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

DPW Issues Medical Assistance Bulletins

The Department of Public Welfare (DPW) has issued a number of new bulletins governing Pennsylvania’s Medical Assistance program.
These new regulations include an amendment to the state’s Medicaid plan for children with disabilities; the process for prior authorization of pituitary suppressive drugs; the process for prior authorization of erythropoiesis stimulating protein; the process for prior authorization of benign prostatic hyperplasia treatments; the process for prior authorization of antibiotics (GI); and the process for the prior authorization of platelet aggregation inhibitors.
In addition, DPW formally announced the expansion of HealthChoices to 13 counties in western Pennsylvania and the termination of ACCESS Plus in those counties effective October 1 and its intention to publish in the near future a new bulletin adding growth factors to the Medical Assistance program’s list of items requiring prior authorization.

PA Safety Net Admin2012-08-27T06:00:55+00:00August 27th, 2012|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

New Medicare Readmissions Policy to Hit Safety-Net Hospitals Hardest

A new Medicare reimbursement policy that will penalize hospitals financially for readmitting patients within 30 days of discharge will have a disproportionate impact on hospitals that care for large numbers of low-income patients.
According to an analysis by Kaiser Health News, hospitals that treat significant numbers of low-income patients – those eligible for Medicare disproportionate share (DSH) payments – are more likely to be penalized by Medicare than other hospitals. Those that serve the most poor patients are twice as likely to suffer the maximum Medicare penalty as those that care for the fewest low-income patients.
The penalties apply to patients readmitted after suffering pneumonia, heart attacks, and heart failure.
The new Medicare readmissions reduction program poses a particular challenge for Pennsylvania’s safety-net hospitals, such as those that belong to the Safety-Net Association of Pennsylvania (SNAP), because so many of their patients have additional medical problems and often have difficulties following post-discharge instructions and getting and paying for follow-up care.
Read more about the new Medicare reimbursement program and the Kaiser analysis in this Kaiser Health News report Hospital building .

PA Safety Net Admin2012-08-24T06:00:45+00:00August 24th, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off

PA Releases DSH Eligibility Lists

The Pennsylvania Department of Public Welfare (DPW) has released its annual list of inpatient hospitals that qualify for Medical Assistance disproportionate share (DSH) payments, including the DSH percentages for acute-care general hospitals, psychiatric units of inpatient hospitals, drug and alcohol units of inpatient hospitals, medical rehab units of inpatient hospitals, freestanding rehab hospitals, private psychiatric hospitals, and private drug and alcohol hospitals.
Find the list and the corresponding DSH percentages in this Pennsylvania Bulletin notice .

PA Safety Net Admin2012-08-23T06:00:56+00:00August 23rd, 2012|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

One-Third of PA Docs Reject Medicaid Patients

A study published in the journal Health Affairs found that 32 percent of office-based physicians in Pennsylvania do not accept new Medicaid patients.
This is slightly higher than the nation-wide rate of 30.9 percent of physicians who will not accept new Medicaid patients.
Read more about the study in this Central Penn Business Journal article or find the study itself here, on the Health Affairs web site.

PA Safety Net Admin2012-08-22T06:00:36+00:00August 22nd, 2012|Uncategorized|Comments Off

DPW Secretary Shares Views on Medicaid Program

In an extensive interview with the Central Penn Business Journal, Pennsylvania Department of Public Welfare Secretary Gary Alexander shared his views on the state’s Medicaid program, the changes he would like to see, and the challenges the state faces in the immediate future.
Among the issues Alexander addressed are his desire to have greater flexibility to operate the state’s Medical Assistance program; the state’s prospects for expanding Medicaid eligibility as called for in the Affordable Care Act; his concern that greater access will increase rather than decrease uncompensated care and emergency room use; his interest in greater transparency for health care costs and quality; and his fight against fraud, waste, and abuse.
Read the complete Central Penn Business Journal interview with Secretary Alexander here .

PA Safety Net Admin2012-08-21T06:00:48+00:00August 21st, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

DPW Updates Dependence Treatment Procedures

The Pennsylvania Department of Public Welfare (DPW) has issued a new Medical Assistance Bulletin updating its procedures for seeking prior authorization for opiate dependence treatment.
The new bulletin, which can be found here, applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services through the Medical Assistance fee-for-service program.
An update of the Medical Assistance handbook for prior authorization of these services can be found here .
The new policy takes effect on September 10.

PA Safety Net Admin2012-08-10T06:00:06+00:00August 10th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Uncategorized|Comments Off

DPW Updates Pharmacy List

The Pennsylvania Department of Public Welfare has issued a new Medical Assistance Bulletin updating the state’s preferred drug list. This bulletin applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services in the fee-for-service delivery system. The new bulletin can be found here.
Another document, an update of the Medical Assistance prior authorization handbook for pharmaceutical services, can be found here .
The new policies take effect August 13.

PA Safety Net Admin2012-08-08T06:00:33+00:00August 8th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PHC4 to Hold Meeting

The Payment Data Advisory Group of the Pennsylvania Health Care Cost Containment Council (PHC4) will meet on Wednesday, August 8 in Harrisburg.
The meeting will be held at the PHC4 office at 225 Market Street, Suite 400. It begins at 10:30 a.m.
The public is welcome to attend.

PA Safety Net Admin2012-08-06T06:00:14+00:00August 6th, 2012|Uncategorized|Comments Off

Hospitals Worry About Lost DSH Money

Hospitals across the country are worried about what will happen come 2014, when the Affordable Care Act’s individual insurance mandate and Medicaid expansion take effect and they lose funds they currently receive from the federal government to help with the cost of caring for their low-income and uninsured patients.
Hospitals that care for large numbers of such patients receive what are known as disproportionate share hospital payments, commonly referred to as “DSH,” from both Medicare and Medicaid. Under the 2009 health care reform law, however, those payments will be reduced drastically in anticipation of a significant decline in the number of uninsured Americans.
The leaders of these hospitals, however, believe that even the individual insurance mandate and Medicaid expansion will still leave them with many uninsured patients to treat, including illegal residents and those who decline to buy insurance despite the insurance mandate.
Historically, DSH funds have been vital to the financial health of Pennsylvania’s safety-net hospitals.
Read more about this situation, and the challenges hospitals believe they will face as a result, in this New York Times article .

PA Safety Net Admin2012-08-01T06:00:12+00:00August 1st, 2012|Health care reform|Comments Off

EHR Use Growing in State Medicaid Program

Roughly one in four Pennsylvania Medical Assistance recipients visited providers last year that used electronic health record (EHR) technology to help manage their health care information.
According to the Department of Public Welfare (DPW), the state has now distributed $130 million in federal EHR incentive payments to 90 hospitals and more than 3000 health care professionals.
Read more about the growing use of EHR technology and the availability of federal funds to support the use of that technology in this Central Penn Business Journal article .

PA Safety Net Admin2012-07-30T06:00:59+00:00July 30th, 2012|Pennsylvania Medicaid policy|Comments Off

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