how to participate in Stakeholder Events below.

DHS has changed the provider application URL domain name. The new URL is: https://promise.dhs.pa.gov/portal/provider/Home/tabid/135/Default.aspx.

Department of Health

The Department of Health (DOH) has reminded long-term care providers that its annual questionnaire of long-term care facilities must be completed and submitted to the department electronically by Friday, October 25, 2024. Any questions regarding the questionnaire may be directed to RA-dohbhssurveys@pa.gov.

Around the State

Spotlight PA published an article about the increasing number of long-term care facility closures in the commonwealth.

Pennsylvania pharmacists are receiving less money for drugs dispensed to Medicaid patients, the Pennsylvania Capital-Star reports.

Stakeholder Events

DHS – Consumer Sub-MAAC – October 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 23 at 1:00 p.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DHS – Medical Assistance Advisory Committee – October 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 24 at 10:00 a.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-10-21T20:36:11+00:00October 18th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for October 11

The following is an update of selected state health policy developments in Pennsylvania October 7 – 11. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Commonwealth of Pennsylvania is taking steps to address the state’s high maternal mortality rate through the development of a statewide “Maternal Health Strategic Plan.” The Shapiro administration is asking stakeholders to complete a survey through November 4 to help inform the development of the strategic plan. Along with the governor’s office, the health agencies involved include the departments of Health, Human Services, Drug and Alcohol Programs, and Insurance. Find the survey here.

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

The Senate unanimously voted to concur with House amendments to Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill will now be presented to Governor Shapiro for his signature.

The Senate unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. Since the bill was amended in the Senate, it will now go back to the House for concurrence.

The Senate unanimously passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill was subsequently received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee for consideration.

The Senate unanimously passed House Bill 2381, which allows a licensing board or commission under the Department of State’s Bureau of Professional and Occupational Affairs to promulgate temporary regulations necessary for the implementation of each interstate licensure compact enacted by the General Assembly. Since the bill was amended in the Senate, it will now go back to the House for concurrence.

The Senate unanimously passed House Bill 2268, which provides coverage for speech therapy for stuttering. The bill was subsequently presented to Governor Shapiro for his signature.

The Senate passed House Bill 2084, which establishes a license for prescription drug virtual manufacturers. The bill was subsequently presented to Governor Shapiro for his signature.

The Senate unanimously voted to concur with the House amendments to Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. The bill was subsequently presented to Governor Shapiro for his signature.

The Senate unanimously passed House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources. The House subsequently voted to concur with the Senate’s amendments and the bill was subsequently presented to Governor Shapiro for his signature.

The Senate unanimously passed House Bill 155, which removes the requirement that direct care workers be interviewed in-person for a position. The bill was subsequently presented to Governor Shapiro for his signature.

The House of Representatives passed House Bill 2562, which prohibits health insurance companies from imposing annual and lifetime limits to the dollar value of core benefits provided under the policy to the enrollee. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2563, which provides for health insurance coverage of dependent children up to age twenty-six by a parent’s health insurance policy. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2564, which prohibits health insurance companies from imposing any rules for initial or continued eligibility for individuals having a preexisting condition. The bill will now be sent to the Senate for consideration.

The House of Representatives passed Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently presented to Governor Shapiro for his signature.

The Senate Health & Human Services Committee met on Monday, October 7 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the hearing is viewable here.

The House Labor & Industry Committee met on Wednesday, October 9 for an informational hearing on the Federated Insurance Company v. Summit Pharmacy court case. A recording of the hearing is viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers are scheduled to return to Harrisburg on Monday, October 21.

Department of Human Services

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced that the proposed Psychiatric Residential Treatment Facilities (PRTF) regulations have been posted for public comment. OMHSAS’ proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

The Department of Human Services (DHS) has published proposed rulemaking to amend a data element in DHS’ case-mix payment system for non-public and county nursing facilities to utilize the patient driven payment model (PDPM) in place of the Resource Utilization Groups, Version III (RUG-III) classification system in setting Medical Assistance (MA) payment rates for nursing facilities. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 773) with information about the first Marburg Virus Disease (MVD) outbreak in the Republic of Rwanda, including information about patient assessment and monitoring of U.S. health care workers who may have been in Rwanda within the last 21 days.

DOH has issued a notice to physicians renewing their licenses in Pennsylvania to ensure their practice information is up to date.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its intent to submit an application to extend the 1332 State Innovation Waiver Reinsurance Program (PA-Re) for another five years. The state reinsurance program helps moderate premiums in the state’s individual health insurance marketplace. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

PID has announced Pennsylvania’s 2025 Affordable Care Act (ACA) health insurance rates. The enrollment period for Pennie, Pennsylvania’s health insurance marketplace, will begin November 1 and go through December 15 for coverage that starts on January 1, 2025.

Around the State

WHYY has published an article about the worsening shortage of IV fluids due to Hurricane Helene which damaged a factory in North Carolina that produces more than half the country’s supply of IV fluids.

The New York Times has written an article about the consequential role Pennsylvania is currently playing in this year’s U.S. Presidential election and the amount of time and money the candidates are spending in Pennsylvania.

Health care professionals from across Pennsylvania rallied at the State Capitol on Tuesday along with gun violence awareness advocates. WGAL reports the rally is part of a new statewide coalition called PA Health Professionals to End Gun Violence.

Stakeholder Events

DOH – WIC State Advisory Board – October 22

The WIC State Advisory Board will hold a meeting on October 22 from 1:00 – 2:00 p.m. The purpose of this meeting is to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-10-11T19:46:11+00:00October 11th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for October 4

The following is an update of selected state health policy developments in Pennsylvania from September 30 – October 4. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

The House of Representatives passed House Bill 2295 and House Bill 2294, which allow a physician assistant to work with either an allopathic or osteopathic physician without having to obtain a license from both medical boards. The bills were subsequently received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.

The House Labor & Industry Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2548, which requires employers to provide paid sick leave. A recording of the hearing is viewable here.

The House Aging & Older Adult Services Committee met on Monday, September 30 for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care. A recording of the hearing is viewable here.

The House Insurance Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. A recording of the hearing is viewable here. The Insurance Committee also met on Tuesday, October 1 for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes. A recording of the hearing is viewable here.

The Senate Aging & Youth Committee met on Tuesday, October 1 and favorably reported, among other bills, Senate Bill 1303, which lowers the influenza vaccine offering from age 65 and older, down to age 50 and older. A recording of the hearing is viewable here.

The Senate Health & Human Services Committee met on Tuesday, October 1 and favorably reported the following bills.
- House Bill 155, which allows two-way video calls to satisfy the face-to-face requirement for job interviews for direct care workers.
- House Bill 1608, which requires coverage of doula services in the Medical Assistance program.
- House Bill 2084, which establishes a license for virtual prescription drug manufacturers.
- House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with information about postpartum depression and counseling resources.

A recording of the Senate Health & Human Services Committee is viewable here.

The House Health Committee met on Wednesday, October 2 and favorably reported the following bills.

- House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
- House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
- Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
- Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

A recording of the Health Committee meeting is viewable here.

- The Human Services Committee met on Wednesday, October 2 for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee held a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. A recording of the meetings is viewable here.

The state House of Representatives and Senate will convene again for voting session Monday, October 7 through Wednesday, October 9.

Department of Human Services

The Department of Human Services (DHS) has announced a Request for Applications (RFA) seeking managed care organizations to administer services for the Children’s Health Insurance Program (CHIP) program.

DHS has announced its intent to increase rates paid in its Behavioral HealthChoices program, which provides access to mental health, substance use disorder, and other behavioral health services for Medicaid recipients. Once approved by CMS, the new rates to the Behavioral HealthChoices Managed Care Organizations (MCOs) will be retroactive to July 1, 2024 for their current 2024 contract agreements.

DHS announced an increase in the assessment fee that managed care organizations (MCOs) will pay per member per month as a means to generate federal matching funds to support the capitation payments. The increase, which becomes effective in January, is expected to generate an additional $223.531 million in assessment revenue for FY 2024-2025.

DHS has shared the following presentations from the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee meeting on September 25.

The Independent Regulatory Review Commission (IRRC) approved the DHS Psychiatric Rehabilitation Services regulations that were first proposed in 2022. With this revision, the regulations expand eligibility for psychiatric rehabilitation services to include individuals 14 years of age or older but under 18 years of age and expand the diagnoses that allow individuals to access PRS without going through the exception process. Find more information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 772) regarding health care and long-term care facility preparedness for the 2024-2025 respiratory virus season.

DOH has issued a Health Advisory (PA-HAN 771) with information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo and prevention strategies for U.S. travelers visiting countries with an outbreak.

DOH has issued a Health Advisory (PA-HAN 770) announcing that has received adequate supplies of Benzathine Penicillin G (Bicillin L-A®) and is now lifting the restrictions for the administration of Bicillin L-A® for individuals who are diagnosed with or suspected of having syphilis.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has issued a licensing alert regarding DDAP’s implementation of the updated federal regulations for the certification of Opioid Treatment Programs (OTPs).

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate.

Stakeholder Events

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-10-07T15:57:14+00:00October 4th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for September 27

The following is an update of selected state health policy developments in Pennsylvania from September 23 – 27. (Some of the language used below is taken directly from state documents).

General Assembly

The House Republican Policy Committee held an informational hearing on Monday, September 23 examining Pennsylvania’s drug crisis. Testimony offered at the hearing is viewable here and a video recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for voting session next Monday, September 30 through Wednesday, October 2. Following is a selection of relevant health care-related legislative activity currently scheduled.

The House Labor & Industry Committee will meet on Monday, September 30 at 9:00 a.m. in Room 60 of the East Wing to consider, among other bills, House Bill 2548, which requires employers to provider paid sick leave.

The House Aging & Older Adult Services Committee will meet on Monday, September 30 at 10:00 a.m. in Room 523 of the Irvis Office Building for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care.

The House Insurance Committee will meet on Monday, September 30 at 10:30 a.m. in Room 60 East Wing to consider, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. The Insurance Committee will also meet on Tuesday, October 1 at 9:00 a.m. in Room 60 of the East Wing for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes.

The House Health Committee will meet on Wednesday, October 2 at 9:00 a.m. in Room G50 of the Irvis Office Building to consider the following bills.

- House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
- House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
- Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
- Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

The Human Services Committee will meet on Wednesday, October 2 at 9:30 a.m. in Room 515 of the Irvis Office Building for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee will hold a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign.

Department of Human Services

The Department of Human Services (DHS) has announced the continuation of the alternative payment methodology for federally qualified health centers and rural health clinics for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. Find additional information in this Pennsylvania Bulletin notice.

DHS has published its report on Medicaid managed care enrollment in Pennsylvania for the month of August.

Insurance Department

The Pennsylvania Insurance Department has announced it received approximately $635,000 from CMS to improve women’s access to health benefits. The funds will be used to launch a multi-faceted campaign focused on awareness and education about preventive care, including contraception. It will also be used to enhance benefit reviews and issuer education to reduce coverage barriers and improve compliance. Find additional information in this press release.

Around the State

Spotlight PA has published an article about Auditory General Tim DeFoor’s report on pharmaceutical benefit managers (PBMs) and the politics surrounding the report in an election year.

Stakeholder Events

DOH – HIV Community Prevention Planning Committee – October 1

The Statewide HIV Community Prevention Planning Committee will hold a public meeting on Tuesday, October 1 from 9:00 a.m. to 4:30 p.m. and Wednesday, October 2 from 9:00 a.m. to 4:30 p.m. The meeting will be held virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-09-27T21:37:45+00:00September 27th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin|Comments Off

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