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PA Health Policy Update for October 18

The following is an update of selected state health policy developments in Pennsylvania October 14 – 18.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

Governor Shapiro has signed the following bills into law this week.

  • House Bill 155, now known as Act 96 of 2024, removes the requirement that direct care workers be interviewed in-person for a position.
  • House Bill 2084, now known as Act 101 of 2024, establishes a license for prescription drug virtual manufacturers.
  • House Bill 2127, now known as Act 102 of 2024, allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources.
  • Senate Bill 668, now known as Act 109 of 2024, permits certified nurse aides to become certified medication aides in long-term care facilities, assisted living residences, and personal care homes.
  • Senate Bill 840, now known as Act 111 of 2024, creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. 

General Assembly

  • The state House of Representatives and Senate are scheduled to return to Harrisburg on Monday, October 21 for session. This is the last scheduled session week prior to the November 5 General Election. 
  • The House Children & Youth Committee will meet on Tuesday, October 22 at 10:00 a.m. in Room 515 of the Irvis Office Building to consider House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system.
  • The House Children & Youth Committee will also meet on Wednesday, October 23 at 10:00 a.m. in Room 515 of the Irvis Office Building for an informational meeting the CCAP Complex Case Task Force report and the DHS Blueprint report. 
  • The Senate Aging & Youth and Banking & Insurance Committees will hold a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. The meeting will be held in Hearing Room 1 of the North Office Building. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that DHS will continue the alternative payment methodology and pay the Medical Assistance (MA) program fee schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit.
  • DHS has shared the agenda for the next Medical Assistance Advisory Committee (MAAC) meeting on Thursday, October 24. Find additional details on how to participate in Stakeholder Events below.

Department of Health 

The Department of Health (DOH) has reminded long-term care providers that its annual questionnaire of long-term care facilities must be completed and submitted to the department electronically by Friday, October 25, 2024. Any questions regarding the questionnaire may be directed to RA-dohbhssurveys@pa.gov.

Around the State  

Spotlight PA published an article about the increasing number of long-term care facility closures in the commonwealth. 

Pennsylvania pharmacists are receiving less money for drugs dispensed to Medicaid patients, the Pennsylvania Capital-Star reports. 

Stakeholder Events 

DHS – Consumer Sub-MAAC – October 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 23 at 1:00 p.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DHS – Medical Assistance Advisory Committee – October 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 24 at 10:00 a.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-21T20:36:11+00:00October 18th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for October 18

PA Health Policy Update for October 11

The following is an update of selected state health policy developments in Pennsylvania October 7 – 11.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The Commonwealth of Pennsylvania is taking steps to address the state’s high maternal mortality rate through the development of a statewide “Maternal Health Strategic Plan.” The Shapiro administration is asking stakeholders to complete a survey through November 4 to help inform the development of the strategic plan. Along with the governor’s office, the health agencies involved include the departments of Health, Human Services, Drug and Alcohol Programs, and Insurance. Find the survey here. 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate unanimously voted to concur with House amendments to Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill will now be presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill was subsequently received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee for consideration.
  • The Senate unanimously passed House Bill 2381, which allows a licensing board or commission under the Department of State’s Bureau of Professional and Occupational Affairs to promulgate temporary regulations necessary for the implementation of each interstate licensure compact enacted by the General Assembly. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed House Bill 2268, which provides coverage for speech therapy for stuttering. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate passed House Bill 2084, which establishes a license for prescription drug virtual manufacturers. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously voted to concur with the House amendments to Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources. The House subsequently voted to concur with the Senate’s amendments and the bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 155, which removes the requirement that direct care workers be interviewed in-person for a position. The bill was subsequently presented to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2562, which prohibits health insurance companies from imposing annual and lifetime limits to the dollar value of core benefits provided under the policy to the enrollee. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2563, which provides for health insurance coverage of dependent children up to age twenty-six by a parent’s health insurance policy. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2564, which prohibits health insurance companies from imposing any rules for initial or continued eligibility for individuals having a preexisting condition. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate Health & Human Services Committee met on Monday, October 7 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the hearing is viewable here.
  • The House Labor & Industry Committee met on Wednesday, October 9 for an informational hearing on the Federated Insurance Company v. Summit Pharmacy court case. A recording of the hearing is viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers are scheduled to return to Harrisburg on Monday, October 21. 

Department of Human Services

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced that the proposed Psychiatric Residential Treatment Facilities (PRTF) regulations have been posted for public comment. OMHSAS’ proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

The Department of Human Services (DHS) has published proposed rulemaking to amend a data element in DHS’ case-mix payment system for non-public and county nursing facilities to utilize the patient driven payment model (PDPM) in place of the Resource Utilization Groups, Version III (RUG-III) classification system in setting Medical Assistance (MA) payment rates for nursing facilities. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 773) with information about the first Marburg Virus Disease (MVD) outbreak in the Republic of Rwanda, including information about patient assessment and monitoring of U.S. health care workers who may have been in Rwanda within the last 21 days.

DOH has issued a notice to physicians renewing their licenses in Pennsylvania to ensure their practice information is up to date. 

Insurance Department  

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its intent to submit an application to extend the 1332 State Innovation Waiver Reinsurance Program (PA-Re) for another five years. The state reinsurance program helps moderate premiums in the state’s individual health insurance marketplace. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

PID has announced Pennsylvania’s 2025 Affordable Care Act (ACA) health insurance rates. The enrollment period for Pennie, Pennsylvania’s health insurance marketplace, will begin November 1 and go through December 15 for coverage that starts on January 1, 2025.

Around the State  

  • WHYY has published an article about the worsening shortage of IV fluids due to Hurricane Helene which damaged a factory in North Carolina that produces more than half the country’s supply of IV fluids. 
  • The New York Times has written an article about the consequential role Pennsylvania is currently playing in this year’s U.S. Presidential election and the amount of time and money the candidates are spending in Pennsylvania.
  • Health care professionals from across Pennsylvania rallied at the State Capitol on Tuesday along with gun violence awareness advocates. WGAL reports the rally is part of a new statewide coalition called PA Health Professionals to End Gun Violence. 

Stakeholder Events

DOH – WIC State Advisory Board – October 22

The WIC State Advisory Board will hold a meeting on October 22 from 1:00 – 2:00 p.m. The purpose of this meeting is to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-11T19:46:11+00:00October 11th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for October 11

PA Health Policy Update for October 4

The following is an update of selected state health policy developments in Pennsylvania from September 30 – October 4.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The House of Representatives passed House Bill 2295 and House Bill 2294, which allow a physician assistant to work with either an allopathic or osteopathic physician without having to obtain a license from both medical boards. The bills were subsequently received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Labor & Industry Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2548, which requires employers to provide paid sick leave. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Monday, September 30 for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care. A recording of the hearing is viewable here.
  • The House Insurance Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. A recording of the hearing is viewable here. The Insurance Committee also met on Tuesday, October 1 for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes. A recording of the hearing is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, October 1 and favorably reported, among other bills, Senate Bill 1303, which lowers the influenza vaccine offering from age 65 and older, down to age 50 and older. A recording of the hearing is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, October 1 and favorably reported the following bills.
    • House Bill 155, which allows two-way video calls to satisfy the face-to-face requirement for job interviews for direct care workers.
    • House Bill 1608, which requires coverage of doula services in the Medical Assistance program.
    • House Bill 2084, which establishes a license for virtual prescription drug manufacturers.
    • House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with information about postpartum depression and counseling resources.

A recording of the Senate Health & Human Services Committee is viewable here.

  • The House Health Committee met on Wednesday, October 2 and favorably reported the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

A recording of the Health Committee meeting is viewable here.

    • The Human Services Committee met on Wednesday, October 2 for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee held a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. A recording of the meetings is viewable here.

The state House of Representatives and Senate will convene again for voting session Monday, October 7 through Wednesday, October 9. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced a Request for Applications (RFA) seeking managed care organizations to administer services for the Children’s Health Insurance Program (CHIP) program. 
  • DHS has announced its intent to increase rates paid in its Behavioral HealthChoices program, which provides access to mental health, substance use disorder, and other behavioral health services for Medicaid recipients. Once approved by CMS, the new rates to the Behavioral HealthChoices Managed Care Organizations (MCOs) will be retroactive to July 1, 2024 for their current 2024 contract agreements. 
  • DHS announced an increase in the assessment fee that managed care organizations (MCOs) will pay per member per month as a means to generate federal matching funds to support the capitation payments. The increase, which becomes effective in January, is expected to generate an additional $223.531 million in assessment revenue for FY 2024-2025. 
  • DHS has shared the following presentations from the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee meeting on September 25.
  • The Independent Regulatory Review Commission (IRRC) approved the DHS Psychiatric Rehabilitation Services regulations that were first proposed in 2022. With this revision, the regulations expand eligibility for psychiatric rehabilitation services to include individuals 14 years of age or older but under 18 years of age and expand the diagnoses that allow individuals to access PRS without going through the exception process. Find more information in this Pennsylvania Bulletin notice. 

Department of Health 

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 772) regarding health care and long-term care facility preparedness for the 2024-2025 respiratory virus season.
  • DOH has issued a Health Advisory (PA-HAN 771) with information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo and prevention strategies for U.S. travelers visiting countries with an outbreak.
  • DOH has issued a Health Advisory (PA-HAN 770) announcing that has received adequate supplies of Benzathine Penicillin G (Bicillin L-A®) and is now lifting the restrictions for the administration of Bicillin L-A® for individuals who are diagnosed with or suspected of having syphilis. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued a licensing alert regarding DDAP’s implementation of the updated federal regulations for the certification of Opioid Treatment Programs (OTPs).

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate. 

Stakeholder Events

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Health Policy Update for September 27

The following is an update of selected state health policy developments in Pennsylvania from September 23 – 27.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House Republican Policy Committee held an informational hearing on Monday, September 23 examining Pennsylvania’s drug crisis. Testimony offered at the hearing is viewable here and a video recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for voting session next Monday, September 30 through Wednesday, October 2. Following is a selection of relevant health care-related legislative activity currently scheduled.

  • The House Labor & Industry Committee will meet on Monday, September 30 at 9:00 a.m. in Room 60 of the East Wing to consider, among other bills, House Bill 2548, which requires employers to provider paid sick leave.
  • The House Aging & Older Adult Services Committee will meet on Monday, September 30 at 10:00 a.m. in Room 523 of the Irvis Office Building for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care.
  • The House Insurance Committee will meet on Monday, September 30 at 10:30 a.m. in Room 60 East Wing to consider, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. The Insurance Committee will also meet on Tuesday, October 1 at 9:00 a.m. in Room 60 of the East Wing for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes.
  • The House Health Committee will meet on Wednesday, October 2 at 9:00 a.m. in Room G50 of the Irvis Office Building to consider the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.
  • The Human Services Committee will meet on Wednesday, October 2 at 9:30 a.m. in Room 515 of the Irvis Office Building for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee will hold a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. 

Department of Human Services 

The Department of Human Services (DHS) has announced the continuation of the alternative payment methodology for federally qualified health centers and rural health clinics for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. Find additional information in this Pennsylvania Bulletin notice. 

DHS has published its report on Medicaid managed care enrollment in Pennsylvania for the month of August. 

Insurance Department 

The Pennsylvania Insurance Department has announced it received approximately $635,000 from CMS to improve women’s access to health benefits. The funds will be used to launch a multi-faceted campaign focused on awareness and education about preventive care, including contraception. It will also be used to enhance benefit reviews and issuer education to reduce coverage barriers and improve compliance. Find additional information in this press release.

Around the State 

Spotlight PA has published an article about Auditory General Tim DeFoor’s report on pharmaceutical benefit managers (PBMs) and the politics surrounding the report in an election year. 

Stakeholder Events

DOH – HIV Community Prevention Planning Committee – October 1

The Statewide HIV Community Prevention Planning Committee will hold a public meeting on Tuesday, October 1 from 9:00 a.m. to 4:30 p.m. and Wednesday, October 2 from 9:00 a.m. to 4:30 p.m. The meeting will be held virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-27T21:37:45+00:00September 27th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 27

PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.
  • DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20

PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

  • Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.
  • Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release. 

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA).  These changes are effective for dates of service on or after September 9, 2024.
  • DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.
  • DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Health Policy Update for September 6

The following is an update of selected state health policy developments in Pennsylvania from September 2 – 6.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives has changed September 23, 24, and 25 to non-voting session days and added October 7, 8, and 9 as voting session days.

The House and Senate are currently recessed until Monday, September 30 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding new procedure codes based on clinical review, provider requests, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the FDA. DHS is also making changes to prior authorization requirements as a result of clinical review. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced updates to the Family Planning Services program fee schedule, effective for dates of service on and after July 1, 2024. Find additional information, including the procedure codes, in this Pennsylvania Bulletin notice. 

Department of Health

  • The Department of Health (DOH) has announced it is conducting its annual questionnaire of long-term care facilities for the data reporting period of July 1, 2023 through June 30, 2024. The mandatory questionnaire must be completed and electronically submitted to DOH by Friday, October 25. If a long-term care facility did not receive an email on September 4th with a link to the questionnaire, please contact Aicha Hassane Noma at ahassaneno@pa.gov  or email RA-dohbhssurveys@pa.gov.
  • Secretary of Health Dr. Debra Bogen visited the Meadville Area Ambulance Service this week to discuss the administration’s ongoing emergency medical services (EMS) recruitment and retention efforts and other investments in EMS professionals across Pennsylvania, including the expansion of a PILOT program to introduce high school students to the EMS profession and the launch of a $1 million tuition assistance program. Find additional information in this press release.
  • DOH has announced it is extending the deadline for the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) Provider Readiness Survey to September 20. The survey can be accessed here. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $53.9 million, or 1.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $5.9 billion, which is $53.9 million, or 0.9 percent, above estimate. 

Around the State 

  • Spotlight PA has published an article about the state Supreme Court and a number of cases related to abortion, gun control, and climate change that are awaiting decisions.
  • An article published in The Center Square highlights the concerning closure of several independent pharmacies and the Auditor General’s recently released PBM audit for Medicaid prescription drug benefits.
  • PennLive has reported on recent polling of Pennsylvania voters that shows Vice President Harris and former President Donald Trump are in a close race. The article also highlights polling for the Pennsylvania U.S. Senate race between incumbent Senator Bob Casey and challenger David McCormick.  

Stakeholder Events 

DOH – WIC State Advisory Board Meeting – September 10

The Department of Health has issued a correction notice in the Pennsylvania Bulletin with a revised link to join the board’s meeting scheduled for Tuesday, September 10 at 1:00 p.m. 

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority Board – September 19

The Patient Safety Authority has announced a meeting of the authority’s board to be held virtually on Thursday, September 19 at 1:00 p.m. The meeting is open to the public. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

2024-09-06T20:01:48+00:00September 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 6

PA Health Policy Update for August 30

The following is an update of selected state health policy developments in Pennsylvania from August 26 – 30.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

The Shapiro administration, including leadership from the Departments of Human Services, Health, Drug & Alcohol Programs, and the Pennsylvania Insurance Department, has announced it is beginning the process of developing a state-wide maternal health strategic plan, which will address high rates of maternal mortality and ensure pregnant women in Pennsylvania receive necessary prenatal and postpartum care. Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

  • The Department of Human Services (DHS) has provided final notice of the fee schedule rates for targeted support management and services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and Department-established fees for residential ineligible services. The rates for community-based services and residential services are effective July 1, 2024. The rates for Agency With Choice Financial Management Services and Life Sharing will be effective October 1, 2024.
  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has shared a comprehensive resource guide for National Suicide Prevention month. The guide offers examples of activities that organizations and/or communities can do to raise awareness of the importance of suicide prevention, including ideas for events, trainings, social media, sample local government proclamations, etc.
  • DHS has published its annual list of each inpatient acute care general hospital, rehabilitation hospital and private psychiatric hospital qualifying for a disproportionate share payment from July 1, 2023 to June 30, 2024 and each hospital’s respective disproportionate share payment percentage. Find the comprehensive list in this Pennsylvania Bulletin notice.

Department of the Auditor General

Auditor General Tim DeFoor has released a report with results from the department’s performance audit of the Physical HealthChoices Medicaid program and its contracted pharmacy benefit manager (PBM), PerformRx, LLC. The report found Pennsylvania paid $7 million more than it should have for Medicaid prescription drug benefits during 2022. The report attributes the overspending to a lack of oversight by the Department of Human Services (DHS). 

Department of State 

The Department of State has announced beginning August 26 out-of-state physicians licensed by a state or territory participating in the Interstate Medical Licensure Compact (IMLC) who obtain a corresponding “letter of qualification” will be permitted to apply to the Pennsylvania state boards of Medicine and Osteopathic Medicine for expedited licensure to practice in the Commonwealth. Find additional information in this press release. 

Around the State 

  • Spotlight PA has published an article about the growing number of vaccine exemptions in Pennsylvania schools and the concerning potential for measles outbreaks. 
  • The Auditor General’s report on the Department of Human Services (DHS) oversight of pharmacy benefit managers (PBMs) was covered in an article published by the Associated Press. 
  • Another article by Spotlight PA highlights efforts to address the rural health care workforce crisis, including a legislative proposal being championed by Rep. Kathy Rapp (R) and Rep. Dan Frankel (D) that would provide grant funding to assist with the hiring of health care practitioners at rural facilities. 

Stakeholder Events

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Tobacco-Free Recovery Statewide Conference – October 9

The Pennsylvania Statewide Tobacco-Free Recovery Initiative will hold its fourth annual “Tobacco-Free Recovery is Recovery” conference on Wednesday, October 9. The conference will be held virtually. Find registration information here.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

2024-08-31T02:41:10+00:00August 30th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for August 30

PA Health Policy Update for August 23

The following is an update of selected state health policy developments in Pennsylvania from August 19 – 23.  (Some of the language used below is taken directly from state documents). 

General Assembly

  • The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.
  • When they return, the Senate Aging and Youth and Banking and Insurance Committees announced they will meet on September 18 at 9:00 a.m. for a joint hearing on protecting seniors from financial exploitation. 

Department of Health 

  • The Department of Health (DOH) has issued a memo to hospitals outlining the department’s plan to comply with the federal government’s renewed data reporting requirements for COVID-19 and other respiratory illnesses. CMS will require weekly reporting beginning November 1 and facilities have the option for DOH to facilitate reporting on their behalf. In the memo, the Bureau of Emergency Preparedness and Response strongly encourages facilities to utilize this reporting pathway. More information, including required data elements and a data dictionary is forthcoming.
  • The DOH policy office has temporarily paused its efforts to collect input on potential amendments to the hospital licensure regulations. The department commenced a stakeholder engagement process earlier this month that was designed to solicit feedback from various stakeholders, including hospitals. DOH will reconvene stakeholder meetings in the fall or winter to inform proposed regulations to be released in Spring 2025.
  • DOH issued a health advisory (PA HAN 766) related to recent Oropouche virus activity in travelers who have visited the Amazon basin and other areas of South America. 

Department of Human Services 

  • The Department of Human Services (DHS) announced the results of the reprocurement of the Community HealthChoices program for plan years beginning in 2025 through at least 2029. Similar to today’s program, the selected applicants are identical for each of the five CHC operating zones and include Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan (AmeriHealth). The plans will begin a readiness review with DHS shortly which will include an examination of their provider network adequacy. Find the DHS announcement here.
  • DHS issued a Medical Assistance provider bulletin to advise providers of changes to the manual edit thresholds for electronic visit verification records in both personal care and home health services effective with dates of service on and after January 1, 2025.
  • The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) encourages providers to participate in a survey of provider readiness to introduce additional tobacco interventions as part of the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) funded by the CDC. The Public Health Management Corporation conducted a similar survey in 2021, and this 15-minute survey will be a useful measure of the initiative’s progress. Click here to access the survey, which will close on August 31. 

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – August 29 – CANCELLED

The statewide Human Immunodeficiency Virus (HIV) Planning Group has cancelled its public meeting on Thursday, August 29 from 9:00 a.m. to 4:30 p.m.

 

2024-08-23T20:40:15+00:00August 23rd, 2024|Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for August 23

PA Health Policy Update for August 16

The following is an update of selected state health policy developments in Pennsylvania from August 12 – 16.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives’ Democratic Policy Committee met on Tuesday, August 13 for an informational hearing on expanding abortion access. The agenda and testimony are viewable here. A recording of the hearing is viewable here.

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Health 

The Department of Health (DOH) has issued a reminder for long-term care facilities to report COVID-19 outbreaks to their respective local health jurisdiction. Only an initial report of a new outbreak, occurring greater than 14 days following the detection of the most recent case, should be made. A summary of COVID-19 data reporting is included under the Reporting Requirements and Recommendations section of the COVID-19 LTC Toolkit. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it is conducting an assessment, in partnership with the Department of Health, Philadelphia Department of Public Health, and the Center for Forensic Science Research and Education. They are working together to expand existing xylazine-associated wound care training currently offered to health care and non-health care professionals across Pennsylvania. The assessment is being conducted to ensure the trainings meet the needs of individuals and organizations who serve people who use drugs. Stakeholders who are interested are asked to complete the assessment by August 30, 2024.

DDAP has announced it is offering the opportunity for public comment on the Pennsylvania Substance Use Prevention Treatment and Recovery Services Block Grant (SUPTRS) Block Grant application submission. The documents are accessible for review here. The login is “citizenpa” and the password is “citizen” 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has announced it received final form regulations from the Department of Human Services regarding psychiatric rehabilitation services. These regulations allow individuals who are 14 years of age or older but under 18 years of age who meet the admission requirements to access psychiatric rehabilitation services (PRS) and amends the diagnoses that allow an individual to access PRS without use of the exception process. The commission will be considering the regulations on September 19, 2024. Find the final form regulations here.

IRRC has also announced it received final form regulations from the State Board of Medicine that provide for licensure by endorsement for applicants from other states, territories, and countries. The commission will be considering the regulations on September 19, 2024. Find the final form regulations here. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the Independent Fiscal Office’s warning that Pennsylvania may deplete its General Fund surplus by the next fiscal year due to “expected spending, in-progress tax cuts, and revenue projections.”
  • Harold Brubaker has written an article for the Philadelphia Inquirer about Penn Medicine’s signing of a definitive agreement with Doylestown Hospital to become the health system’s seventh hospital.
  • PoliticsPA has published an overview of the most recent Franklin & Marshall College survey. The poll has Vice President Kamala Harris leading former President Donald Trump by three points in Pennsylvania; although, the margin does fall within the poll’s 3.8 percent margin of error. The poll also has Senator Casey leading his challenger, David McCormick.
  • Crozer Health’s announcement that it will shutter operating room services at Taylor hospital by September 1 was covered by WHYY. 

Stakeholder Events 

DOH – WIC State Advisory Board – August 21

The WIC State Advisory Board, which was established by Senate Bill 721 (Act 22 of 2024), will hold its first regular meeting on August 21 from 1:00 p.m. to 2:00 p.m. The meeting will be held in person and virtually. Find additional details, as well as a schedule of its remaining meetings through January 2026 here. 

DOH – HIV Community Prevention Planning Committee – August 29

The statewide Human Immunodeficiency Virus (HIV) Planning Group will hold a public meeting on Thursday, August 29 from 9:00 a.m. to 4:30 p.m. The meeting will be held in person and virtually. Find additional information and registration details here.

2024-08-16T21:10:19+00:00August 16th, 2024|Governments, Meetings and notices|Comments Off on PA Health Policy Update for August 16
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