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

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

No-Hospitalization Group Plans To Be Banned

Companies will no longer be able to provide their employees with group health insurance plans that do not cover inpatient hospitalization.
This news came in a recent notice published by the Internal Revenue Service.
Recently, many large employers with lower-wage workers were purchasing low-cost health insurance that does not cover hospitalization. The IRS, however, has ruled that such plans do not meet the Affordable Care Act’s minimum value threshold. Companies were only able to purchase such plans because they are not required meet the reform law’s essential health benefits package requirement, which applies only to plans offered to individuals on health insurance exchanges.
The no-hospitalization policies were likely to leave many lower-income workers without the coverage they needed – and with large medical bills. They also were likely to leave hospitals with unexpected uncompensated care. This could have proven especially challenging for Pennsylvania safety-net hospitals because they serve larger numbers of lower-income workers than the typical hospital.
The administration is permitting employers that committed to such plans by November 4 to use them for one year and is offering affected workers access to premium subsidies that some of those workers did not otherwise have if they choose to purchase insurance on an exchange instead.
The IRS will issue regulations formalizing this policy next year.
To learn more about this issue and its implications for large businesses, low-wage workers, and hospitals, see this Kaiser Health News report. Go here to see the IRS notice.

PA Safety Net Admin2014-11-11T06:00:31+00:00November 11th, 2014|Affordable Care Act|Comments Off

PA Contacts Medicaid Recipients About Benefits

The Pennsylvania Department of Public Welfare is in the process of sending letters to all current adult Medicaid recipients in the state advising them of changes in their Medicaid benefits to take effect on January 1 as a result of the state’s Healthy Pennsylvania Medicaid expansion.
The Pennsylvania Health Law Project has published an explanation of the situation, including sample copies of the letters the state is sending, information about the different benefit packages available to Medicaid recipients, and advice on how recipients who believe they have more serious medical problems can apply for a benefits package better suited to their needs.
Find the Pennsylvania Health Law Project notice here.

PA Safety Net Admin2014-11-10T09:05:50+00:00November 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Suit Against Medicare Rate Cut Continues

Hospital groups are suing the Centers for Medicare & Medicaid Services (CMS) over the 0.2 percent rate cut in Medicare inpatient payments during the 2014 fiscal year.
According to the hospital groups, CMS failed to provide a rationale for the rate cut and denied interested parties access to the data and analysis underlying its rate cut decision.
At the heart of the cut was CMS’s expectation that implementation of Medicare’s controversial “two-midnight rule” would result in an increase in admissions. The rule was never fully implemented.
CMS has asked the court to dismiss the suit.
Learn more about the suit and find links to the hospitals’ and CMS’s legal briefs in this Fierce Healthcare article.

PA Safety Net Admin2014-11-07T06:00:29+00:00November 7th, 2014|Uncategorized|Comments Off

PA Makes Healthy PA Implementation Official

The Pennsylvania Department of Public Welfare (DPW) has published an official notice in the state’s Medical Assistance Bulletin announcing the implementation of the Healthy Pennsylvania Medicaid expansion program on January 1, 2015.
The notice provides background information about the plan, how it will work, and how it will differ from the state’s current Medicaid program. It also presents the final word on how the state will define “medically frail” for determining which benefits package participants will receive, outlines how the program’s health screening of applicants will work, and explains enrollees’ cost-sharing responsibilities.
The Bulletin notes that the state will issue a separate announcement to providers with more information about the scope of benefits to be provided, how the program will employ private insurers to serve the state’s Medicaid population, and when training will be offered to familiarize providers on how to work with the new program.
Find the Bulletin here.

PA Safety Net Admin2014-11-05T06:00:17+00:00November 5th, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

SNAPShots

SNAPShots

About PA Safety Net Admin

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us