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

Budget Bill Proposed in PA House

The chairman of the Pennsylvania House Appropriations Committee has introduced a bill proposing a budget for the state’s 2014 fiscal year.
House Bill 1437, sponsored by Rep. Bill Adolph (R-Delaware), calls for $100 million less spending than the $28.4 billion budget proposed by Governor Tom Corbett in February.
The bill also includes a number of differences in proposed spending for Medicaid and Department of Health programs.
For a summary of the bill, with an emphasis on provisions with the greatest interest to Pennsylvania’s safety-net hospitals, please hit the “contact us” link at the top of this screen.

State Budget

PA Safety Net Admin2013-05-31T06:00:08+00:00May 31st, 2013|Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget|Comments Off

PA Announces Plans for Increased Medicaid Fees

The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014. The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act.
A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here.
The revised fee schedule with the new, higher fees can be found here .

PA Safety Net Admin2013-05-29T06:00:17+00:00May 29th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Says Fiscal Office Understates Cost of Medicaid Expansion

The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.

PA Safety Net Admin2013-05-22T06:00:40+00:00May 22nd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Uncategorized|Comments Off

Medicaid Pay Raise Isn’t Reaching Docs

The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians.
Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients.
The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions. Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014.
Five months into 2013, however, only Maryland, Massachusetts, Nevada, and Michigan are making the higher payments.
Pennsylvania is among the states still not making the enhanced Medicaid payments, but state officials have promised further information about their plans in the coming days.
Learn more about the thinking behind the pay raise and why most states still are not paying it in this Washington Post article.

PA Safety Net Admin2013-05-21T06:00:54+00:00May 21st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Seeks Fair Share for Fair Care

Pennsylvania is asking the federal government to continue full funding of the health insurance program for hard-to-insure people created under the Affordable Care Act.
PA Fair Care currently provides health insurance for 6900 Pennsylvanians with medical conditions that usually make health insurance too expensive for them to purchase. The federal government allocated $5 billion for the program, but even though nation-wide enrollment is less than one-third of what the Obama administration estimated, the program has expended most of its initial appropriation and the federal government has asked states to stop enrolling new members and shift existing members into the federal version of the program or risk liability for costs the federal government will no longer subsidize.
Read more about PA Fair Care, why the program is in trouble, and what the state and federal government are trying to do about it in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2013-05-20T06:00:44+00:00May 20th, 2013|Uncategorized|Comments Off

DPW Secretary: Medicaid Expansion No Sooner Than 2015

Even if Pennsylvania decides to go ahead and expand its Medicaid program, such expansion is unlikely before January of 2015, according to the state official who would be responsible for leading that expansion.
State officials still have not decided whether the state will expand its program as envisioned under the Affordable Care Act, but even if they decide to expand, Department of Public Welfare acting secretary Beverly Mackereth has indicated that the work involved in such an undertaking makes it unlikely that expansion could begin until January of 2015.
Currently, state officials are negotiating possible terms of expansion with the U.S. Department of Health and Human Services. A decision on expansion most likely depends on the outcome of those negotiations.
Read more about Secretary Mackereth’s comments about a possible expansion time-frame and the issues that still need to be addressed in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2013-05-15T06:00:22+00:00May 15th, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

Congressman Calls for Delay on DSH Cuts

Cuts in Medicare DSH and Medicaid DSH payments, scheduled to be take effect beginning in FY 2014, would be delayed for two years under a new bill proposed in Congress.
Under the DSH Reduction Relief Act of 2013, Affordable Care Act-mandated cuts in Medicare disproportionate share payments (Medicare DSH) and Medicaid disproportionate share payments (Medicaid DSH) would not begin until FY 2016, instead of in FY 2014, as the reform law requires.
The bill was proposed by Representative John Lewis (D-GA).
Read more about The DSH Reduction Relief Act in this article from Becker’s Hospital Review.

PA Safety Net Admin2013-05-13T09:36:10+00:00May 13th, 2013|Health care reform|Comments Off

Will Medicaid Coverage Mean Access?

With many states preparing to expand their Medicaid programs and enroll unprecedented numbers of new people, it is not clear whether Medicaid coverage will lead to access to care.
That concern arises in the wake of a survey that found that only 43 percent of physicians accept Medicaid patients. Other providers, moreover, may not be up to filling the gap: the same survey found that only 20 percent of physician assistants and nurse practitioners serve Medicaid patients.
Thus, while more people than ever will have health insurance once the Medicaid expansion component of the Affordable Care Act takes effect, it is not clear whether those who find themselves newly insured will have reasonable access to medical services.
While the Affordable Care Act attempts to anticipate this challenge by raising the traditionally low fees that Medicare pays primary care physicians to the same level as those paid by Medicare for the next two years, it is not clear whether this new policy is working and if will have a lasting impact after the two-year experiment ends.
This could become a major challenge for Pennsylvania’s safety-net hospitals if the state eventually chooses to expand its Medicaid program. To date, the state has chosen not to expand the program but has been discussing the possibility of doing so with federal officials. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about the survey and its implications in this Healthcare Finance News report .

PA Safety Net Admin2013-05-08T06:00:00+00:00May 8th, 2013|Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

DPW Establishes Exceptions to Monthly Prescription Limit

Since January of last year, Pennsylvania’s Medical Assistance program has limited categorically needy adult recipients over the age of 21 to six prescriptions a month.
While Medical Assistance has established a process for seeking exceptions to this limit, the Department of Public Welfare has now published a new MA Bulletin that lists exceptions that will automatically be granted.
Find that list in this MA Bulletin.

PA Safety Net Admin2013-05-03T06:00:51+00:00May 3rd, 2013|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Questions Financial Underpinnings of Medicaid Expansion

In a letter to the leaders of the two legislative appropriations committees, Pennsylvania Department of Public Welfare Acting Secretary Beverly Mackereth has questioned whether the state can rely on the continued availability of certain key parts of funding Medicaid expansion in the commonwealth.
In particular, Secretary Mackereth questioned whether Pennsylvania would be able to continue levying its gross receipts tax on managed care organizations, which is expected to produce $1.5 billion in revenue to use for Medicaid over the next seven years.
Pennsylvania also has a number of potential Medicaid deferrals and allowances under consideration by the federal government that could result in the state receiving less federal Medicaid matching money.
Read Secretary Mackereth’s letter to legislative leaders, and a press release that accompanies that letter, here on the web site of PR Newswire.

PA Safety Net Admin2013-05-02T06:00:58+00:00May 2nd, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

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