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PA Health Policy Update for July 12

The following is an update of selected state health policy developments in Pennsylvania from July 8 – 12.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.
  • The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration. 

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024. 

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee. 

Centers for Medicare and Medicaid Services 

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics.  In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas.  For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking. 

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Health Policy Update for July 5

The following is an update of selected state health policy developments in Pennsylvania from July 1 – 5.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

The Commonwealth of Pennsylvania is five days into the new Fiscal Year (FY) and still doesn’t have an enacted budget, but legislative leaders remain optimistic that an agreement will be reached in the near term. The state House of Representatives and Senate, who recessed briefly for the Fourth of July, are currently scheduled to return on Saturday, July 6 to continue work on the FY 2024-2025 budget and its related bills. 

Governor Shapiro 

Governor Shapiro signed House Bill 1754 into law on Monday. Now known as Act 39 of 2024, this legislation requires public and private insurers to cover biomarker testing. Find additional information in this press release.

On Wednesday Governor Shapiro signed Senate Bill 739 into law. Now known as Act 42 of 2024, this piece of legislation provides for coverage of telemedicine services. Find additional information in this press release 

General Assembly

The state House of Representatives and Senate held voting session Monday, July 1 through Wednesday, July 3. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate confirmed Dr. Debra Bogen as Secretary of the Department of Health by a vote of 42 – 8 on Monday, July 1. Dr. Bogen has been serving as Acting Secretary since the beginning of the Shapiro administration. Find additional information in this press release.
  • The Senate passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent back to the House for concurrence.
  • The Senate passed Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill was received in the House and referred to the Health Committee.
  • The House of Representatives passed House Bill 2429, which establishes an inmate reentry program operated by the Department of Human Services to provide substance use disorder treatment and case management services prior an inmate’s release from a correctional institution. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2175, which creates a permanent Office of Child Advocate. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. The bill will now be sent to the Senate for consideration. 

The House and Senate are currently scheduled to return to Harrisburg for voting session Saturday, July 6.  

Department of Human Services 

  • The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) for nursing facilities. Find the list and additional information in this Pennsylvania Bulletin notice.
  • DHS has published two notices in the Pennsylvania Bulletin related to the implementation and reauthorization of the Philadelphia hospital assessment, including the establishment of a new class of supplemental payments and the discontinuation of certain DSH and supplemental payments.
  • DHS has published updates to the Medical Assistance (MA) program fee schedule for ophthalmology services, effective for dates of service on and after August 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued a number of Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health 

The Department of Health (DOH) has requested providers who operate mobile clinics complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania ended Fiscal Year (FY) 2023-2024 with $45.5 billion in General Fund collections. That total is $862.9 million, or 1.9 percent, above estimate. 

Stakeholder Events   

DOH – WIC Advisory Board – July 9

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory will meet on July 9 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-07-08T20:21:52+00:00July 5th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for July 5

PA Health Policy Update for June 28

The following is an update of selected state health policy developments in Pennsylvania from June 24 – 28.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future. 

General Assembly

The state House of Representatives and Senate were in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity.

  • The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 194-8. The bill will now be sent to the Senate for consideration.
  • The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.
  • The Senate unanimously passed on 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 received in the House and referred to the Health Committee.
  • The House unanimously passed House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2400, 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 will now be sent to the Senate for consideration.
  • The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.
  • The House Children & Youth Committee met on Tuesday, June 25 and favorably reported House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.
  • The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here. 

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the proposed assessment amount, the proposed assessment methodology and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.
  • DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

Department of Health 

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.  

Stakeholder Events   

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 28

PA Health Policy Update for June 21

The following is an update of selected state health policy developments in Pennsylvania from June 17 – 21.  (Some of the language used below is taken directly from state documents). 

General Assembly

  • The state House of Representatives and Senate will reconvene for voting session next Monday, June 24. Both chambers are currently scheduled to remain in session until Monday, June 30, which is Pennsylvania’s constitutional deadline to enact a budget.
  • The House Children & Youth Committee is scheduled to meet on Tuesday, June 25 at 9:00 a.m. to consider House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The meeting will be held in Room B-31 of the Main Capitol. It will be livestreamed here.
  • The House Health Committee is scheduled to meet on Wednesday, June 26 at 9:30 a.m. to consider House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. The meeting will be held in Room G-50 of the Irvis Building. It will be livestreamed here. 

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July 2024. 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 announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death.  Find the notice here. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced it will offer a virtual “Implementation, Improvement, Sustainability and Coaching of the ASAM Criteria – A How-To Science Based Approach” training in conjunction with Train for Change. The training will be offered in three series. It will teach the NIATx model for process improvement in conjunction with the ASAM Criteria Implementation Guide. Find the three series’ dates and additional information here. 

Around the State 

  • The Pennsylvania Capital-Star has reported about the state’s looming budget deadline and Senator Majority Leader Joe Pittman’s assertion that “[negotiations] could perhaps use… a kick in the pants to get moving.”
  • The New York Times has published an article about the role of pharmacy benefit managers (PBMs) and how they contribute to the cost of prescription drugs.
  • Spotlight PA has published an article about efforts to legalize recreational marijuana and the likelihood of legalization being a part of this year’s budget package.

Stakeholder Events   

DHS – Consumer Sub-MAAC – June 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 26 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – June 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 27 at 10:00 a.m. Find the agenda here and register to participate here.

2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off on PA Health Policy Update for June 21

PA Health Policy Update for June 14

The following is an update of selected state health policy developments in Pennsylvania from June 10 – 14.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

Governor Shapiro signed, among other bills, Senate Bill 721 into law this week. Senate Bill 721, now known as Act 22 of 2024, establishes the Women, Infants and Children (WIC) State Advisory Board. Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The House of Representatives passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to the Senate and reported favorably from the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1783, which requires the Department of Health to develop and publish educational material about opioid-related overdose and requires the Department of Drug & Alcohol Programs to establish a grant program from the development, expansion, or improvement of recovery support services. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2127, which allows clinicians to distribute information related to postpartum depression and counseling resources. It also requires the Department of Health to publish those resources on its website. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed  House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational hearing on Senate Bill 840 and House Bill 2400, which both create an Alzheimer’s Disease and related disorders division within the Department of Aging and establish an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the hearing is viewable here.
  • The House Children & Youth Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, June 11 and favorably reported House Bill 1140, which expands access to contraceptives, and House Bill 2268, which provides coverage for speech therapy for stuttering. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, June 11 and favorably reported Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions, and Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. A recording of the meeting is viewable here.
  • The Senate Banking & Insurance Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 1664, which prohibits insurers from restricting their method of payment to solely credit card, and House Bill 1754, which requires public and private insurers to cover biomarker testing. A recording of the meeting is viewable here.
  • The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 12 and favorably reported, among other bills, Senate Bill 1251, which aligns Pennsylvania’s nursing statute with federal rules regarding accreditation. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee and the Senate Aging & Youth Committee held a combined hearing on Wednesday, June 12 regarding the status of the state’s Aging Our Way plan. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, June 12 and favorably reported the following bills.
    • House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients,
    • House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance.
    • House Bill 2363, which expands the existing Cancer Drug Repository Program to allow both health care facilities and individuals to donate prescription drugs (other than cancer drugs) to the program.

A recording of the meeting is viewable here.

  • The House Human Services Committee met on Wednesday, June 12 and favorably reported House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, June 12 and favorably reported, among other bills, House Bill 2198, which caps the fees for obtaining electronic medical records. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee met for a voting meeting on Wednesday, June 12 and favorably reported, among other bills, House Bill 2400, 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. A recording of the meeting is viewable here.

The state House of Representatives and Senate will be in recess next week. Both chambers are scheduled to return to Harrisburg, Monday June 24.

Department of Human Services 

The Department of Human Services (DHS) has announced it is making available for public review and comment the Office of Long-Term Living’s proposed amendment for the OBRA waiver. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced it is making available for public comment and review the Office of Long-Term Living’s proposed renewal for the Community HealthChoices (CHC) waiver. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 753) regarding testing for influenza in persons with severe respiratory illness given the potential for severe human infections with influenza A(H5N1) viruses and the recent spread into dairy cattle. 

Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

2024-06-14T21:14:14+00:00June 14th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for June 14

PA Health Policy Update for June 7

The following is an update of selected state health policy developments in Pennsylvania from June 3 – 7.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed Senate Bill 1102, which increases the availability of long-term care training courses for nurse aides and expands eligibility for individuals to take the nurse aide competency exam, by a vote of 42 – 8. The bill was subsequently sent to the House and referred to the Health Committee.
  • The Senate passed Senate Bill 1104, which allow high school juniors and seniors to earn up to two credits toward their graduation requirement for employment in a congregate health care setting, by a vote of 29 – 21. It was subsequently sent to the House and referred to the Education Committee.
  • The Senate passed Senate Bill 1165, which makes certain statutory changes that will enable the state to join, among others, the medical and nursing interstate licensure compacts, by a vote of 46 – 4. The bill will now be sent to the House for consideration.
  • The House passed House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange, by a vote of 106 – 96. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program, by a vote of 123-79. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 851, which establishes the menstrual hygiene products grant program under the Public School Code, by a vote of 117-85. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services, by a vote of 181 – 21. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3. A recording of the meeting is viewable here.
  • The House Insurance Committee convened on Monday, June 3 and favorably reported, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. A recording of the meeting is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, June 4 and favorably reported Senate Bill 840, which creates an Alzheimer’s Disease and Related Disorders Division in the Department of Aging, and House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys. A recording of the meeting in viewable here.
  • The Senate Health & Human Services Committee convened on Tuesday, June 4 and favorably reported Senate Bill 1000, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients. A recording of the meeting is viewable here.
  • The House Children & Youth Committee met on Wednesday, June 5 and favorably reported, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Health Committee convened Wednesday, June 5 and favorably reported House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session again next Monday, June 10 through Wednesday, June 13.

Department of Human Services 

The Department of Human Services (DHS) has published a Medical Assistance Bulletin to advise providers of the updates to the Medical Assistance (MA) program dental fee schedule.

DHS has issued Provider Quick Tip #207 with information about fee schedule updates to Act 62, the Autism Insurance Act, procedure codes. 

Department of Health

  • DOH, in partnership with the Bradbury-Sullivan LGBT Community Center and Public Health Management Corporation (PHMC), has announced the start of the Pennsylvania LGBTQ Health Needs Assessment Survey, which is a biannual survey conducted to evaluate health needs, health disparities, and barriers to care impacting LGBTQ+ Pennsylvanians. 

Department of Aging 

The Department of Aging has announced the release of Aging Our Way PA, which is the state’s 10-year strategic plan that will help transform service delivery and serve as a roadmap for older adult services in Pennsylvania, ensuring services meet the needs of older adults as they address everyday issues such as healthcare, transportation, housing, long-term care and social connections. 

Department of State 

Several of the state’s professional licensure boards have adopted a statement of policy regarding conversion therapy. Following are the respective boards’ conversion therapy statements of policy.

 Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

 

2024-06-07T20:44:00+00:00June 7th, 2024|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for June 7

PA Health Policy Update for May 31

The following is an update of selected state health policy developments in Pennsylvania from May 27 – 31.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate will return to Harrisburg for voting session Monday, June 3 through Wednesday, June 5. Following is an overview of selected health care-related legislative activity currently scheduled.

  • The House Aging & Older Adult Services Committee will hold an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3 at 10:00 a.m. The meeting will take place in Room 140 of the Main Capitol. It will also be livestreamed here.
  • The House Insurance Committee will convene on Monday, June 3 at 10:30 a.m. to consider, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. The meeting will be held in the East Wing, Room 60. It will also be livestreamed here.
  • The House Children & Youth Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. The meeting will be held in East Wing, Room 60. It will also be livestreamed here.
  • The House Health Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider House Bill 2283, which requires operating rooms utilize surgical smoke evacuation systems. The meeting will be held in Room G-50 of the Irvis Office Building. It will also be livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule as a result of the 2024 Healthcare Common Procedures Coding System (HCPCS) updates. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 751) with information for health care providers about 2024 West Nile and other arboviral infections in Pennsylvania.

DOH has announced the publication of an updated list of academic clinical research centers (ACRC) under the Medical Marijuana program on the department’s website and established the time period during which applications for clinical registrants (CR) will be accepted by the department. Find additional information in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has announced it disapproved the Bureau of Professional and Occupational Affairs final-form regulation that lists criminal convictions directly related to each of the 29 professional and occupational licensing boards and commissions. IRRC indicated the regulation was not in the public interest due to the removal of certain offenses that may have direct bearing on the conduct, services, and practices of various occupations and professions. Find additional information in this Pennsylvania Bulletin notice. 

Stakeholder Events   

DHS – Long-Term Services and Supports Subcommittee – June 5

The Long-Term Services and Supports Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on Wednesday, June 5 at 10:00 a.m. Find additional information and details on how to participate here. 

The Patient Safety Authority – June 20

The Patient Safety Authority will hold a public meeting of the Authority’s Board on Thursday, June 20 at 10:30 a.m. The meeting will take place at the Central Penn College conference center (600 Valley Road, Summerdale, PA 17093). The meeting will also be held virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-06-03T17:47:33+00:00May 31st, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 31

PA Health Policy Update for May 24

The following is an update of selected state health policy developments in Pennsylvania from May 20 – 24.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives returned to Harrisburg this week for voting session. Following is a selection of health care-related legislative activity that occurred.

  • The House passed Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board, on final consideration by a vote of 119-83. The bill will now be sent to the governor’s desk.
  • The House passed House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service, by a vote of 154-48. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana, by a vote of 196-6. The bill will now be sent to the Senate for consideration.
  • The House Health Committee convened on Tuesday, May 21 and favorably reported, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Wednesday, May 22 for an informational hearing on the Living Independence for the Elderly (LIFE) program. A recording of the hearing is viewable here.

The state House and Senate are both recessed until Monday, June 3.

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding and end-dating procedure codes as a result of the 2024 updates published by CMS to the Healthcare Common Procedure Coding System (HCPCS). These changes are effective for dates of service on and after May 28, 2024.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June 2024. Find the updated calendar here.
  • The Office of Long-Term Living (OLTL) has communicated to personal care homes and assisted living residences that unlicensed staff persons may not administer Glucagon-like peptide (GLP)-1 agonist medications, such as Ozempic (Semaglutide) and Trulicity (Dulaglutide) via subcutaneous injection unless they seek a regulatory waiver and submit it to ra-pwarlheadquarters@pa.gov. 

Department of Health 

  • The Department of Health (DOH) has announced it is extending the temporary scheduling of any material, compound, mixture or preparation which contains any quantity of Nitazene substances for an additional year. Find additional information in this Pennsylvania Bulletin notice. 
  • DOH has issued a Health Advisory (PA-HAN 749) with Influenza A/H5N1, a highly pathogenic avian influenza (HPAI) virus, guidance for health care providers.
  • DOH also issued a Health Advisory (PA-HAN 750)  alerting healthcare providers of an increase in meningococcal disease, linked to Umrah travel to the Kingdom of Saudi Arabia. 

Health Insurance Exchange Authority 

The Pennsylvania Health Insurance Exchange Authority, which is the state-affiliated entity that operates the commonwealth’s state-based health insurance marketplace, has issued a proposed regulation that would require insurers selling qualified plans through the Exchange Authority to be accredited in health equity. 

Around the State   

  • PennLive has published an article about legislative efforts to require state-regulated commercial insurers to cover blood pressure monitors when necessary during pregnancy and for up to a year after delivery. 
  • The Philadelphia Inquirer has reported about an effort to subpoena Philadelphia mayor Cherelle Parker’s administration regarding its plans to expand addiction treatment services in the city. 
  • An article published by PennLive highlights the Shapiro administration’s efforts to seek a Medicaid 1115 waiver to provider continuous Medicaid coverage for children from birth through age six.
2024-06-03T17:42:15+00:00May 24th, 2024|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for May 24

PA Health Policy Update for May 17

The following is an update of selected state health policy developments in Pennsylvania from May 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

  • The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
  • The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024. 

Department of Health 

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page. 

State Board of Medicine 

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice 

State Board of Osteopathic Medicine 

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.
  • City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.
  • The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120. 

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

PA Health Policy Update for May 10

The following is an update of selected state health policy developments in Pennsylvania from May 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed Senate Bill 739 by a vote of 47-1. Senate Bill 739, which was amended before final passage, provides for coverage of telemedicine services. The bill will now be sent to the House for consideration.
  • The Senate unanimously passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system. The bill will now be sent to the House for consideration.
  • The House passed House Bill 1632, which amends the Workers’ Compensation Act to recognize post-traumatic stress injuries as eligible for workers’ compensation claims, by a vote of 154-46. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries, by a vote of 164-37. The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, May 6 and favorably reported, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.
    • House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange.

A recording of the meeting is viewable here.

  • The House Labor & Industry Committee met on Tuesday, May 7 and favorably reported House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee held an informational meeting on the nursing workforce crisis. A recording of both meetings is viewable here.

The state House of Representatives and Senate are now recessed. The House will return to session Monday, May 20 and the Senate will return Monday, June 3.

Department of Human Services 

The Department of Human Services (DHS) has announced its intent to increase the funding for a class of supplemental payments to qualifying hospitals for Fiscal Year (FY) 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional information in this Pennsylvania Bulletin notice. 

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on April 25.

Department of Health 

The Department of Health (DOH) has announced it will hold a public hearing on its proposed Preventive Health and Health Services Block Grant application for Federal Fiscal Year 2024. The hearing will take place on May 28 from 10:00 – 11:00 a.m. Find additional details on how to attend and comment in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Pharmacy’s proposed pharmacy technician registration regulations. Find additional information and IRRC’s comments in this Pennsylvania Bulletin notice 

Around the State 

  • The Pennsylvania Capital-Star has reported about legislation that would cover post-traumatic stress injuries for first responders under the state’s Workers’ Compensation Act.
  • Governor Shapiro has indicated he will sign legislation criminalizing the misuse of xylazine, which is contributing to a growing number of overdose deaths, according to a Philadelphia Inquirer article. 
  • PennLive has published an article about House Democrats’ efforts to pass legislation that would enact a key part of Governor Shapiro’s budget proposal to provide assistance to individuals purchasing insurance of the commonwealth’s state-based insurance exchange, Pennie.

Stakeholder Events 

PA Chamber – Healthcare Summit – May 22

The Pennsylvania Chamber of Business and Industry is holding its inaugural health care summit on Wednesday, May 22. The event will feature conversations about leading health care topics, including innovations in pharmaceuticals, workforce development, the medical malpractice landscape, and the role of AI in health care. To view additional details and register click here 

DOH – Preventive Health and Health Services Block Grant Committee – May 28

The Preventive Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, May 28 from 2:00 – 4:00 p.m. The purpose of the meeting is to present the Federal Fiscal Year 2024 workplan and budget information. The meeting will be held virtually and in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

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