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

Medicare Notification of Observation Care Requirement Set

Beginning on August 6, hospitals will be required to notify patients if they are under observation care and have not formally been admitted to the hospital.
The new policy, required by last year’s Notice of Observation Treatment and Implication for Care Eligibility Act, requires hospitals to provide a written notice to patients “in plain language” explaining that they have not been admitted to the hospital and how that might affect what they owe the hospital for the care they receive and their eligibility for follow-up services. Hospitals will be required to provide this information no more than 36 hours after the observation care has begun.
Hospital building More than two million Medicare patients were hospitalized under observation status in 2014.
Learn more about the new policy, what it means, and some of the challenges it may pose in this Kaiser Health News article.

PA Safety Net Admin2016-06-23T06:00:08+00:00June 23rd, 2016|Medicare|Comments Off

SNAP Asks Legislature for Help With State Budget

The Safety-Net Association of Pennsylvania has asked Pennsylvania’s General Assembly to restore all funding for Medicaid ob/nicu, burn center, and critical access hospital payments and not to increase current hospital assessments in Pennsylvania’s FY 2017 budget.
In SNAP’s view, maintaining vital Medicaid funding is critical to ensuring that hospitals in general, and safety-net hospitals in particular, can deliver quality health care services to the state’s growing Medicaid population while also investing in innovative ways to improve the quality and efficiency of health care for all Pennsylvanians.
See SNAP’s FY 2017 budget advocacy document here.

PA Safety Net Admin2016-06-22T06:00:53+00:00June 22nd, 2016|Uncategorized|Comments Off

Medicaid Expansion Producing Benefits for Safety-Net Providers

Seeing fewer uninsured patients, safety-net hospitals in states that have expanded their Medicaid programs as provided for under the Affordable Care Act are finding themselves able to use money previously caring for the uninsured for things like more and better primary and behavioral health services, more staff, new or improved health centers and clinics, and better equipment.
This conclusion is drawn in a new study from the Georgetown University Health Policy Institute based on interviews with leaders of eleven hospital systems and federally qualified health centers (FQHCs) in seven states: four that expanded their Medicaid programs and three that did not.
While Pennsylvania was not one of the states included in the study, it is one of more than 30 states that has expanded its Medicaid program.
To learn more about what the study revealed, go here to read Beyond the Reduction in Uncompensated Care: Medicaid Expansion is Having a Positive Impact on Safety Hospitals and Clinics.

PA Safety Net Admin2016-06-21T06:00:03+00:00June 21st, 2016|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

SNAP Comments on Proposed Medicaid Observation Care Payment

The Safety-Net Association of Pennsylvania has written to the state’s Department of Human Services about DHS’s proposal to establish a payment policy for hospital observation services covered by the state’s Medicaid fee-for-service program.
While SNAP has long supported the concept of a Medicaid fee-for-service rate for observation services and welcomes DHS’s decision to create such a rate and associated policies, it expressed a number of concerns about DHS’s proposal, including about:

the proposed observation rate
the classification of observation care as an outpatient service
the manner in which the state proposes financing observation care
program integrity issues

To learn more about SNAP’s concerns, see its entire comment letter to DHS here, on the SNAP web site.

PA Safety Net Admin2016-06-20T06:00:37+00:00June 20th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Examining Medicare’s Skilled Nursing Facility Three-Day Inpatient Stay Requirement

The Congressional Research Service has prepared a new report that takes a look at the requirement that Medicare patients spend three days as hospital inpatients before Medicare will pay for post-discharge skilled nursing care.
The report reviews the current requirements for Medicare coverage of skilled nursing care, describes the role of hospital outpatient observation care in clouding the question of whether individual patients have spent three days in the hospital, and examines proposals for changing the three-day requirement. It also addresses the need for greater transparency in hospital decisions to classify patients as under observation status rather as inpatients, the need to educate patients about the impact of such classification decisions, and the potential impact of changing the current policy.
Go here to see the CRS report Medicare’s Skilled Nursing Facility (SNF) Three-Day Inpatient Stay Requirement.

PA Safety Net Admin2016-06-17T06:00:14+00:00June 17th, 2016|Medicare|Comments Off

Pennsylvania Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the May 2016 edition of Health Law News, its monthly newsletter.
phlp Included in this edition are articles about a new federal managed care regulation and federal policy governing balance billing of dual-eligible (Medicare- and Medicaid-covered) individuals. The newsletter also takes a look at Pennsylvania one year after the state expanded its Medicaid program and offers an update on Community HealthChoices, the new program of managed long-term services and supports the state intends to implement.
Find the latest edition of Health Law News here.

PA Safety Net Admin2016-06-16T06:00:37+00:00June 16th, 2016|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

New MLTSS Program Delayed Six Months

The launch of Community HealthChoices, Pennsylvania’s new approach to the delivery of managed long-term services and supports for seniors eligible for both Medicare and Medicaid, will be delayed six months.
The program was scheduled to begin in southwestern Pennsylvania on January 1, 2017 but state officials recently announced that they have pushed back the start date to July 1, 2017.
In a message to interested parties, state officials wrote that

The decision to extend our start date builds on this approach and allows more time for the 420,000 Pennsylvanians who will ultimately benefit from CHC to understand the program adjustments that will occur, including how access to and receipt of home- and community-based services will be improved. We will continue to work with all stakeholders, such as the Area Agencies on Aging and Centers for Independent Living, on a robust CHC education and outreach effort to ensure that we reach as many consumers and caregivers as possible.

The time-frame for implementation in other parts of the state remains unchanged.
To learn more about what Community HealthChoices is and why its launch has been delayed, see this Pittsburgh Post-Gazette article.

PA Safety Net Admin2016-06-15T06:00:05+00:00June 15th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Hepatitis C Treatment Challenges PA’s Medicaid Program

The cost of treating Medicaid patients who suffer from hepatitis C is posing a challenge to Pennsylvania’s Medicaid program.
As new, more expensive, but more effective hepatitis C drugs reach the market, the state’s costs for treating Medicaid patients with the disease have doubled since 2013.
Meanwhile, the state continues to consider at what point in the progression of their hepatitis C Medicaid patients should be offered the most expensive drugs.
Prescription Medication Spilling From an Open Medicine Bottle Current guidelines are evolving both in the state and nationally, with medical authorities and federal regulators weighing in with their views. Recently, an advisory committee to the Pennsylvania Department of Human Services offered its own recommendations for criteria for prescribing the most expensive drugs.
Learn more about the issue, the cost of treatment, and current Pennsylvania Medicaid policy on when hepatitis C patients must be offered the most expensive drugs and how that policy might be changing in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2016-06-14T11:23:40+00:00June 14th, 2016|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Uncategorized|Comments Off

Fewer People Skipping Care for Financial Reasons

Fewer Americans are choosing not to pursue medical care for financial reasons, according to new information from the Centers for Disease Control and Prevention.
According to the CDC’s National Health Interview Survey, 4.5 percent of the people surveyed reported not getting medical attention they needed for financial reasons in 2015, down from 6.9 percent in 2009 and 2010.
This suggests that the Affordable Care Act’s changes in providing access to health insurance are making a different in the ability of people to get the care they believe they need.
Prior to the reform law’s passage, the proportion of people reporting that they chose not to seek care for financial reasons had been rising steadily since 1998.
This is good news for Pennsylvania safety-net hospitals, which often must deal with the medical and financial implications of serving especially large numbers of patients who, for financial reasons, have had limited and sporadic contact with the health care system over the years.
To learn more about the survey’s findings see this CQ HealthBeat report presented by the Commonwealth Fund and go here to see the CDC report Early Release of Selected Estimates Based on Data From the 2015 National Health Interview Survey.

PA Safety Net Admin2016-06-06T06:00:03+00:00June 6th, 2016|Affordable Care Act, Pennsylvania safety-net hospitals|Comments Off

2015 Financial Performance Mixed for PA Hospitals

Most Pennsylvania acute-care hospitals fared well financially in 2015.
But not all of them.
According to a new report issued by the Pennsylvania Health Care Cost Containment Council, total acute-care hospital margins fell 0.01 percentage points in 2015 but operating margins rose 1.21 percentage points.
49 of the state’s 170 acute-care hospitals lost money on operations and 46 lost money overall.
phc4 Other highlights:

uncompensated care fell 8.6 percent
inpatient days declined for the eighth straight year
outpatient visits rose 2.5 percent
53.7 percent of net patient revenue came from inpatient care

Go here for a news release summarizing PHC4’s finding and go here to see the complete report Financial Analysis 2015: An Annual Report on the Financial Health of Pennsylvania Hospitals, which includes state-wide analyses and performance data on individual hospitals.

PA Safety Net Admin2016-06-03T06:00:51+00:00June 3rd, 2016|Uncategorized|Comments Off

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