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If the Affordable Care Act Survives Legal Challenges…

$2 billion in extra costs over the first five years.  750,000 new recipients.
These are some of the changes that can be expected in Pennsylvania’s Medicaid program if the Medicaid expansion component of the Affordable Care Act is left standing after the Supreme Court rules on the legal challenge to the landmark health care reform legislation.
The online publication PA Independent takes a look at the implications of Medicaid expansion for Pennsylvania:  implications for the state’s finances, for potential beneficiaries, and for public health.  Read the article here.

2012-06-26T06:00:27+00:00June 26th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on If the Affordable Care Act Survives Legal Challenges…

DPW Announces Fee Schedule Changes, More

The Department of Public Welfare (DPW) has announced changes in the Medical Assistance fee schedule and prior authorization requirements.  To read a notice describing these changes and find a list of affected procedure codes, see this notice in the Pennsylvania Bulletin.

2012-06-25T06:00:41+00:00June 25th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Announces Fee Schedule Changes, More

PA to Discontinue Quality Incentive Program

The Pennsylvania Department of Public Welfare (DPW) is discontinuing its Hospital Quality Incentive Pilot Program.  The program had been “established to provide and reward a hospital’s performance on various quality related measures” in the state’s Medical Assistance program.
Read a formal notice of the termination of this program, and the state’s Hospital Quality Care Investment Grant Program, in this Pennsylvania Bulletin noticeBookshelf with law books.

2012-06-22T11:28:16+00:00June 22nd, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA to Discontinue Quality Incentive Program

DPW Publishes Bulletin Addressing Preventable Conditions

The Pennsylvania Department of Public Welfare (DPW) has posted a new Medical Assistance Bulletin presenting the state Medicaid program’s policies governing the reporting of “provider preventable conditions” effective July 1, 2012.  The policy applies to providers that serve Medical Assistance recipients enrolled in the fee-for-service and ACCESS Plus programs.
Find the Bulletin hereBookshelf with law books.

2012-06-20T06:00:09+00:00June 20th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Publishes Bulletin Addressing Preventable Conditions

Supreme Court Decision Has Huge Medicaid Implications

When the Supreme Court rules on the challenge to the Affordable Care Act, its decision will have enormous implications for states, low-income and uninsured people, and health care providers.
Among the many features of the health care reform act on which the Supreme Court will rule is the single biggest expansion of eligibility since Medicaid was introduced in the mid-1960s.
As they await the court’s decision, many states already are laying the groundwork for the addition of between 15 million and 20 million people to the nation’s Medicaid rolls.
Pennsylvania’s safety-net hospitals have a considerable stake in the court’s decision because the planned Medicaid expansion could add as many as a half-million people to the state’s Medical Assistance rolls.
The New York Times has taken a closer look at the stakes in the court’s upcoming decision.  Read that Times article here.

2012-06-18T10:11:29+00:00June 18th, 2012|Health care reform, Uncategorized|Comments Off on Supreme Court Decision Has Huge Medicaid Implications

Safety-Net Hospitals Await Medicaid DSH Cuts

Across Pennsylvania, safety-net hospitals are bracing for major cuts in their Medicaid disproportionate share (DSH) payments starting in FY 2014, when a provision of the Affordable Care Act requiring such cuts takes effect.
Under the Affordable Care Act, the number of uninsured patients hospitals treat is expected to decline as health insurance becomes more affordable and accessible, theoretically reducing hospitals’ need for Medicaid DSH revenue.  Under the reform law, federal spending on Medicaid DSH will be slashed $18 billion over six years.
Historically, Medicaid DSH has been viewed as a program to help hospitals that treat especially large numbers of uninsured and Medicaid patients.  The cut will be implemented, however, before it is clear how many currently uninsured people will purchase health insurance – and at a time when the number of Medicaid patients safety-net hospitals serve is expected to rise significantly, not fall, when the Affordable Care Act’s new criteria for Medicaid eligibility take effect.
The scheduled cut in Medicaid DSH payments is of particular concern to the Safety-Net Association of Pennsylvania (SNAP) and Pennsylvania’s private safety-net hospitals.
Read more about the anticipated reduction of Medicaid DSH payments and its implications for safety-net hospitals in this CQ report presented by the Commonwealth Fund.

2012-06-13T06:00:48+00:00June 13th, 2012|Health care reform, Medicaid supplemental payments, Safety-Net Association of Pennsylvania|Comments Off on Safety-Net Hospitals Await Medicaid DSH Cuts

Newspaper Joins Call for Restoring Newborn Payments

Last month, Pennsylvania’s Medical Assistance program stopped paying hospitals for the inpatient care they provide to healthy babies newly born to Medical Assistance-covered mothers.  The hospital industry – including the Safety-Net Association of Pennsylvania (SNAP) – immediately expressed opposition to this new policy and has continued to seek the restoration of these payments as the state legislature considers Pennsylvania’s fiscal year 2013 budget.
Now, the Pittsburgh Post-Gazette has weighed in on this issue – on the side of the hospital industry and the low-income patients it serves – with an editorial entitled “Dropping the baby:  DPW is wrong to cut newborns’ hospital care.”  Read that editorial here.

2012-06-11T06:00:13+00:00June 11th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off on Newspaper Joins Call for Restoring Newborn Payments

Forum on Safety-Net Hospitals

Health care reform presents a number of challenges to safety-net hospitals.  Recently, the Alliance for Health Reform and the Commonwealth Fund hosted a forum, “The Health of Safety-Net Hospitals:  How are They Faring?  What’s the Outlook?” to discuss these challenges.
Among the issues addressed in the forum were the financial challenges safety-net hospitals face in the coming years as a result of health care reform and implementation of the Affordable Care Act; the response of safety-net hospitals to these challenges; the special challenges safety-net hospitals face as a result of social, economic, and environmental conditions in the communities they serve; and proposed changes in some of the payments safety-net hospitals have long counted upon to help underwrite the care they provide to their uninsured, underinsured, and publicly insured patients.
These are the very issues that confront the the Safety-Net Association of Pennsylvania (SNAP) and private safety-net hospitals everywhere.
Visit the Alliance for Health Reform’s web site to learn more about the forum.  Available there are the participants’ PowerPoint presentations; videos and podcasts of the proceedings; and links to various source materials.  This can be found here.

2012-06-08T06:00:19+00:00June 8th, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off on Forum on Safety-Net Hospitals

News from the Pennsylvania Health Law Project

The Pennsylvania Health Law Project has issued its May 2012 newsletter.  Included in it are articles on the expanded use of HealthChoices in the Medical Assistance program; information about proposed changes in the Medical Assistance Transportation Program; an update on limits on Medicaid recipients’ use of prescription drugs; the removal of children from the state’s Medicaid rolls; and the 2013 increase in Medicaid payments for primary care providers.
Download the May edition of Health Law PA News, the newsletter of the Pennsylvania Health Law Project, hereHarrisburg, PA capital building.

2012-06-07T06:00:24+00:00June 7th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on News from the Pennsylvania Health Law Project

Maternity Payment Cut Takes Effect

The Medical Assistance cut in fee-for-service inpatient payments for the care of normal newborns took effect on June 1.
According to the Department of Public Welfare (DPW), the payment reduction brings Pennsylvania into line with what other states’ Medicaid programs pay for such care.  According to hospital industry representatives, Pennsylvania hospitals still lose money on Medicaid deliveries and now will lose more.
This policy will be especially damaging to Pennsylvania’s safety-net hospitals.  Although only one-third of the state’s acute-care hospitals, safety-net hospitals perform two-thirds of all Medicaid deliveries according to the March 2012 report “Pennsylvania’s Safety-Net Hospitals:  Vital Providers, Vital Employers” prepared by the Safety-Net Association of Pennsylvania.
Read more about the state’s new policies, how it will affect hospitals, and how hospitals are responding to it in this Pittsburgh Post-Gazette articleHospital building.

2012-06-06T06:00:00+00:00June 6th, 2012|Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Maternity Payment Cut Takes Effect
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