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PA Proposes Changes in County Assistance Office Operations

The manner in which Pennsylvania operates its county assistance offices would change under a new proposal from the Department of Human Services that was included in Governor Wolf’s proposed FY 2018 budget.
Under the plan, the state would consolidate county assistance office back-office operations in five new regional processing centers.  While every county will have what DHS is calling a county assistance office “presence,” the new approach would lead to the lay-off of 70 of the county assistance office program’s nearly 7000 employees.
The process of determining Medicaid eligibility in Pennsylvania either begins or works its way through the state’s county assistance offices.
Learn more about the proposal to change some aspects of county assistance office operations in this DHS notice.

2017-03-21T06:00:22+00:00March 21st, 2017|Pennsylvania Medicaid policy|Comments Off on PA Proposes Changes in County Assistance Office Operations

PA Takes Steps to Fight Opioid Epidemic

The Pennsylvania Department of Human Services has announced new steps designed to combat opioid abuse within the state’s Medicaid population.
Among those steps are ensuring that only providers registered with the state’s Medicaid program can prescribe opioids and fill opioid prescriptions for Medicaid patients; monitoring the opioid-prescribing practices of participating Medicaid providers and taking actions when those practices are inappropriate; introducing new opioid prescribing guidelines; improving access to naloxone to fight opioid overdoses; expanding drug treatment programs; and more.
To learn more, see this news release from the office of Pennsylvania Governor Tom Wolf.

2017-03-15T06:00:56+00:00March 15th, 2017|Pennsylvania Medicaid policy|Comments Off on PA Takes Steps to Fight Opioid Epidemic

MACPAC Meets, Discusses Medicaid, CHIP Issues

The non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on a variety of Medicaid and State Children’s Health Insurance Program issues met last week in Washington, D.C.
Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were:

  • the flexibility of states in structuring and administering their Medicaid and CHIP programs
  • state Medicaid responses to fiscal pressures
  • studies requested by Congress on mandatory/optional benefits and populations
  • current Medicaid parallels to per capita financing options
  • illustrations of state-level effects of per capita cap design elements
  • high-cost hepatitis C drugs in Medicaid
  • the role of section 1915(b) waivers in Medicaid managed care

Because Pennsylvania safety-net hospitals serve so many low-income Medicaid and CHIP beneficiaries, MACPAC’s deliberations are often very important to them.
Go here, to the MACPAC web site, for links to documents on all of these subjects.
 

2017-03-09T06:00:59+00:00March 9th, 2017|Federal Medicaid issues|Comments Off on MACPAC Meets, Discusses Medicaid, CHIP Issues

New HealthChoices Contracts Delayed

Pennsylvania’s plan to implement new contracts with HealthChoices physical health managed care plans on June 1 has been put on hold.
The reason:  for the second time, companies that lost a public bidding process protested the state’s choices.  The first time, the state threw out all the bids and started over again.  This time the state says it needs more time to deal with the protests, negotiate new contracts, and get the new contractors up and running.
In addition to the delay, the new contracts will be phased in at different times in different parts of the state, with the first regional launch now scheduled for January of 2018 and the last a year later.
Learn more about why the new contracts have been delayed and how they will be implemented from this Philadelphia Inquirer article and this notice from the Pennsylvania Department of Human Services.

2017-03-06T06:00:15+00:00March 6th, 2017|HealthChoices|Comments Off on New HealthChoices Contracts Delayed

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2017 newsletter.
Included in this edition are stories about:

  • the potential implications of turning Medicaid into a block grant program
  • the governor’s proposed FY 2018 budget
  • a new federal requirement that hospitals must inform Medicare patients if they are designated as hospitalized under “observation status”
  • counseling services available through PA LINKs

Find the latest edition of PA Health Law News here.

2017-03-02T12:21:18+00:00March 2nd, 2017|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget|Comments Off on Pennsylvania Health Law Project Newsletter

Controversy Continues Over HealthChoices Awards

Pennsylvania appears to be no closer to awarding new contracts to serve its HealthChoices Medicaid physical health program than it was when it first launched the process of soliciting bids for such contracts in September of 2015.
When losing bidders protested the contracts awarded based on the state’s original request for proposals and took the state to court, the state threw out all the bids and cast aside its decision and started the process all over again, issuing a new request for proposals last year.  When the state announced new awards in January the losing bidders again protested, this time alleging “irregularities” in the decision-making process.  With the renewed threat of litigation, the planned implementation of the new contracts on June 1 now appears to be in jeopardy.
For a closer look at the issues, the alleged irregularities, and what is being done to resolve this matter once and for all, see this Philadelphia Inquirer article.

2017-02-28T17:16:45+00:00February 28th, 2017|HealthChoices|Comments Off on Controversy Continues Over HealthChoices Awards

Comparing “Repeal and Replace” Proposals

How can you keep score while Congress considers multiple proposals to repeal and replace the Affordable Care Act?
The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals:  you pick the proposals you want to compare and you select the aspects of those proposals that interest you.
Find this new interactive tool here, on the web site of the Kaiser Family Foundation.

2017-02-22T06:00:39+00:00February 22nd, 2017|Affordable Care Act|Comments Off on Comparing “Repeal and Replace” Proposals

Impact of ACA Repeal on Pennsylvania

How might Pennsylvania be affected by a repeal of the Affordable Care Act?
In a new report, the Pennsylvania Health Funders Collaborative attempts to answer that question, offering projections on the impact of the 2010 health reform’s repeal on jobs, prescription drug coverage for seniors, insurance status for low-income Pennsylvanians, hospitals, and the state’s economy as a whole.
The study looks at this impact on a state-wide level as well as on a congressional district-by-district basis while also examining anticipated impact on some individual counties and even some individual hospitals.
Learn more about how repeal of the Affordable Care Act might affect Pennsylvania and Pennsylvanians by going here to see the Pennsylvania Health Funders Collaborative report The Pennsylvania Health Funders Collaborative Impact to Pennsylvania of Repealing the Affordable Care Act.

2017-02-21T06:00:18+00:00February 21st, 2017|Affordable Care Act|Comments Off on Impact of ACA Repeal on Pennsylvania

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing.
In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing:  what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts.
Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently chosen to serve the state’s Medicaid population through the HealthChoices physical health program.
For a closer look at Medicaid value-based purchasing, go here to read the National Association of Medicaid Directors’ issue brief “Medicaid Value-based Purchasing:  What Is It & Why Does It Matter?”

2017-02-17T06:00:19+00:00February 17th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Medicaid Directors Look at Value-Based Purchasing
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