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

SNAP Rallies PA Delegation to Oppose Proposed Medicaid Fiscal Accountability Regulation (Letter)

SNAP asks members of Pennsylvania’s congressional delegation to sign onto a bipartisan letter written by delegation members Brendan Boyle (D) and Mike Kelly (R) asking the Centers for Medicare & Medicaid Services Administration to reconsider a proposed regulation that could limit the state’s ability to finance its share of its Medicaid spending and appropriately reimburse providers of high volumes of Medicaid-covered services.

PA Safety Net Admin2020-09-01T17:59:31+00:00February 27th, 2020|Advocacy|Comments Off

HealthChoices MCO Seeks to Address Social Determinants of Health

A managed care plan that participates in Pennsylvania’s Medicaid program is slowly dipping its toe into an effort to address the social determinants of health in Philadelphia.

United Healthcare, with 57,000 Medicaid members in the city, has placed six homeless members with multiple health problems into apartments in the city – it plans to add four more – and is spending between $1200 and $1800 a month on rent and wrapround services. Its theory: with one percent of the population accounting for 22 percent of annual health care spending nation-wide, helping some of that one percent could improve lives while saving a great deal of money.

Pennsylvania’s Department of Human Services has awarded nearly $9 million in grants since 2016 to groups attempting to address the social determinants of health and to help the more than 300,000 Medicaid participants in north Philadelphia.

Learn more about what United Healthcare is doing and why it is doing it in the Philadelphia Inquirer article “United Healthcare tackles homelessness as a root cause of poor health, and Philly is a test case.”

PA Safety Net Admin2020-02-25T06:00:04+00:00February 25th, 2020|Pennsylvania Medicaid, social determinants of health|Comments Off

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company.

MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could

…reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone. States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications.

Bookshelf with law books Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that

Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities reliant on state funding, including local governments and providers. States would need to find revenue or cost savings, either in Medicaid or elsewhere, to offset reduced federal contributions.

Because Pennsylvania safety-net hospitals care for more Medicaid patients than the typical hospital, both proposed policy changes have a potentially greater impact on them.

Last month SNAP conveyed its opposition to the proposed MFAR regulation in a formal comment letter to the Centers for Medicare & Medicaid Services in response to the regulation’s publication late last year. Pennsylvania Governor Tom Wolf has already rejected the idea of using block grants in the state’s Medicaid program.

Learn more about the potential impact of the proposed Medicaid fiscal accountability regulation and Medicaid block grants in the Fitch Ratings analysis “Fitch Rtgs: Medicaid Changes Will Affect States, NFP Healthcare Providers.”

PA Safety Net Admin2020-02-20T06:00:08+00:00February 20th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

PA Seeks to Connect Medicaid Beneficiaries With Job

Pennsylvania has launched a new program that seeks to help Medicaid beneficiaries who would like to find jobs.

The program, called Medicaid Work Supports, is a joint project of the state’s Department of Human Services and Department of Labor & Industry.

As described in The Impact, DHS’s weekly newsletter:

The Medicaid Work Supports initiative will create a more direct and systematic introduction to employment and training resources available to Pennsylvanians. When people are deemed eligible and enroll in a new Medicaid health plan, they will be asked if they are interested in help finding a job, training programs, and opportunities to get a high school diploma or GED. The referral system will help identify this population for the first time and create the opportunity for a meaningful, encouraging partnership between the MCOs, the PA CareerLink® system, and the enrollee to facilitate connections to employment and success in the workforce.

Individuals interested in learning more about these services will receive outreach either through PA CareerLinks®, their selected health plan, or their local county assistance office to provide awareness of and referrals to resources and programs available in their local community.

Learn more about Medicaid Work Supports in the February 14, 2020 edition of The Impact, DHS’s weekly newsletter.

PA Safety Net Admin2020-02-18T06:00:22+00:00February 18th, 2020|Uncategorized|Comments Off

Verma Responds to MFAR Critics

CMS administrator Seema Verma addresses criticism of her agency’s proposed Medicaid fiscal accountability regulation in a new commentary on the CMS blog.

Critics of the so-called MFAR regulation have argued that the Centers for Medicare & Medicaid Services’ proposed regulation, if adopted, will lead to a reduction of federal funding for state Medicaid programs, jeopardize access to care and the financial health of providers by leading to a reduction of supplemental payments to high-volume Medicaid providers, and possibly even force some states to raise taxes to compensate for the loss of federal funding.

In her commentary Verma rebuts these criticisms, maintaining that the proposed regulation seeks to ensure that states pay their fair share of their Medicaid partnership with the federal government, raise that share in a manner consistent with federal guidelines, and spend it in ways that fall within regulatory standards. She also maintains that the regulation will foster greater transparency and accountability for the Medicaid program.

Verma notes that more than 4000 stakeholders submitted written comments in response to the proposed regulation. SNAP was among those commenters, writing that MFAR would give too much authority to federal regulators; create new administrative burdens for hospitals and state governments; and inappropriately limit state financing of their share of Medicaid spending.

Learn more from the Verma CMS blog commentary “Medicaid Fiscal Integrity: Protecting Taxpayers and Patients” and from SNAP’s letter in response to the proposed regulation.

PA Safety Net Admin2020-02-14T06:00:39+00:00February 14th, 2020|Federal Medicaid issues, Safety-Net Association of Pennsylvania|Comments Off

340B Déjà Vu: CMS Seeks to Collect Data From Hospitals

For the second time in four months, the federal government has announced its intention to collect data from hospitals and other providers on what they pay for the prescription drugs they purchase through the section 340B prescription drug discount program.

Last week the Centers for Medicare & Medicaid Services published a notice announcing its intention to collect this data. Previously, health care interests sued CMS when it attempted in 2018 to reduce payments to providers for drugs purchased through the 340B program and the court ruled against CMS, maintaining that the agency did not have enough data on hospitals’ acquisition costs for the drugs to justify the proposed payment reduction. The newly announced data collection effort seeks to rectify that shortcoming as the court considers CMS’s appeal of a similar decision in a lawsuit filed after CMS again proposed reducing 340B payments and was again rebuffed by the courts in 2019.

Under federal law, CMS must publish a notice declaring its intention to collect such data and seek input from stakeholders. For this particular notice, stakeholders have until March 9 to respond.

CMS published a similar notice in September of 2019 announcing its intention to collect similar data. That data collection never took place.

Most Pennsylvania safety-net hospitals participate in the 340B program and consider it a vital tool in serving the many low-income residents of the communities in which they are located.

To learn more about CMS’s 340B data collection effort, see the notice it published in the Federal Register and read the Becker’s Hospital Review article “CMS ready to survey 340B hospitals about drug acquisition costs.”

PA Safety Net Admin2020-02-13T06:00:33+00:00February 13th, 2020|340b, Pennsylvania safety-net hospitals|Comments Off

Verma Responds to Medicaid Block Grant Critics

Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs.

Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders.

Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post. See her commentary “No, the Trump administration is not cutting Medicaid.”

PA Safety Net Admin2020-02-12T06:00:12+00:00February 12th, 2020|Federal Medicaid issues|Comments Off

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups.

The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them.

Bookshelf with law books The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal government.

Numerous health care groups have expressed reservations or direct opposition to one or both of the proposals. Among them:

AARP
America’s Essential Hospitals
America’s Health Insurance Plans
American College of Emergency Physicians
American Health Care Association
American Hospital Association
American Medical Association
Association for Community Affiliated Plans
Association of American Medical Colleges
Coalition of Long-Term Acute-Care Hospitals
LeadingAge
National Alliance of Safety-Net Hospitals
National Association of State Budget Officers
National Association of Medicaid Directors
National Continuing Care Residents Association
National Governors Association
Private Essential Access Community Hospitals

Among the groups submitting formal comment letters to the Centers for Medicare & Medicaid Services in response to the proposed Medicaid fiscal accountability regulation was the Safety-Net Association of Pennsylvania. See SNAP’s letter here.

Learn more about why these groups object to these two new policy developments in articles in Axios (“A little-noticed Medicaid proposal could have huge consequences”), Bloomberg Law (“Trump Plan to Tame State Medicaid Finance Schemes Sees Pushback”), Health Affairs (“Proposed Rules On Medicaid Financing Miss Mark And Threaten Access”), Healthcare Dive (“Payers, providers urge CMS to scrap rule targeting supplemental Medicaid payments”), Healthcare Finance News (“Providers, payers, others speak out against federal proposals for Medicaid funding”), McKnight’s Long-Term Care News (“Providers rally against proposed Medicaid supplemental payment rules that threaten ‘major financial burdens’”), McKnight’s Senior Living (“CMS proposal would be ‘major financial burden’ for CCRCs, residents, organizations say”), and U.S. News & World Report (“Governors Warn Trump Rule Could Lead to Big Medicaid Cuts”)

PA Safety Net Admin2020-02-10T06:00:34+00:00February 10th, 2020|Federal Medicaid issues, Safety-Net Association of Pennsylvania|Comments Off

Wolf Administration Proposes New Human Services Initiatives for FY 2021

New human services efforts to support vulnerable populations are a major part of Governor Tom Wolf’s proposed $36.06 billion FY 2021 budget for Pennsylvania.

The proposed budget, presented to the state legislature earlier this week, includes the following new initiatives:

creating pathways to success in the workforce for low-income Pennsylvanians
increasing the minimum wage to $15
increasing Department of Human Services staffing to support licensing and oversight
supporting adults in long-term-care facilities
legal services for vulnerable populations
direct care worker comprehensive training
commitment to performance-based metrics, accountability, and transparency in services and licensing
supporting vulnerable populations through home- and community-based services and reducing waiting lists
prevention services to support at-risk families
improving food security while supporting agriculture

Go here to see DHS’s presentation of these initiatives.

In addition, the Safety-Net Association of Pennsylvania has prepared a detailed memo describing the proposed FY 2021 budget’s implications for Pennsylvania safety-net hospitals and the state’s Medicaid program. For a copy of this memo, use the “contact us” link in the upper right-hand corner of this page.

PA Safety Net Admin2020-02-07T06:00:38+00:00February 7th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2021 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2020 newsletter.

Included in this month’s edition are articles about:

the transition to a new Medicaid prescription drug list (PDL);
the rollout of a new electronic visit verification system for Medicaid-paid home health services; and
progress in the state’s effort to introduce major changes in its Medical Assistance transportation program (MATP).

Read about these subjects and more in the Pennsylvania Health Law Project’s January 2020 newsletter.

PA Safety Net Admin2020-02-05T06:00:12+00:00February 5th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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