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

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

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, here .

PA Safety Net Admin2012-06-07T06:00:24+00:00June 7th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 article .

PA Safety Net Admin2012-06-06T06:00:00+00:00June 6th, 2012|Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

The Language of Medicaid

Enhanced medical homes. Global bundling. Risk-based managed care.
The list goes on.
Current efforts to find new, better, and more economical ways to serve the Medicaid population have given rise to a new language: the language of Medicaid in the 21st century. Some of the terms used in today’s policy discussions are old, some are new, and some are not nearly as self-explanatory as they might seem.
The Kaiser Commission on Medicaid and the Uninsured has compiled a glossary of these terms – a useful tool in an environment in which the federal government and state governments are constantly producing proposals for new ways to address enduring challenges. Find the Kaiser Medicaid glossary here .

PA Safety Net Admin2012-06-05T06:00:35+00:00June 5th, 2012|Uncategorized|Comments Off

DPW Launches “Open Government” Web Site

The Pennsylvania Department of Public Welfare (DPW) has launched a new “transparency portal” on its web site through which the public can obtain a broad array of DPW information and data.
The available information includes facility and program audits, Medical Assistance fee schedules and payments, and individual provider reimbursement data.
The reimbursement data is especially broad, offering detailed information about state Medical Assistance payments to individual providers.
Read a DPW news release about the new DPW web site feature here and visit the site itself through this link .

PA Safety Net Admin2012-06-01T14:58:49+00:00June 1st, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

HealthChoices Expands, ACCESS Plus Contracts

Effective July 1, the Pennsylvania Medical Assistance program’s HealthChoices mandatory managed care program will expand to seven new counties: Bedford, Blair, Cambria, Franklin, Fulton, Huntingdon, and Somerset. At the same time, the state’s ACCESS Plus Medicaid managed care program will cease operations in those same counties.
Further information can be found in a May 25 Department of Public Welfare (DPW) Medical Assistance Bulletin, which can be found here.

PA Safety Net Admin2012-05-31T06:00:15+00:00May 31st, 2012|Meetings and notices|Comments Off

Medical Assistance Primary Care Rates to Rise

Rates for primary care services covered by Pennsylvania’s Medical Assistance program will rise upon implementation next year of a new federal regulation recently published in draft form by the Centers for Medicare & Medicaid Services (CMS).
Under the proposed regulation, Pennsylvania must pay Medicare-level rates for Medicaid-covered primary care services in 2013 and 2014. Medicare rates are higher for such services than Pennsylvania’s Medical Assistance rates, and under the proposed regulation the federal government, not the state, will pay for the difference between Medicare and Medicaid rates.
This new policy was mandated by the Affordable Care Act. In addition to raising fee-for-service rates, Pennsylvania will be expected to revise agreements with its contracted HealthChoices plans to ensure that they, too, pay the better rates.
The higher rates should be especially beneficial for Pennsylvania safety-net hospitals because of the large numbers of Medicaid patients they serve.
Proponents of the higher rates believe they will improve access to primary care services for the Medicaid population and possibly reduce future Medicaid costs by helping recipients get more timely care and thereby avoid more serious illnesses.
Learn more about the proposed Medicaid rate increase in a Commonwealth Fund blog entry and find the entire proposed regulation here . Interested parties have until June 11 to submit written comments to CMS.