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

PA Lags in Developing Health Insurance Exchange

Pennsylvania is unlikely to have a health insurance exchange (HIE) up and running when the individual insurance requirement mandated by the Affordable Care Act takes effect in 2014.
According to state insurance commissioner Michael Consedine, while Pennsylvania has laid considerable groundwork for developing its own exchange, its efforts have been hampered by lack of direction from the federal government on a number of key exchange-related issues. An August letter from Mr. Consedine to U.S. Health and Human Services Secretary Kathleen Sebelius has not yet been answered. In addition, the state legislature has not passed necessary enabling legislation.
If Pennsylvania does not establish its HIE by 2014, residents of the state will be served by an exchange established by the federal government. The state would still be free to establish its own exchange at a later date.
Read more about the situation in Pennsylvania today, what the state has done so far, and the obstacles to completing developing of the HIE in this Pittsburgh Post-Gazette report.

PA Safety Net Admin2012-10-15T10:42:06+00:00October 15th, 2012|Health care reform|Comments Off

PA Relents on New Co-Pays for Selected Medicaid Recipients

The Pennsylvania Department of Public Welfare (DPW) has announced that it will not require selected Medical Assistance recipients with incomes 200 percent above the federal poverty level to pay co-payments for Medicaid services.
The new co-pay policy, implemented October 1, affected about 48,000 families and especially targeted children with autism and other disabilities.
Instead of seeking co-payments, DPW intends to seek federal permission to charge insurance premiums to the same patients.
Read more about the controversy and the decision that temporarily ends it in this Pittsburgh Post-Gazette article .

PA Safety Net Admin2012-10-10T06:00:13+00:00October 10th, 2012|Pennsylvania Medicaid policy|Comments Off

DPW Announces Selected Co-Payments

The Department of Public Welfare (DPW) has issued a Medical Assistance Bulletin to announce that it “is implementing copayments for services provided to children with disabilities, under the age of 18, who are eligible for Medical Assistance (MA) under the PH95 category” – that is, with incomes greater than 200 percent of the federal poverty level. Find that bulletin here. The state further elaborates on why it has adopted this policy in this Pennsylvania Bulletin notice .

PA Safety Net Admin2012-10-02T06:00:44+00:00October 2nd, 2012|Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Notice Confirms FY 2012 Burn Center, Trauma Payment Cuts

The Pennsylvania Department of Public Welfare has published final notices confirming FY 2012 reductions in payments to burn centers and trauma disproportionate share (DSH) payments.
Both notices were published in the Pennsylvania Bulletin: the burn center notice here and the trauma notice here .

PA Safety Net Admin2012-09-28T06:00:36+00:00September 28th, 2012|Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Issues Notice Governing Revised Payment Methodologies

The Pennsylvania Department of Public Welfare (DPW) has published a notice providing final notice of implementation of its revised Medical Assistance (MA) payment methodology for inpatient hospital services provided, on a fee-for-service (FFS) basis, in acute care general hospitals. Additionally, the Department is giving final notice of its amended qualifying criteria and payment methodology for inpatient disproportionate share hospital (DSH), outpatient DSH supplemental and direct medical education (DME) payments and allocated funding for Fiscal Year (FY) 2010-2011 for these payments. The Department is also providing final notice of the establishment of additional types of DSH and supplemental payments.”
This notice essentially describes the new eligibility criteria and payment methodologies arising from Act 49 and can be seen in its entirety in this Pennsylvania Bulletin notice.

PA Safety Net Admin2012-09-27T06:00:59+00:00September 27th, 2012|Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Issues DSH and Supplemental Payment Allocation Notice

The Pennsylvania Department of Public Welfare (DSH) has published a notice “announcing its intent to allocate funding for Fiscal Year (FY) 2012-2013 for several disproportionate share hospital (DSH) and supplemental hospital payments made to qualifying Medical Assistance (MA) enrolled hospitals.”
Among the allocations addressed in this notice are funds for inpatient disproportionate share payments (inpatient DSH), outpatient DSH payments, direct medical education (DME) payments, Medical Assistance stability payments, Medical Assistance dependency payments, Medical Assistance rehab adjustment payments, small and sole-community hospital payments, and enhanced outpatient DSH payments for selected providers.
Find the complete Pennsylvania Bulletin notice here .

PA Safety Net Admin2012-09-26T06:00:28+00:00September 26th, 2012|Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Issues DSH Notice

The Pennsylvania Department of Public Welfare (DPW) has published a notice “announcing its intent to allocate funding for several classes of disproportionate share hospital (DSH) payments made to qualifying Medical Assistance (MA) enrolled acute care general hospitals.” These allocations include funding for FY 2013 critical access, OB/NICU, trauma, burn center, academic medical center, and other supplemental DSH payments.
Find the complete Pennsylvania Bulletin notice here .

PA Safety Net Admin2012-09-25T06:00:18+00:00September 25th, 2012|Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Goes Slow on Health Exchanges

Pennsylvania is not engaging in extensive planning on the development of key components of the Affordable Care Act and will not do so until it receives additional information from the federal government.
So explained state Insurance Commissioner Michael Consedine in an August letter to U.S. Health and Human Services Secretary Kathleen Sebelius. Mr. Consedine reinforced this message in a statement he submitted to the U.S. House Ways and Means Committee on September 12.
According to Mr. Consedine, Pennsylvania lacks the information it needs on two important aspects of the 2010 health care reform law: the creation of health insurance exchanges and the development of the essential benefits packages that insurers will be required to offer Pennsylvanians.
Read more about the state’s position on this issue in this Central Penn Business Journal article. In addition, read Mr. Consedine’s letter to Secretary Sebelius here and his statement to the House Ways and Means Committee here .

PA Safety Net Admin2012-09-24T06:00:47+00:00September 24th, 2012|Health care reform|Comments Off

Number of Uninsured in PA Unchanged

The number of uninsured Pennsylvanians is not growing. According to data released by the U.S. Census Bureau, about one out of every eight Pennsylvanians under the age of 65 was uninsured in 2010-2011, roughly the same number as in 2008-2009. 16.2 percent under the age of 65 were covered by Medicaid in 2010-2011, the same as 2008-2009 but up sharply over previous years.
Find more data about the uninsured in Pennsylvania, those living below the federal poverty level, and those covered by Medicaid in this Central Penn Business Journal article .

PA Safety Net Admin2012-09-21T06:00:14+00:00September 21st, 2012|Uncategorized|Comments Off

DPW Issues Bulletin on Peritoneal Dialysis

The Pennsylvania Department of Public Welfare (DPW) has issued a new Medical Assistance Bulletin titled “Information Regarding Peritoneal Dialysis Treatment.” The stated purpose of the bulletin is “to provide information to providers regarding the use of peritoneal dialysis (PD) in treating beneficiaries with kidney failure, the potential benefits of PD over hemodialysis, and the screening of beneficiaries for PD suitability.”
The new bulletin is available here .

PA Safety Net Admin2012-09-20T06:00:28+00:00September 20th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations|Comments Off

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