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

Philadelphia Hospitals Hoping for Medicaid Expansion

Hospitals in the greater Philadelphia want the state to expand its Medicaid program as envisioned in the Affordable Care Act, the Philadelphia Business Journal reports.
According to a spokesman for the Delaware Valley Healthcare Council, Philadelphia-area hospitals are concerned that the state might not expand Medicaid eligibility. That expansion, mandated by the 2010 health care reform law, was made optional earlier this year by a Supreme Court decision.
Read more about why Philadelphia-area hospitals – many of which are safety-net hospitals – are eager for the state to embrace the reform law’s Medicaid eligibility expansion in this Philadelphia Business Journal article .

PA Safety Net Admin2012-10-22T06:00:32+00:00October 22nd, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Medicare DSH Cuts Loom for PA Safety-Net Hospitals

Safety-net hospitals across the country will soon lose important funding that helps them care for many of their low-income and uninsured patients: their Medicare disproportionate share hospital payments (Medicare DSH).
Come 2014, the Affordable Care Act mandates a significant cut in hospitals’ Medicare DSH payments. The underlying rationale for this cut is that once the health care reform law’s individual insurance mandate takes effect and states begin greatly expanding Medicaid eligibility (a reform law mandate made optional by this year’s Supreme Court decision), hospitals will have fewer such patients and less need for supplemental DSH funding.
But as a Kaiser Health News article points out, hospital officials are concerned that the funding will phase out before the expanded insurance phases in, leaving them with fewer resources to care for their low-income, still-uninsured patients.
Pennsylvania’s safety-net hospitals, which care for large numbers of low-income and uninsured patients, figure to suffer considerably under such circumstances.
Learn more about the phase-down of Medicare DSH payments and the challenges hospitals will face in its wake in this Kaiser Health News article .

PA Safety Net Admin2012-10-17T06:00:13+00:00October 17th, 2012|Health care reform|Comments Off

New Medicare Wrinkle May Hurt Safety-Net Hospitals

A new Medicare program that bases payments to hospitals in part on patient satisfaction with those hospitals could be especially harmful to the nation’s safety-net hospitals.
The Medicare value-based purchasing program, which took effect on October 1, will withhold one percent of all hospitals’ Medicare payments and then redistribute that money based on hospitals’ compliance with selected standards-of-care requirements and on the results of surveys of hospitalized Medicare patients. The withheld one percent will then be redistributed to hospitals that perform well based on these criteria. Beginning in 2017, two percent of hospitals’ Medicare payments will be withheld and eventually redistributed in this manner.
Learn more about the Medicare value-based purchasing program and how hospitals are preparing for the survey component of its payment adjustments in this Wall Street Journal article .

PA Safety Net Admin2012-10-16T06:00:55+00:00October 16th, 2012|Health care reform|Comments Off

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

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