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

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So far PA Safety Net Admin has created 1226 blog entries.

Medicaid and CHIP Enrollment Rising in Pandemic

Medicaid enrollment rose 6.2 percent and CHIP enrollment 0.5 percent during the first four months of the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services reports.

The enrollment increase can be traced to rising unemployment, with many people losing their employer-sponsored health insurance. The new figures cover five months, from February through June, the latter four of which marked the beginning of the COVID-19 pandemic.

Pennsylvania safety-net hospitals already serve significant numbers of Medicaid and CHIP patients; an increase in their rolls will prove financially challenging to them.

The information comes from CMS’s first monthly “Medicaid and CHIP Enrollment Trends Snapshot.” Go here for CMS’s news release explaining its new initiative and here to see the trends snapshot itself, which includes figures for Pennsylvania.

PA Safety Net Admin2020-10-06T06:00:16+00:00October 6th, 2020|Pennsylvania Medicaid, Uncategorized|Comments Off

Payer Mix to Change, Providers Anticipate

Health care providers expect to serve higher proportions of Medicaid and uninsured patients in the coming year, according to a new survey.

The shift will be driven by the COVID-19 pandemic, which as unemployment remains high is leading to fewer patients with commercial insurance and more with Medicaid or no insurance all, according to provider financial executives.

Such a shift would be especially challenging for Pennsylvania safety-net hospitals because they already serve higher proportions of Medicaid and uninsured patients than the typical community hospital.

Learn more about the reimbursement changes health care providers expect to see over the next twelve months in the Healthcare Dive article “Provider finance execs bracing for unfavorable shift in payer mix, survey finds.”

PA Safety Net Admin2020-10-05T06:00:21+00:00October 5th, 2020|Pennsylvania safety-net hospitals|Comments Off

COVID-19 Update: Thursday, October 1

The following is the latest COVID-19 information from the state and federal governments as of 3:30 p.m. on Thursday, October 1.

Pennsylvania Update

Governor Wolf

The Wolf administration has introduced an enhanced strategy to make COVID-19 testing more accessible, available, and adaptable as the state learns more about the virus. The test is built around four tiers for determining priority for testing. Learn more about the strategy here.

Department of Health

The Department of Health has published an updated FAQ with interim guidance for skilled nursing facilities that addresses questions related to recent department guidance during the COVID-19 emergency.
The Department of Health has updated its on-site survey guidance for hospitals and ambulatory surgical facilities to add instructions to notify the department if a surveyor comes in close contact with a confirmed or probable COVID-19 case in the course of a survey.
The Department of Health addressed questions from skilled nursing facilities about respirator fit testing and home visitation guidance in its weekly COVID-19 Guidance Wrap-up document.

Department of Health – by the numbers

This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of September 18 to September 24 the number of new COVID-19 cases in Pennsylvania fell 8.7 percent.
The total number of COVID-19 deaths in Pennsylvania since the start of the pandemic climbed today past 8100.
Centre and Northumberland counties are experiencing the highest rate of community transmission.
For the past week the number of daily cases has risen and has included two of the highest new case counts in a month, including today’s new case count, the highest since September 3.
The continued high numbers are driven in part by persistent increases in the number of young people between the ages of 19 and 24 who are contracting COVID-19.
The number of Pennsylvanians currently hospitalized with COVID-19 has risen in nine of the past ten days. The number of such patients breathing with the help of a ventilator, on the other hand, has changed little in the past week.
More than 10,800 health care workers in the state have contracted COVID-19.
20 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 25 percent of adult ICU beds, 16 percent of pediatric ICU beds, 38 percent of pediatric beds, and 40 percent of airborne isolation rooms.

Department of Human Services

DHS has issued a Medical Assistance Bulletin on COVID-19 specimen collection and testing at pharmacies. It takes effect immediately.

DHS’s Office of Developmental Programs has posted updated guidance to Individual Support Planning Teams on the criteria for requesting a cap exception for the Person/Family Directed Support (P/FDS) and Community Living Waivers.

Federal Update

Provider Relief Fund

HHS announced the planned distribution of $20 billion in new funding for providers on the front lines of the COVID-19 pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and increased expenses experienced due to COVID-19. Previously ineligible providers, such as those that began practicing in 2020, will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.
This new distribution should be especially helpful for providers that have received minimum or no targeted relief, such as safety-net, high-impact, or rural distributions.
Providers can begin applying for funds on Monday, October 5, 2020 and the application deadline is November 6.
According to HHS’s news release,

All provider submissions will be reviewed to confirm they have received a Provider Relief Fund payment equal to approximately 2 percent of patient care revenue from prior general distributions. Applicants that have not yet received Relief Fund payments of 2 percent of patient revenue will receive a payment that, when combined with prior payments (if any), equals 2 percent of patient care revenue.
With the remaining balance of the $20 billion budget, HRSA will then calculate an equitable add-on payment that considers the following:
- A provider’s change in operating revenues from patient care.
- A provider’s change in operating expenses from patient care, including expenses incurred related to coronavirus.
- Payments already received through prior Provider Relief Fund distributions.

Go here to learn more about the distribution.

HHS has published a new summary of reporting requirements for recipients of the Provider Relief Fund grants.

Department of Health and Human Services

HHS announced that beginning on October 1, hospitals can purchase Veklury (remdesivir) directly from the drug’s distributor.

Centers for Medicare & Medicaid Services

Congress has passed, and the president has now signed, a continuing resolution to fund the federal government through December 11. The resolution includes a provision that would change the terms under which providers must repay federal CARES Act money they received through the Medicare Accelerated and Advance Payment program, which is administered by CMS. Now, recoupment will begin only a year after providers received their loan and recoupment is reduced from 100 percent to 25 percent during the first 11 months of repayment and 50 percent for the six following months, with hospitals now having 29 months to repay their loans in full before they would need to begin paying interest. That interest rate, too, is lowered under the continuing resolution from 9.6 percent to 4.0 percent.
CMS has updated its compendium of temporary waivers and flexibilities for teaching hospitals, teaching physicians, and medical residents during the COVID-19 pandemic. A new flexibility, on page 2 of the document, explains that instead of requiring that new Medicare GME affiliation agreements be submitted to CMS and MACs by July 1, 2020 for the academic year starting July 1, 2020 and amendments to Medicare GME affiliation agreements be submitted to CMS and the MACs by June 30, 2020 for the academic year ending June 30, 2020, CMS is permitting hospitals to submit new and/or amended Medicare GME affiliation agreements as applicable to CMS and the MACs by January 1, 2021.
CMS has updated its COVID-19 testing methodology for nursing homes by revising the methodology it employs to determine the rate of COVID-19 positivity in counties across the country.
CMS has published guidance addressing the emergency preparedness testing exercise requirements for COVID-19. CMS regulations for emergency preparedness require specific testing exercises to validate facilities’ emergency programs.

Food and Drug Administration

The FDA has published state-by-state and national forecasts of COVID-19 hospitalizations for the next four weeks.
The FDA has issued emergency use authorization for a prediction system to be used by health care providers in hospitals for adult patients with confirmed COVID-19 for the computation of proprietary patient status indices referred to as Respiratory Decompensation Status and Hemodynamic Instability Status (collectively referred to as “risk level determinations”) as an adjunct to patient monitoring during the COVID-19 outbreak.

National Institutes of Health

The NIH has awarded $234 million to improve COVID-19 testing for underserved and vulnerable populations. The program will support 32 institutions and focus on populations disproportionately affected by the pandemic, including African Americans, American Indians/Alaskan Natives, Latinos/Latinas, Native Hawaiians, older adults, pregnant women, and those who are homeless or incarcerated.

Federal Communications Commission

The FCC has extended from September 30 to December 31, 2020 the deadline for recipients of funding from its $200 million COVID-19 Telehealth Program to purchase eligible devices and implement eligible services.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-10-02T06:00:18+00:00October 2nd, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Tuesday, September 22

The following is the latest COVID-19 information from Pennsylvania’s state government (as of 3:30 on Tuesday, September 22) and the federal government (as of 2:45 p.m. on Monday, September 21).

Pennsylvania Update

Governor Wolf

Governor Wolf and Health Secretary Levine introduced “COVID-19 Alert PA,” a new cell phone app that the state hopes will facilitate contact tracing. The app, which works on Android and Apple cell phones, uses bluetooth technology to identify people who were recently near someone who has been diagnosed with COVID-19. The app notifies individuals who may have been exposed and directs them to resources but does not provide the name of the person who was diagnosed and does not provide the state with the names of people who may have been exposed, protecting the privacy of everyone involved and leaving responsibility to act at the discretion of the people with the app on their phone. The app, which is free, does not track people and their location. Learn more from this news release.

Department of Health

The Department of Health answered several provider questions in its COVID-19 Guidance Wrap-up document related to recommendations for eye protection, data sources for county positivity rates, and skilled nursing facility data reporting.

The Department of Health issued a new health alert on Testing and Management Guidance for Patients After Exposure to SARS-CoV-2, recommending testing for asymptomatic persons who were in close contact with someone who tested positive for COVID-19.

The Department of Health announced that Walmart is closing its remaining nine drive-through parking lot COVID-19 testing sites on September 26.

Department of Health – by the numbers

This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of September 11 to September 17 the number of new COVID-19 cases rose 10.5 percent but the state-wide rate of positive tests fell from 4.2 percent to 3.8 percent.
Counties with especially high positivity rates are Centre (12.1 percent), Indiana (11.6) and York (7.8 percent).
On a day-to-day basis the number of new COVID-19 cases continues to fluctuate considerably.
The continued high numbers are driven in large part by major increases in the number of young people between the ages of 19 and 24 who are contracting COVID-19. Eight percent of all cases of COVID-19 among children between the ages of five and 18 occurred between September 11 and September 27.
The number of Pennsylvanians currently hospitalized with COVID-19 and the number of such patients breathing with the help of a ventilator continue to decline slowly.
More than 10,400 health care workers in the state have contracted COVID-19.
21 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 24 percent of adult ICU beds, 16 percent of pediatric ICU beds, 37 percent of pediatric beds, and 40 percent of airborne isolation rooms.

Department of Human Services

DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.

Federal Update (as of Monday, September 21)

Provider Relief Fund Reporting Requirements

HHS has updated its Provider Relief Fund web page with the document “General and Targeted Distribution: Post-Payment Notice of Reporting Requirements.” The purpose of this document is to inform recipients of Provider Relief Fund payments that received one or more payments exceeding $10,000 in the aggregate of the data elements they will be required to report as part of the post-payment reporting process. This is important because it identifies how HHS will calculate lost revenue and COVID-related expenses for both general distribution and targeted Provider Relief payments for reporting requirements.

A key passage in this document, on page 1 under “Reporting Guidance on Use of Funds,” states that “Recipients will report their use of PRF [Provider Relief Fund] payments by submitting the following information:”

Healthcare related expenses attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse, which may include General and Administrative (G&A) or healthcare related operating expenses (further defined within the data elements section below).

PRF payment amounts not fully expended on healthcare related expenses attributable to coronavirus are then applied to lost revenues, represented as a negative change in year-over-year net patient care operating income (i.e., patient care revenue less patient care related expenses for the Reporting Entity, defined below, that received funding), net of the healthcare related expenses attributable to coronavirus 2 calculated under step 1. Recipients may apply PRF payments toward lost revenue, up to the amount of their 2019 net gain from healthcare related sources. Recipients that reported negative net operating income from patient care in 2019 may apply PRF amounts to lost revenues up to a net zero gain/loss in 2020.

If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the 2019 net gain. For example, the reporting period January – June 2021 will be compared to the same period in 2019.

Providers should review the entire document “General and Targeted Distributions: Post-Payment Notice of Reporting Requirements” very carefully.

In addition, HHS has updated its Provider Relief Fund web page with the following notice:

In accordance with the Office of Management and Budget’s Memorandum M-20-21, all financial information that agencies are required to report concerning their disposition of CARES Act and other supplemental COVID-19 appropriated funds is publicly available on USAspending.gov. View the COVID-19 Spending profile page.

Medicare Accelerated and Advance Payment Program

In an interview with Modern Healthcare, CMS Administrator Seema Verma confirmed that the federal government is delaying recoupment of the Medicare revenue provided to hospitals through the CARES Act’s Accelerated and Advance Payment Program to help them weather the onslaught of COVID-19 and the loss of revenue they anticipated because of their temporary need to suspend non-urgent procedures during the early months of the pandemic. The original plan was for CMS to withhold 100 percent of Medicare payments to hospitals beginning in August until the money advanced to them was repaid, but that withholding has now been put off for an unspecified period of time. Find the interview with Administrator Verma (by subscription only) here.
The House has released a draft bill for a continuing resolution to fund the federal government when the 2021 fiscal year begins on October 1 through December 11. That bill addresses the same Accelerated and Advance Payment Program. Its highlights include:
For the first 11 months during which a provider is repaying, the recoupment may be up to 25 percent of what Medicare would otherwise be paying that provider for items and services provided.
For the next six months the offset may be up to 50 percent of what Medicare would be paying that provider.
Providers have 29 months from the date the first accelerated payment was made to repay the amount in full.
The interest on accelerated and advance payments only appears to begin 30 days after the 29-month period at four percent. Under the CARES Act, the interest rate is around 10 percent.
The continuing resolution would establish a $10 million cap a year for future advance payments to Medicare Part B providers.
CMS is given two weeks to publish a list of providers that received these payments on a public website.
Learn more from this House summary of the bill or go here to see the bill itself.

Department of Health and Human Services

HHS has issued a memo on agency procedures clarifying that all department rules, which are all issued by the Secretary, must now be signed by the Secretary.

The department released the following statement on this action:

Before and after this action, no regulation issues from any part of HHS without the approval of the Secretary and the White House. The only change made by this memo is that, instead of the Secretary’s just approving all agency regulations, each regulation now also will be formally signed by him. Any speculation about this memo being motivated by policy considerations is utterly misinformed. This good-government action is only prospective in effect and minimizes litigation risk for the department’s public health actions, prevents potential future abuse of authority, and is consistent with congressional intent. The memo should have no effect on operational work and does not pertain in any way to guidance or any vaccine or drug approval or authorization. This action will not slow any HHS agencies’ work. It is simply the ministerial, administrative act of attaching a signature to a document.

HHS’s Office of the Inspector General has updated its calendar of inspections, audits, and evaluations on COVID-19-related matters.

Centers for Medicare & Medicaid Services

CMS has posted new information on Medicare payment for COVID-19 testing in nursing facilities based on whether the payer is Medicare, Medicaid, the Provider Relief Fund, the Centers for Disease Control and Prevention, or private insurance. The information includes a summary of clinical laboratory fee schedule codes.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Call

Tuesday, September 22 at 5:00 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 2409459

To join call, go here.

Home Health and Hospice Call

Tuesday, September 22 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 1169237
To join call, go here.

Dialysis Organizations Call

Wednesday, September 23 at 5:30 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 7026727
To join call, go here.

Nurses Call

Thursday, September 24 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 5872398
To join call, go here.

Conference lines are limited, so CMS encourages interested parties to join via audio webcast. To listen to the audio files and read the transcripts for these and past COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

Food and Drug Administration

The FDA has updated its guidance on the use of convalescent plasma in the treatment of patients with COVID-19. The update, introduced by regulation, withdraws previous guidance and provides updated guidance that

… includes a discussion to facilitate the availability of investigational convalescent plasma when blood establishments, hospitals, and healthcare providers collect plasma that does not meet the Conditions of Authorization of the Emergency Use Authorization (EUA).

The FDA has approved an abbreviated new drug application for propofol injectable emulsion for single patient use only. Propofol injectable emulsion is an intravenous general anesthetic and sedation drug that can be used to sedate patients undergoing intubation for treatment of COVID-19.

Centers for Disease Control and Prevention

The CDC has updated its guidance on when individuals should be tested for COVID-19. The updated guidance states that “Due to the significance of asymptomatic and pre-symptomatic transmission, this guidance further reinforces the need to test asymptomatic persons, including close contacts of a person with documented SARS-CoV-2 infection.” This essentially reverses CDC guidance issued in August.
The CDC has updated its interim laboratory biosafety guidelines for handling and processing specimens associated with COVID-19.

Government Accountability Office

The GAO has published a new report on its oversight of federal actions to support public health, individuals, and the economy during the COVID-19 pandemic. Go here to see “COVID-19: Federal Efforts Could Be Strengthened by Timely and Concerted Actions.”

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-09-23T08:47:58+00:00September 23rd, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Friday, September 18

The following is the latest coronavirus information from Pennsylvania’s state government as of 1:30 p.m. on Friday, September 18.

The Courts

A federal court has ruled that parts of Governor Wolf’s orders closing down aspects of life and commerce in the state in response to the COVID-19 emergency were unconstitutional. Find the entire court decision in this Pittsburgh Tribune-Review article that also summarizes the decision, its implications, and reactions to it.

Governor Wolf

Governor Wolf called on the General Assembly to provide an additional $225 million in CARES Act funding for the state’s COVID-19 hazard pay program to support front-line workers risking their health to continue working in life-sustaining industries during the COVID-19 pandemic.

Department of Health

The Department of Health has issued guidance for individuals who have had close contact with someone who has been diagnosed with COVID-19.
Following up on its guidance released last week on compassionate care access to skilled nursing facilities, the Department of Health has posted a fact sheet on compassionate care, a comparison between regular visiting and compassionate care visiting, and an infographic showing these differences.
The Department of Health issued a health alert providing recommendations and considerations for point-of-care antigen testing in nursing homes.

Department of Health – by the numbers

This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of September 4 to September 10 the number of new COVID-19 cases fell 8.9 percent but the state-wide rate of positive tests rose from 4.0 to 4.2 percent.
Counties with especially high positivity rates are Columbia (13.4 percent), Indiana (10.7 percent), Juniata (10.3 percent), and Centre (9.2 percent), and these are also the counties the state believes are experiencing the highest rate of community transmission.
For the past week the number of daily cases has differed significantly from day to day, from some of the state’s highest to some of its lowest numbers in the past six weeks.
The continued high numbers are driven in large part by major increases in the number of young people between the ages of 19 and 24 who are contracting COVID-19. In southeastern Pennsylvania, for example, nearly five percent of COVID-19 cases fell in this age group in April; in September so far, that number has risen to nearly 32 percent. The trends are similar in other parts of the state except in the north central part of the state, where the proportion of 19-24-year-olds contracting COVID-19 rose from seven percent of cases in April to 71 percent this month so far, and in northeastern Pennsylvania, where the number of people in this age group diagnosed with COVID-19 rose from six percent of that region’s total in April to 39 percent in September.
Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 and the number of such patients breathing with the help of a ventilator are lower than they have been since the spring of 2020.
More than 10,200 health care workers in the state have contracted COVID-19.
20 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 25 percent of adult ICU beds, 16 percent of pediatric ICU beds, 38 percent of pediatric beds, and 40 percent of airborne isolation rooms.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-09-20T17:21:14+00:00September 20th, 2020|Coronavirus, COVID-19|Comments Off

MFAR is Dead

At least for now.

The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time.

In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that

We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study. Therefore, CMS is withdrawing the rule from the regulatory agenda.

If implemented, opponents maintained, the regulation would have:

Deprived states of important, established policy-making prerogatives.
Created major new administrative burdens for state governments and hospitals.
Inappropriately regulated financing of the state share of Medicaid spending.
Introduced new, unspecified standards for state Medicaid programs.

While CMS maintained that MFAR would have enhanced the transparency of state Medicaid programs, the rule’s opponents maintained that it could lead to a major reduction of resources for serving the Medicaid population.

SNAP was among those opponents, arguing that the regulation could have hurt Pennsylvania safety-net hospitals and others that serve low-income communities by inappropriately regulating how states can finance their Medicaid programs. CMS proposed the rule last November; SNAP submitted formal comments expressing its opposition in January; and SNAP rallied Pennsylvania’s congressional delegation to oppose the rule in February, March, and July.

It is worth noting that in “withdrawing the rule from the regulatory agenda,” Verma did not preclude the possibility of reintroducing MFAR at some point in the future.

Learn more from article “Trump administration backing off Medicaid rule that states warned would lead to cuts” in the online publication The Hill.

PA Safety Net Admin2020-09-17T06:00:46+00:00September 17th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency.

Or so reports the organization Families USA in a new study.

Pennsylvania State Map According to the study,

Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%.

But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss,

Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health Management Associates projects that up to 27 million people will lose their job-based insurance this year and that Medicaid will see an increase in enrollment of up to 18 million people by the end of 2020, depending on the severity of the economic downturn.

The effects of COVID-19 job loss and accompanying loss of insurance already appears to be visible in Pennsylvania, where Medicaid enrollment rose from 2.84 million in March of 2020 to 2.89 million in April, 2.94 million in May, and 2.977 million in June. Growing Medicaid enrollment poses a challenge for Pennsylvania’s safety-net hospitals because they care for so many low-income patients and payments from the state’s Medicaid program often do not cover the cost of the care they provide.

Learn more about the nation-wide trend in the Families USA report “Rapid Increases in Medicaid Enrollment: A Review of Data from Six Months.”

PA Safety Net Admin2020-09-16T06:00:58+00:00September 16th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals|Comments Off

Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders.

The cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to the delegation, SNAP wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with COVID-19. When these people are sick or injured, most will turn to the state’s 41 private safety-net hospitals for care. These hospitals depend heavily on their Medicaid DSH payments to underwrite the cost of care for their uninsured patients, so they have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never permitted those cuts to go into effect. The most recent delay expires after November 30..

Because they serve so many uninsured and underinsured patients, Medicaid DSH payments from the state are especially important for Pennsylvania’s safety-net hospitals.

PA Safety Net Admin2020-09-15T06:00:16+00:00September 15th, 2020|Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Eliminate Medicaid DSH Cut, SNAP Asks PA Congressional Delegation (Letter)

SNAP has written to the Pennsylvania congressional delegation asking its members to urge congressional leaders to eliminate a cut in federal Medicaid DSH allotments to the states.

PA Safety Net Admin2021-05-27T14:47:43+00:00September 14th, 2020|Advocacy|Comments Off

COVID-19 Update: Friday, September 11

The following is the latest coronavirus information from the state and federal governments as of 1:30 p.m. on Friday, September 11.

Pennsylvania State Government

Department of State

The Department of State has suspended the initial medical history and physical examination required for prescribing buprenorphine via telemedicine to treat opioid use disorder for the duration of the COVID-19 disaster declaration.

Department of Health

The Department of Health has revised its health alert Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (COVID-19) in a Healthcare Setting to add information on extended-use eye protection and to update language regarding the use of respirators.

The Department of Health has clarified that it does not need to approve a skilled nursing facility’s testing plan before it is used by the facility and providers should defer to the CMS-reported county positivity rate if there is a conflict between CMS and Department of Health data. Learn more here.

Department of Health – by the numbers

This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of August 28 to September 3, the number of COVID-19 cases rose 30 percent over the previous week, the state-wide rate for positive tests rose from 3.2 percent to four percent, and community transmission was high in Columbia and Centre counties.
Since that time, the number of daily cases has differed significantly from day to day, from some of the state’s highest to some of its lowest numbers in the past six weeks.
In recent days the number of COVID-19 cases in Pennsylvania surpassed 142,000 and the number of COVID-19 deaths rose past 7800.
Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 continues a very slow decline, as does the number of such patients breathing with the help of a ventilator.
The number of health care workers in the state who have contracted COVID-19 just surpassed 10,000.
More than 21,700 residents of long-term-care facilities and 4700 people who work in those facilities have contracted COVID-19 in 947 such facilities in 61 of the state’s 67 counties.
22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 26 percent of adult ICU beds, 13 percent of pediatric ICU beds, 35 percent of pediatric beds, and 42 percent of airborne isolation rooms.

Federal Update

Provider Relief Fund

Reminder: Applications are currently open for Phase 2 general distribution funding for Medicaid, Medicaid managed care, the Children’s Health Insurance Program (CHIP), dental providers, certain Medicare providers, hospitals that have changes in ownership, and assisted living facilities. All groups have until September 13, 2020 to submit their tax identification number for validation and apply for funding from the phase 2 general distribution. Go here for more information.
HHS has updated its Provider Relief Fund FAQ with one modified question marked 9/4/2020 on page 32 of the document. The revised response addresses the tax treatment by parent companies of grants awarded to subsidiaries with separate National Provider Identifiers.

American Medical Association

The American Medical Association has published an update of the Current Procedural Terminology (CPT) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic. Learn more from this AMA announcement.

Department of Health and Human Services

HHS has published a request for information seeking stakeholder input regarding the ability of CLIA-accredited commercial, academic, medical center, and public health laboratories to feasibly perform more COVID-19 testing if additional testing instruments were made available to them. Interested parties have ten days to submit written comments.
HHS has issued new guidance authorizing state-licensed pharmacists to order and administer, and state-licensed or registered pharmacy interns acting under the supervision of the qualified pharmacist to administer, COVID-19 vaccinations to persons ages three or older, subject to certain requirements. See HHS’s announcement of the new guidance and go here to see the guidance itself.

Centers for Medicare & Medicaid Services

CMS has posted the document “New COVID 19 Testing and Reporting Requirements” that collects and summarizes the latest testing, training, and data-reporting requirements for nursing homes.
In late August, CMS published a regulation that required nursing homes to test their staff for COVID-19; that regulation included other testing and reporting requirements as well. The frequency of such testing was to be tied to the degree of community spread of COVID-19, with the details of how that would work to be announced later. CMS has now published the county-by-county positivity rates on which the frequency of nursing home testing will be based. Find those rates here.
CMS has updated its tip sheets to help providers understand its public reporting strategy for quality programs during the COVID-19 emergency. Find tip sheets for the following types of providers:
- For long-term-care hospitals, here and here.
- For skilled nursing facilities, here and here.
- For inpatient rehabilitation faculties, here and here.
- For home health providers, here and here.
CMS has published updated provider-specific fact sheets on new COVID-19-related waivers and flexibilities for home health agencies, ambulances, and durable medical equipment.

CMS COVID-19 Stakeholder Calls

CMS COVID-19 Office Hours Call

Tuesday, September 22 at 5:00 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 2409459

To join call, go here.

Lessons from the Front Lines: COVID-19

Friday, September 18 at 12:30 – 2:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 4446447

To join call, go here.

Home Health and Hospice Call

Tuesday, September 22ⁿ at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 1169237
To join call, go here.

Nursing Homes Call

Friday, September 18 at 12:30 – 2:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 4446447

To join call, go here.

Dialysis Organizations Call

Wednesday, September 23 at 5:30 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 7026727
To join call, go here.

Thursday, September 24 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 5872398
To join call, go here.

Centers for Disease Control and Prevention

The CDC has updated its guidance for the clinical management of patients suffering from COVID-19.
The CDC has posted information about how long people who have COVID-19 or are suspected of having COVID-19 should remain in isolation. This information includes other precautions such individuals should take.
The CDC has posted guidance for people about when they can be around other people after they have had COVID-19 or believe they likely had COVID-19.
The CDC has updated its interim guidance for implementing safety practices for critical infrastructure workers who may have been exposed to people with suspected or confirmed COVID-19.
The CDC has updated its information about the precautions that should be taken by people with certain medical conditions to avoid contracting COVID-19.
The CDC has updated its interim guidance for rapid antigen testing for COVID-19.

Food and Drug Administration

The FDA has revoked its emergency use authorization of oral formulations of chloroquine phosphate and hydroxychloroquine sulfate as treatments for COVID-19.
The FDA will host virtual town halls on September 16, September 23, and September 30 for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19. The purpose of this event is to help answer technical questions about the development and validation of tests for COVID-19. Learn more about the town halls, when they will be held, and how interested parties can participate in this FDA notice.