The Fee for Service Subcommittee of Pennsylvania’s Medical Assistance Advisory Committee (MAAC) has approved the minutes of the subcommittee’s February 11 meeting.
That meeting addressed the introduction of in-house radiology review in the state’s Medicaid fee-for-service program, Medicaid expansion in the state, provider enrollment and revalidation efforts as required by the Affordable Care Act, and more.
See those minutes here.
The chairmen of four key congressional committees have written to the Medicaid and CHIP Payment and Access Commission (MACPAC) seeking “assistance in developing policy options to ensure the sustainability of the Medicaid program so it can continue to provide essential coverage and services to vulnerable populations.”
The letter, signed by the chairmen of the Senate Finance Committee, Senate Committee on Health, Education, Labor, and Pensions, the House Energy and Commerce Committee, and the Energy and Commerce Committee’s Health Subcommittee, asks MACPAC to “analyze and evaluate” financing reforms to reduce government spending; past reform proposals; ways to give states greater flexibility; options for Medicaid block grants; and other potential changes.
See the letter here.
The Pennsylvania Department of Human Services (DHS) has issued a report on its progress toward stated goals in the transition from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s Medicaid expansion via the state’s existing HealthChoices managed care program.
See that report here.
Saying he wants to “protect 382,000 Pennsylvanians from potentially losing subsidies that help them afford health care coverage” if the Supreme Court rules that Affordable Care Act health insurance subsidies are available only to individuals who purchase insurance on state-operated insurance exchanges and not the federal exchange, Pennsylvania Governor Tom Wolf has informed the U.S. Department of Health and Human Services Secretary Sylvia Burwell that his state intends “implement a State-based Marketplace for Pennsylvanians to shop for health insurance coverage.”
Governor Wolf notified the HHS Secretary of his decision in a May 1 letter. The letter does not commit the state to developing its own exchange; it only declares the state’s intention to develop such an exchange if the Supreme Court rules against the Obama administration in the King v. Burwell case in June.
Go here to see the letter and an announcement of the Wolf administration’s intentions.
The Pennsylvania Department of Human Services (DHS) has issued a new Medical Assistance Bulletin on the state’s expansion of its Medicaid program via the HealthChoices managed care program.
The bulletin notifies providers of the introduction of a new adult benefit package that applies to all adult Medicaid recipients in the state, highlighting some of the major changes in benefits from past packages. It also provides information about the state’s plan for a phased transition from the current private care option (PCO) insurance plans to HealthChoices plans over the coming months.
See DHS Medical Assistance Bulletin 99-15-05 here.
Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program.
Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014. In the next few days they will receive written notification of the shift. All will receive the same Medicaid benefits: a basic adult benefit package.
Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by September 1.
For more information about the continued transition from Healthy Pennsylvania to HealthChoices, see this news release from the governor’s office.
With the state still struggling to enroll and revalidate Medicaid providers, the Pennsylvania Department of Human Services (DHS) presented an update on its efforts to improve that process at the April 23 meeting of its Medical Assistance Advisory Committee (MAAC).
According to the presentation, DHS is focusing its improvements in three primary areas: introducing a new electronic enrollment web portal this fall; standardizing its processes and procedures; and adding staff next month to facilitate enrollments.
DHS staff made a presentation on its latest efforts at the April 23 MAAC meeting. See that presentation here.
Pennsylvania will need 11 percent more primary care doctors by 2030, according to the Joint State Government Commission.
The state already has 155 health professional shortage areas for primary care, and with 27 percent of Pennsylvania’s doctors 60 years of age or older and more than half older than 50, the commission believes the state needs to take steps to ensure the adequacy of its future supply of physicians.
With this need in mind, the commission has offered a series of recommendations for increasing Pennsylvania’s supply of doctors, including encouraging medical schools to do more to train primary care providers, improving student loan repayment programs, and offering more residency positions in the hope that more residents will remain in the state.
For a closer look at the commission’s findings and recommendations, go here for a Central Penn Business Journal article and here for the commission’s report itself.
In response to the challenges the state has encountered processing Medicaid provider enrollment applications, the Pennsylvania Department of Human Services (DHS) has unveiled what it believes will be an improved approach to tackling this problem.
The improvements include electronic enrollment, standardization of policies and procedures, and additional provider enrollment staffing.
At the heart of the backlog are Affordable Care Act requirements.
Go here to see a message from DHS acting secretary Theodore Dallas on this subject.
Come 2017, states will have a new tool at their disposal through which to pursue health care reform.
At that time, states will be able to seek new state innovation waivers from the federal government that will enable them to change covered benefits and insurance subsidies; replace health insurance exchanges; modify the individual or employer mandate; and do other things so long as their efforts ensure continued access to comprehensive and affordable health insurance. The waivers, created under the Affordable Care Act, are good for five years.
The Commonwealth Fund has published an issue brief that explains the section of the Affordable Care Act that includes state innovation waivers and outlines how states might use innovation waivers to customize health care reform for their own residents. Find that issue brief here.