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

Budget Brings Good News for PA Safety-Net Hospitals

The new state budget passed in Harrisburg last weekend restored cuts to key payments to Pennsylvania’s safety-net hospitals.
Although the budget proposed by Governor Corbett in February called for a four percent cut in fee-for-service hospital base rate payments, that cut was restored – as were mid-year cuts to OB/NICU, burn center, and trauma center payments, which were restored to their FY 2012 enacted levels.
In addition, the budget increased payments to critical access hospitals and restored payments to academic medical centers and physician practice plans.
The budget also restored funding for separate fee-for-service payments for normal newborn care, thereby rescinding at least for FY 2013 an expedited regulation promulgated by the Department of Public Welfare that would have eliminated payments for such services.
For further information about Pennsylvania’s FY 2013 Medical Assistance budget and its implications for Pennsylvania’s safety-net hospitals, please contact Michael Chirieleison, SNAP’s president, at 717-234-6970 or mike@debrunner.us.

PA Safety Net Admin2012-07-02T16:24:34+00:00July 2nd, 2012|Medicaid supplemental payments, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Court Affirms Reform Law, Changes Medicaid Provision

The Supreme Court has upheld the constitutionality of the 2009 Affordable Care Act – including the much-disputed mandate that everyone obtain health insurance.
The court’s only disagreement with the reform law was with its provision requiring states to expand Medicaid eligibility as a future condition of obtaining federal Medicaid matching funds. The court ruled that expanding Medicaid eligibility should be optional and that states that choose not to expand their Medicaid programs would still receive the federal matching funds to which they have always been entitled.
In the wake of this decision, SNAP is very concerned about the interplay between the loss of the mandated Medicaid expansion and the Affordable Care Act’s requirement that Medicare DSH and Medicaid DSH payments be cut significantly in the coming years. Those cuts were predicated on the Medicaid expansion adding as many as 20 million people to the ranks of the insured, which was expected to provide additional revenue to hospitals that would help offset a reduction in their Medicare DSH and Medicaid DSH revenue.
For now, all eyes will be on Pennsylvania state officials as they decide what to do in light of the greatly enhanced federal matching funds still available for states that choose to expand Medicaid eligibility.

PA Safety Net Admin2012-06-28T15:19:30+00:00June 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off

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 .

PA Safety Net Admin2012-06-26T06:00:27+00:00June 26th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

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.

PA Safety Net Admin2012-06-25T06:00:41+00:00June 25th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 notice .

PA Safety Net Admin2012-06-22T11:28:16+00:00June 22nd, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 here .

PA Safety Net Admin2012-06-20T06:00:09+00:00June 20th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 .

PA Safety Net Admin2012-06-18T10:11:29+00:00June 18th, 2012|Health care reform, Uncategorized|Comments Off

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.

PA Safety Net Admin2012-06-13T06:00:48+00:00June 13th, 2012|Health care reform, Medicaid supplemental payments, Safety-Net Association of Pennsylvania|Comments Off

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.

PA Safety Net Admin2012-06-11T06:00:13+00:00June 11th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

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 .

PA Safety Net Admin2012-06-08T06:00:19+00:00June 8th, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off

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