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

Bill in Congress Would Benefit PA Safety-Net Hospitals

New legislation introduced in Congress would add a risk adjustment component to Medicare’s hospital readmissions reduction program.
Such a measure would benefit Pennsylvania’s safety-net hospitals.
H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmission Program Act, proposes modifying Medicare’s hospital readmissions reduction program. Under the bill, hospitals’ performance in preventing Medicare readmissions would be risk-adjusted for patients who are dually eligible for Medicare and Medicaid; for patients who are considered non-compliant; for patients whose readmission has been classified as based on psychosis or substance abuse; and for patients who have specific medical conditions.
Hospitals found to have too many Medicare readmissions suffer financial penalties under Medicare’s hospital readmissions reduction program. Recent studies suggest that in its current form, the program unfairly targets safety-net hospitals for financial penalties.
Learn more about the bill from this news release from its sponsor, Rep. James Renacci (R-Ohio), or find the bill itself here.

PA Safety Net Admin2014-03-17T06:00:07+00:00March 17th, 2014|Uncategorized|Comments Off

Providers Must Re-enroll to Serve PA Medicaid Population

All health care providers that serve Pennsylvania’s Medicaid population must re-enroll with the state if they wish to continue doing so.
The requirement, established under the Affordable Care Act, applies to providers that participate in both the state’s Medicaid managed care and fee-for-service programs.
Additional information can be found about the requirement and how to re-enroll in this Medical Assistance Bulletin notice.

PA Safety Net Admin2014-03-14T06:00:34+00:00March 14th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

How Did Healthy PA Change?

In December, the Corbett administration released a draft of its application to the federal government for a waiver from aspects of existing Medicaid law so it could implement its “Healthy Pennsylvania” Medicaid reform and health insurance expansion program.
The public was then invited to comment on the draft application, and in late February, the administration submitted its official Medicaid waiver application to the federal government. That official application included a number of changes from the December draft, reflecting comment submitted to state officials.
What were those changes?
The state has published a brief document, “Healthy Pennsylvania Demonstration Adjustments,” that summarizes those changes. Find that document here.

PA Safety Net Admin2014-03-13T06:00:00+00:00March 13th, 2014|Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Learns of 43,000 New Medicaid Applicants

The federal government has sent to Pennsylvania state officials data on 43,000 people whose applications for Medicaid eligibility have been tied up for months in the federal government’s computers as part of the troubled launch of the healthcare.gov web site.
Most of the applicants will be contacted by Department of Public Welfare caseworkers while applications for the Children’s Health Insurance Program (CHIP) will be handled by the state Insurance Department.
Learn more about this situation in this article on the web site of KYW radio.

PA Safety Net Admin2014-03-12T06:00:18+00:00March 12th, 2014|Affordable Care Act|Comments Off

Increase Use of Value-Based Purchasing, HHS Told

A study performed for the U.S. Department of Health and Human Services calls for greater use of value-based purchasing in federal health care reimbursement policy.
The study, performed by the RAND Corporation, recommends developing a national value-based purchasing strategy; developing a more deliberate approach to evaluating the effectiveness of value-based purchasing efforts; and developing performance measures that support value-based purchasing approaches.
Such an approach could be a major challenge for Pennsylvania’s safety-net hospitals, according to a Harvard School of Public Health analysis that found that in the first year of Medicare’s value-based purchasing program, hospitals that served the largest numbers of low-income patients suffered the largest financial penalties from that program.
Read more about the RAND study in this Fierce Healthcare story and find the RAND study itself here. Read another Fierce Healthcare article about the impact of value-based purchasing on safety-net hospitals here.

PA Safety Net Admin2014-03-11T06:00:25+00:00March 11th, 2014|Uncategorized|Comments Off

State Seeks Restoration of Tobacco Money

Pennsylvania has gone to court to seek the restoration of more than $200 million in tobacco funds that it lost as a result of an arbitration ruling last year.
The money, from the national master tobacco settlement agreement, is used to make Tobacco Uncompensated Care Fund payments that are vital to the state’s safety-net hospitals. The purpose of the tobacco money is to help underwrite the cost of uncompensated care provided by hospitals that serve especially large numbers of uninsured patients.
Last year an arbitration panel ruled that the state had failed to collect the tobacco taxes owed to it as part of the national tobacco settlement agreement. In its suit attempting to overturn the arbitration decision, the state maintains that the state has, in fact, collected the taxes in a manner consistent with the settlement agreement and that the tobacco companies have significant overstated how much loose tobacco they sell in Pennsylvania.
Read more about the arbitration ruling that cost Pennsylvania more than $200 million in tobacco funds and the state’s efforts to overturn that ruling in this Philadelphia Inquirer article.

PA Safety Net Admin2014-03-10T06:00:24+00:00March 10th, 2014|Uncategorized|Comments Off

PA Relents on Medicaid Work-Search Requirement

One of the most controversial aspects of the Corbett administration’s proposal to expand the state’s Medicaid program was that every able-bodied adult of working age be required to demonstrate that they were pursuing employment.
On Thursday, the administration agreed to drop that proposal in the face of opposition from the Obama administration.
Instead, the Corbett administration will propose a one-year, voluntary, incentive-based pilot program requiring participants to document their work-search efforts. Like the original work-search requirement, this proposal will be subject to federal review.
Read more about this development in Pennsylvania’s pursuit of federal approval to expand its Medicaid program in this Lancaster Online article. Find a copy of Governor Corbett’s letter dropping the controversial component and proposing an alternative here.

PA Safety Net Admin2014-03-07T06:00:25+00:00March 7th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its February Health Law News newsletter.
The publication includes features on Governor Corbett’s recently proposed FY 2015 state budget; new state criteria for qualifying for PACE and PACENET, programs that help low-income seniors with the cost of prescription drugs; a clarification of state policy governing complaints and grievances about HealthChoices Medicaid managed care plans; and more.
Find the February edition of Health Law News here.

PA Safety Net Admin2014-03-06T06:00:37+00:00March 6th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Submits Medicaid Plan to Feds

Yesterday the Corbett administration submitted a waiver application to the federal government requesting permission to expand the state’s Medicaid program as described in its “Healthy Pennsylvania” proposal.
The Pennsylvania proposal seeks to vary from the approach taken by most states expanding their Medicaid programs in accordance with the Affordable Care Act by directing the expansion population into private health insurance plans.
A draft waiver application, released in December, was the subject of public hearings throughout the state. The Safety-Net Association of Pennsylvania (SNAP) testified at one of those hearings and also submitted detailed written comments about the proposal; both can be found here.
The state’s waiver application, the December draft application, a summary of the application, and the written and oral comments about the proposed application submitted by interested parties can be found here, on the Pennsylvania Department of Public Welfare’s web site. Learn more about the proposal’s submission to the federal government and where it goes from here in this Ellwood City Ledger article and the reaction of some elected officials to the submission here.
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PA Safety Net Admin2014-02-20T06:00:20+00:00February 20th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

New Approaches to Serving Dual Eligibles Set to Launch

Provisions in the Affordable Care Act that encourage states to take new approaches to serving their dually eligible residents – low-income seniors eligible for both Medicare and Medicaid – will soon translate into new state programs.
Massachusetts has already launched such an initiative, a new California program will begin in May, and 17 additional states are scheduled to begin new efforts later this year and next.
New federal policies encourage state Medicaid programs to work with Medicare in service to their dually eligible population, with the states and Medicare sharing in the savings they produce. Currently, dually eligible patients constitute 15 percent of the Medicaid population but account for 40 percent of Medicaid’s costs and 20 percent of the Medicare population but 30 percent of Medicare’s costs.
Eighteen percent of Pennsylvania’s Medicaid population is dually eligible. The state is not among those with new dual eligibles programs preparing to launch.
How are states tackling this challenge? Learn more in this Stateline report.

PA Safety Net Admin2014-02-18T06:00:56+00:00February 18th, 2014|Pennsylvania Medicaid policy|Comments Off

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