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.
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.
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 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
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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
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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
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Parts of Central PA Feature High Uninsured Rate, Low Access to Care
Five counties in central Pennsylvania currently suffer from a high rate of uninsured residents and limited access to medical care.
According to an assessment commissioned by three mid-state hospitals, one out of every 3.5 residents in the surveyed counties lack health insurance, compared to one in 10.4 Pennsylvanians overall.
The assessment covered Cumberland, Dauphin, Lebanon, Perry, and northern York counties.
Read more about the assessment, and find a direct link to the assessment, in this Central Penn Business Journal article
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Sequestration Could Cost Health Care Jobs in PA
Unless Congress reverses the sequestration of $2 billion in Medicare funding by the end of 2012, that cut in federal Medicare spending could result in the loss of nearly a half-million health care jobs across the country in 2013 alone.
And more than 37,000 of those lost health care jobs could be in Pennsylvania.
So says a new report sponsored by the American Hospital Association, the American Medical Association, and the American Nurses Association.
The cuts are mandated by the Budget Control Act, which Congress adopted late last year. While discussions are under way in Congress to block or delay implementation of the sequestration cuts in Medicare, defense, and other spending areas, it is not clear at this time whether those efforts will succeed.
It also is not clear what cuts the federal government will make to save the required $2 billion.
Any large-scale job losses associated with reduced federal Medicare spending would no doubt hit Pennsylvania’s safety-net hospitals hard because of the large numbers of Medicare patients they serve and their already-thin operating margins.
Download the report describing the impact of the $2 billion Medicare sequestration on health care employment here and read more about the prospects for health care jobs in Pennsylvania in this
Pittsburgh Business Times report.
NY Times Looks at Safety-Net Hospitals
The New York Times’ “Doctor and Patient” blog has taken a brief look at safety-net hospitals.
In the article “The Fraying Hospital Safety Net,” Dr. Pauline Chen examines the challenges safety-net hospitals face and the ability of many of them, even in the face of those challenges, to deliver quality care.
Read this New York Times article on safety-net hospitals here.