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

Richman to Advise Wolf on Medicaid

Pennsylvania Governor-elect Tom Wolf has appointed former Department of Public Welfare Secretary Estelle Richman to advise him on Medicaid matters during his transition period.
Richman served as secretary of the Department of Public Welfare – now the Department of Human Services – from 2003 to 2009, during the administration of former governor Ed Rendell.
Richman is expected to focus on the expansion of the state’s Medicaid program, authorized under the federal Affordable Care Act and to begin on January 1 as part of Governor Corbett’s Healthy Pennsylvania program. Instead of expanding the state’s traditional Medicaid program, Healthy Pennsylvania will involve those newly eligible for Medicaid choosing from a pool of private insurers selected by the state, with their insurance premiums to be paid with federal Medicaid funds.
Learn more about Ms. Richman and her expected role in the Wolf transition in this Harrisburg Patriot-News article.

PA Safety Net Admin2014-12-01T06:00:24+00:00December 1st, 2014|Pennsylvania Medicaid policy|Comments Off

Administration Delays Major 340B Program Regulation

The U.S. Department of Health and Human Services has decided against releasing a long-awaited regulation that was expected to bring sweeping changes to the federal government’s 340B Drug Pricing Program.
The 340B program requires drug manufacturers to sell drugs at a discount to hospitals and other providers that serve especially large proportions of low-income patients. While providers believe the program enables them to serve more vulnerable patients at a reasonable cost, drug companies have argued that the federal government has expanded the program to include more providers and more drugs than the program originally envisioned.
A spokesman for the federal Health Resources and Services administration told Bloomberg BNA that the release has been delayed until next year and that the agency

…plans to issue a proposed guidance for notice and comment that will address key policy issues raised by various stakeholders committed to the integrity of the 340B program. HRSA is also planning to issue proposed regulations where the statute provides explicit rulemaking authority, pertaining to civil monetary penalties for manufacturers, calculation of the 340B ceiling price, and administrative dispute resolution.

Because they serve so many low-income patients and typically participate in the 340B program, Pennsylvania’s private safety-net hospitals have a great deal of interest in any attempt by the federal government to alter the scope or regulation of the program.

To learn more about the delay in the anticipated 340B regulation, see this Bloomberg BNA article.

PA Safety Net Admin2014-11-24T06:00:26+00:00November 24th, 2014|Uncategorized|Comments Off

Full Speed Ahead on Healthy PA Medicaid Expansion

When the federal government approved the Corbett administration’s Healthy Pennsylvania Medicaid proposal at a time when the governor trailed in the polls in his bid for re-election, observers wondered whether Mr. Corbett would continue to implement the program if he lost even if his opponent opposed that implementation.
The answer, apparently, is yes.
Department of Public Welfare Secretary Beverly Mackereth told the Pittsburgh Post-Gazette that the state continues to implement the Healthy Pennsylvania Medicaid expansion and will begin enrolling participants on December 1 in anticipation of the program’s official launch on January 1.
It is doing so despite being asked not to do so by representatives of Governor-elect Tom Wolf, who does not take office until January 20.
Learn more about the circumstances surrounding Medicaid expansion in Pennsylvania in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-11-21T06:00:26+00:00November 21st, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Feds Share Pennsylvania Health Insurance Rate Data

The Centers for Medicare & Medicaid Services (CMS) has published data showing changes in the premiums for individual and small group health insurance plans offered in Pennsylvania for 2015.
Including plans offered both within and outside the federal health insurance marketplace, the numbers show that individual plan premiums are up an average of 2.31 percent while small group plans have seen rates rise 3.19 percent.
Learn more about the data release in this Central Penn Business Journal article or go here for the entire CMS database, where you can search for data by state.

PA Safety Net Admin2014-11-20T06:00:51+00:00November 20th, 2014|Affordable Care Act|Comments Off

States Face Medicaid Challenges

Fifty American states have 50 different Medicaid programs. While no two state Medicaid programs are alike, the people who run those programs often share common concerns, problems, and priorities.
The National Association of Medicaid Directors has surveyed its members on the challenges they face, their priorities, and the matters they see occupying most of their time in the coming years. Among the areas the survey explored are:

budgets
Affordable Care Act implementation
relationships with others in their state government, federal agencies, and regulators
program integrity
innovations like bundled payments, accountable care organizations, demonstration projects, delivery system reform and improvements, and challenges in the area of long-term services and supports

Find out how the country’s 50 Medicaid directors view the challenges they face in the coming year in State Medicaid Operations Survey: Third Annual Survey of Medicaid Directors, which you can find here.

PA Safety Net Admin2014-11-19T06:00:27+00:00November 19th, 2014|Uncategorized|Comments Off

PA Congressional Delegation Seeks Medicare “Doc Fix”

Seventeen of the 18 members of Pennsylvania’s U.S. House delegation have sent a joint, bipartisan letter to House Speaker John Boehner and minority leader Nancy Pelosi asking them make a priority of repealing – before the current session of Congress ends – the sustainable growth rate formula (SGR) used to determine how doctors are paid to serve Medicare patients.
See their letter here.

PA Safety Net Admin2014-11-18T06:00:21+00:00November 18th, 2014|Uncategorized|Comments Off

MedPAC Meets, Addresses Hospital Issues

The independent federal agency that advises Congress on Medicare payment issues met last week in Washington and addressed a number of issues of importance to hospitals.
Among the issues discussed by the Medicare Payment Advisory Commission (MedPAC) were:

beneficiary access to hospital care and how service volume affects hospital costs
hospital short stay policy issues
per beneficiary payment for primary care
the 340B drug pricing program
site-neutral payments for selected conditions treated in inpatient rehabilitation facilities and skilled nursing homes
payment policies to promote the use of services based on clinical evidence

Find links to the presentations offered by MedPAC staff on these issues here, on MedPAC’s web site.

PA Safety Net Admin2014-11-17T06:00:53+00:00November 17th, 2014|Uncategorized|Comments Off

Medicaid Expansion in PA: What Happens Now?

Pennsylvania Governor Tom Corbett’s Healthy Pennsylvania program calls for the state to expand its Medicaid program on January 1 through a private insurance market option in which people choose private insurance plans through which to receive the Medicaid benefits for which they are newly eligible.
But Pennsylvania Governor-elect Tom Wolf wants to expand the state’s traditional Medicaid program and not employ the private insurance market coverage.
Governor Corbett will still be in office when his program is set to take effect on January 1, 2015. Mr. Wolf will not take the oath of office until January 20.
The Philadelphia Inquirer takes a look at how Pennsylvania’s private insurance market option came about and what may happen next. See its story here.

PA Safety Net Admin2014-11-14T06:00:22+00:00November 14th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Pennsylvania Health Law Project’s October Newsletter

The Pennsylvania Health Law Project has released its October newsletter.
It includes articles about Healthy Pennsylvania’s Medicaid expansion and its impact on behavioral health benefits; about letters the state is sending to current Medicaid recipients about changes in their benefits; and about letters from the federal government to those enrolled in federal marketplace plans reminding them that they need to renew their health insurance.
The newsletter also features an article about how the state will address those currently enrolled in federal marketplace plans who will become eligible for Medicaid on January 1.
Find the Pennsylvania Health Law Project’s newsletter here.

PA Safety Net Admin2014-11-13T06:00:55+00:00November 13th, 2014|Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Mcare Assessment Goes Down

The Mcare assessments of Pennsylvania hospitals and doctors will decrease 48 percent in 2015.
Pennsylvania’s Medicare Care Available and Reduction of Error Fund, or Mcare, provides supplemental medical malpractice liability insurance for Pennsylvania health care providers. Pennsylvania requires hospitals and doctors to have a minimum level of liability coverage and they obtain half of that minimum amount from the Mcare Fund.
Next year’s assessment is smaller because of reduced claims against the Mcare Fund and leftover money from previous years that a court ordered to be used for this purpose.
To learn more about the fund and the decrease, see this news release on the state Insurance Department’s web site.

PA Safety Net Admin2014-11-12T06:00:03+00:00November 12th, 2014|Uncategorized|Comments Off

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