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

Will Fiscal Cliff Deal Make Medicaid, Medicare More Vulnerable?

The relative lack of spending cuts included in the fiscal cliff/Medicare doc fix deal passed by Congress last week could increase the pressure to reduce costs in key safety-net programs like Medicare, Medicaid, and Social Security.
Or so some policy analysts believe.
Many members of Congress supported the fiscal cliff bill only reluctantly because of it lacked the bigger spending cuts they sought, the thinking goes. Now, with another fiscal cliff deadline looming on March 1, when the previously passed sequestration law takes effect, many who compromised last week will be demanding bigger cuts in exchange for their vote.
As a result, Medicare and Medicaid, two of the federal government’s fastest-growing expenses, are expected to be targets for those in search of cuts. In addition, Medicare has proven to be among the first places many officials look in their search for savings.
Any attempt to implement additional reductions in Medicaid and Medicare, beyond those already scheduled to take effect through the Affordable Care Act and last week’s fiscal cliff bill, would be especially damaging to Pennsylvania’s private safety-net hospitals.
Read more about how last week’s budget solution is far from the end of the threat to Medicare and Medicaid in this Boston Globe article .

PA Safety Net Admin2013-01-08T06:00:47+00:00January 8th, 2013|Uncategorized|Comments Off

PA Paves Way for Primary Care Pay Raise

The Pennsylvania Department of Public Welfare has published a notice that it will increase the fees Medical Assistance pays for selected primary care services.
The pay raise, funded 100 percent by the federal government, is part of the Affordable Care Act.
For further information about the pay raise, which physicians qualify for it, and how they can receive the pay raise, see the notice here, in the Pennsylvania Bulletin.
In addition, members of the Safety-Net Association of Pennsylvania (SNAP) have received a detailed memo outlining the terms of the Medicaid primary care pay raise. Members who have not seen the memo and others who would like a copy can request it at info@paysafetynet.org.

PA Safety Net Admin2013-01-07T06:00:48+00:00January 7th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

Insurance Commissioner Explains Why PA Rejected Health Exchange

Writing in the Pottstown Mercury, Pennsylvania Insurance Commissioner Michael Consedine has outlined why the Corbett administration chose not to develop the health insurance exchange that is one of the centerpieces of the 2010 Affordable Care Act.
Mr. Consedine’s explanation mirrors that offered last month by Pennsylvania Governor Tom Corbett: the federal government did not provide enough information and guidance to enable the state to develop its own exchange. (Go here for a summary of Governor Corbett’s op-ed piece and a direct link to that piece.)
As a result of this decision, Pennsylvania will use a health insurance exchange developed for it by the federal government.
Read Mr. Consedine’s guest column in the Pottstown Mercury here.

PA Safety Net Admin2013-01-03T06:00:13+00:00January 3rd, 2013|Health care reform, Uncategorized|Comments Off

Medicare Reveals First Results of Quality Program

Slightly more than half of all U.S. hospitals will receive enhanced payments from Medicare and slightly fewer than half will see their payments reduced slightly as a result of the first reporting period for Medicare’s new value-based purchasing program.
The largest bonus will be awarded to Treasure Valley Hospital, in Utah. Each of its Medicare payments will rise 0.83 percent. The largest penalty will be assessed to Auburn Community Hospital, in Syracuse, which will see its Medicare payments reduced 0.9 percent. Two-thirds of all hospitals will see their payments rise or fall less than 0.25 percent.
Medicare’s value-based purchasing program, created by the Affordable Care Act, seeks to enhance provider accountability for the care they deliver. Seventy percent of a hospital’s score is based on its performance according to 12 basic standards of care and the rest of the score is based on the results of patient satisfaction surveys.
The program will be expanded in the coming years to encompass more standards of care. A companion program, based on Medicare readmissions within 30 days of patient discharge, is already under way and rewarding top performance and penalizing underperforming hospitals.
According to the figures released, 51 percent of Pennsylvania hospitals will receive bonuses through the value-based purchasing program and 49 percent will be penalized. Between the two programs – the value-based purchasing program and the readmissions reduction program – 20 percent of Pennsylvania hospitals will see a net increase in payments and the remaining 80 percent either broke even or will see their payments reduced.
Read more about the quality program in this Kaiser Health News report , which also offers links to lists of the results for every hospital in the country for both the Medicare value-based purchasing and readmissions reduction programs.

PA Safety Net Admin2012-12-31T06:00:30+00:00December 31st, 2012|Uncategorized|Comments Off

GAO Finds Problems With Medicaid DSH Payments

The U.S. Government Accountability Office (GAO) is now reviewing audits of states’ Medicaid disproportionate share payments (Medicaid DSH) to hospitals and is raising questions about states’ compliance with federal requirements for those payments.
Based on its analysis of state Medicaid DSH audits, GAO found that states are making Medicaid DSH payments to hospitals that exceed those hospitals’ uncompensated care costs and are inaccurately calculating those hospital uncompensated care costs. The GAO also found that states are not always targeting their Medicaid DSH payments to the hospitals that provide the most uncompensated care.
States are required to submit audits and data as a condition of receiving Medicaid DSH funds from the federal government. Currently, the Centers for Medicare & Medicaid Services (CMS) is not acting on the information it receives but will begin doing so after a transition period that ends when 2014 audits are completed. In anticipation of that time, GAO is reviewing the information CMS receives for state compliance with six federal standards for Medicaid DSH payments.
This data also may eventually be used to help implement the Medicaid DSH payment reduction mandated under the Affordable Care Act.
According to the report, Pennsylvania did not provide some of the required data, so in several instances in which the document provides specific information about individual state performance, it has nothing about Pennsylvania. It does note, however, that in FY 2007, six hospitals in the state received Medicaid payments greater than their Medicaid costs.
Because Pennsylvania’s safety-net hospitals care for so many uninsured and low-income patients and receive higher Medicaid DSH payments than other hospitals, they are far more dependent on these payments than other hospitals and will need to watch this situation closely in the future.
Learn more about GAO’s examination of Medicaid DSH payments – why it is undertaking this review, what it found, and how its findings may be used in the future – in the report More Transparency of and Accountability for Supplemental Payments are Needed, which can be found here , on GAO’s web site.

PA Safety Net Admin2012-12-28T06:00:33+00:00December 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off

SNAP Seeks Provider Fee Help from PA Congressional Delegation

In a message to members of Pennsylvania’s congressional delegation, the Safety-Net Association of Pennsylvania (SNAP) has asked elected officials in Washington, D.C. to protect the state’s ability to levy assessments on providers to help fund the commonwealth’s Medicaid program. The proceeds from the state’s current provider assessments, SNAP notes, have made a major difference in ensuring the ability of Pennsylvania’s safety-net hospitals to continue serving their many Medicaid patients.
Read SNAP’s message to the Pennsylvania congressional delegation here Safety-Net Association of Pennsylvania logo .

PA Safety Net Admin2012-12-26T15:00:08+00:00December 26th, 2012|Safety-Net Association of Pennsylvania|Comments Off

Corbett Explains ‘No’ Decision on Health Exchanges

In an op-ed piece in Sunday’s Philadelphia Inquirer, Pennsylvania Governor Tom Corbett presented the reasons he decided to let the federal government develop the state’s health insurance exchange – a key part of the Affordable Care Act – instead of having his own administration develop the exchange.
Read Governor Corbett’s op-ed piece here .

PA Safety Net Admin2012-12-24T11:08:31+00:00December 24th, 2012|Health care reform|Comments Off

Medicaid Enrollment Down in Philadelphia Area

Medicaid enrollment in southeastern Pennsylvania fell 10,000 people between June and September of this year, with most of that loss occurring in Philadelphia.
Read more about this change in Medical Assistance enrollment, and the HealthChoices plans in which active participants are enrolled, in this report from the Delaware Valley Healthcare Council.

PA Safety Net Admin2012-12-21T06:00:46+00:00December 21st, 2012|Pennsylvania Medicaid policy|Comments Off

DPW Announces Fee Schedule Changes

The Pennsylvania Department of Public Welfare has issued a Medical Assistance Bulletin detailing changes in the fee-for-service fee schedule. The changes take effect immediately.

Read the bulletin with the changes here .

PA Safety Net Admin2012-12-19T06:00:54+00:00December 19th, 2012|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Welfare Secretary Testifies About Medicaid Expansion

Declaring that “We in the commonwealth have never witnessed a law so vast, with such demands on state resources, and lack of federal guidance,” Pennsylvania Department of Public Welfare Secretary Gary Alexander told the House Energy and Commerce Committee last week that while Pennsylvania has not ruled out expanding its Medicaid program in accordance with the Affordable Care Act, “Under the constraints of the health care reform law, I do not think we can afford the expansion.”
Mr. Alexander made these remarks at a hearing of the committee’s Health Subcommittee, which was taking testimony on the Medicaid expansion component of the 2010 health care reform law.
While the Kaiser Foundation on Medicaid and the Uninsured says that expansion would cost Pennsylvania $2 billion through 2022, the Corbett administration has put a $4 billion price tag on such expansion.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about Mr. Alexander’s testimony in this Pittsburgh Post-Gazette article and this Central Penn Business Journal article, which also includes a direct link to the secretary’s testimony.