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

PA to Submit Healthy Pennsylvania Application Soon

Pennsylvania will submit its “Healthy Pennsylvania” Medicaid expansion waiver application to the federal government in about two weeks, Governor Tom Corbett told a central Pennsylvania public radio station last week.
Once the state submits that application, according to the Harrisburg Patriot-News, “…the process should go quickly, he [Corbett] said, since the details have been worked out through ‘constant negotiations’ with federal officials at the Department of Health and Human Services.”
Read more about Governor Corbett’s radio appearance and his thoughts on Healthy Pennsylvania and Medicaid expansion in this Harrisburg Patriot-News report.

PA Safety Net Admin2014-02-10T06:00:26+00:00February 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Corbett Budget Proposes Mixed Bag for Safety-Net Hospitals

Yesterday Pennsylvania Governor Tom Corbett unveiled his proposed FY 2015 budget – a mixed bag for the state’s safety-net hospitals.
The budget proposes increased spending for Medicaid services, compensates for the loss of federal Medicaid funding expected when the state’s Medicaid matching rate declines later this year, and proposes new funding to help develop clinics and encourage medical professionals to work in rural and underserved parts of Pennsylvania.
On the other hand, the budget proposes slight reductions in selected supplemental payments that are important to safety-net hospitals, counts on significant savings derived through the Healthy Pennsylvania program that has not yet been approved by the federal government, and assumes that the state will prevail in its appeal of an arbitration ruling that would severely reduce the funding the state uses to make tobacco uncompensated care payments to qualified hospitals.
SNAP has prepared a detailed summary of the budget proposal that addresses the aspects of the budget that are most important to safety-net hospitals. Interested parties may request a copy by hitting the “contact us” link in the upper right-hand corner of this screen.

PA Safety Net Admin2014-02-05T10:53:42+00:00February 5th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA’s Proposed Medicaid Work-Search Requirement

Governor Corbett’s “Healthy Pennsylvania” health care reform and Medicaid expansion proposal includes a component without precedent: a work-search requirement that would require most but not all Medicaid recipients to meet designated job search requirements as a condition for continuing to qualify for Medicaid benefits.
As yet unknown is whether the federal government, which must approve the state’s plan, will permit Pennsylvania to impose such a requirement.
The Philadelphia Inquirer has taken a closer look at the proposed work-search requirement, the rationale behind it, the challenges inherent in administering it, and the perspectives of various groups about the advisability of such a new approach. Read the Inquirer report here.

PA Safety Net Admin2014-02-04T06:00:34+00:00February 4th, 2014|Pennsylvania Medicaid policy|Comments Off

PA Creates Long-Term-Care Commission

Pennsylvania Governor Tom Corbett has announced the creation of a New Long-Term Care Commission “to ensure access to quality, affordable health care with the signing of an Executive Order establishing the Pennsylvania Long-Term Care Commission.”
The commission’s stated mission is to “… develop recommendations focused on improving the current long-term care system, including identifying effective ways to provide a better coordinated approach to delivering services and support, and ensuring quality health care for older Pennsylvanians and individuals with physical disabilities.”
The commission is expected to deliver its findings and recommendations to the governor by December.
See the executive order creating the commission here and the news release announcing its formation here.

PA Safety Net Admin2014-02-03T06:00:05+00:00February 3rd, 2014|Uncategorized|Comments Off

PA Labeled “State to Watch” for Medicaid in 2014

The Corbett administration’s “Healthy Pennsylvania” Medicaid expansion proposal has earned the commonwealth recognition from the Washington Post’s “Wonkblog” feature as one of four “states to watch” in 2014.
The Post notes that “How much flexibility the Obama administration grants to Pennsylvania could be influential to the other states, still sitting on the sidelines, waiting to decide whether to expand their own Medicaid programs in the future.”
The other states to watch cited by the Post are Arkansas, approved to use federal Medicaid money to purchase private insurance for its Medicaid population but now in jeopardy of backing out of its own expansion plan; Virginia, where a serious effort is expected to expand the state’s Medicaid program; and Utah, whose governor has declared that doing nothing “is off the table.”
Read the Washington Post article “The four most important states to watch on Obamacare’s Medicaid expansion” here.

PA Safety Net Admin2014-01-30T14:16:11+00:00January 30th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

The Path to PA’s Medicaid Waiver

The Corbett administration’s Healthy Pennsylvania proposal seeks to go where only two states have gone so far with their Affordable Care Act-enabled Medicaid expansion: the unconventional route.
While many of the states that have chosen to expand their Medicaid programs under the terms of the Affordable Care Act did so by embracing those terms, others are viewing Medicaid expansion as an opportunity to pursue wholesale changes in how they serve their low-income residents.
Arkansas and Iowa have already received federal waivers – exemptions from selected aspects of existing Medicaid law– to expand their Medicaid programs. Under these waivers, the states operate demonstration programs to test the effectiveness of their variations on ordinary Medicaid practices.
Pennsylvania seeks to follow in their path, and Virginia, New Hampshire, Indiana, and possibly a few other states are expected to do the same in 2014.
Learn more about the path to obtaining such a waiver and the challenges Pennsylvania may face along the way in this Stateline report.

PA Safety Net Admin2014-01-28T06:00:55+00:00January 28th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

CMS Offers Advice on Managing Expected Upsurge in ER Visits

With Medicaid enrollment rising because of eligibility changes introduced through the Affordable Care Act, hospital emergency rooms expect to see an increase in the number of emergency room visits as new Medicaid enrollees seek care for long-neglected health problems.
In anticipation of this rise in ER visits, the Centers for Medicare & Medicaid Services (CMS) has issued an informational bulletin with suggestions for hospitals on how to manage the expected increase in ER utilization.
Among CMS’s suggestions are for hospitals to broaden access to primary care services (because much of the increased utilization will be because the newly insured still do not know where to turn for care); focus on helping especially frequent ER visits find more appropriate sources of care; and target the needs of people with behavioral health problems.
This influx of new ER patients will pose a challenge for Pennsylvania’s safety-net hospitals because even though the state has not expanded its Medicaid eligibility criteria as provided for in the Affordable Care Act, other reform-related measures should result in some increase in the state’s Medicaid population.
To learn more about CMS’s recommendations for addressing this ER challenge, including some of the legal and reimbursement-related challenges this will pose, see the CMS informational bulletin “Reducing Nonurgent Use of Emergency Departments and Improving Appropriate Care in Appropriate Settings.”

PA Safety Net Admin2014-01-24T06:00:53+00:00January 24th, 2014|Affordable Care Act|Comments Off

CHIP Option Granted Temporary Stay in PA

Children currently receiving Children’s Health Insurance Program (CHIP) benefits in Pennsylvania will have the option of remaining in the program for one more year.
This comes as a result of negotiations between state officials and the U.S. Department of Health and Human Services.
Under the Affordable Care Act, children eligible for CHIP benefits who previously did not qualify for Medicaid now do qualify for Medicaid and the federal government expected states to fold these CHIP participants into their Medicaid programs. Pennsylvania officials, however, argued that CHIP participants often had a broader choice of providers than Medicaid recipients and that taking those children out of CHIP would damage the continuity of care they were receiving.
State and federal officials negotiated this issue for months until this week, when federal officials announced that Pennsylvania children in families whose income is between 100 percent and 133 percent of the federal poverty level can choose whether to remain in CHIP or move to the state’s Medicaid program. That choice ends at the close of 2014, when these participants will be enrolled in Medicaid.
CHIP insurers will mail information about this option to the 30,000 affected families.
To learn more about this issue and how it might affect care for low-income children, see this news release from the Pennsylvania Insurance Department.

PA Safety Net Admin2014-01-23T06:00:39+00:00January 23rd, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Safety-Net Hospitals Hurt More by Readmissions Reduction Program

Hospitals that care for large numbers of low-income seniors are disproportionately harmed by Medicare’s hospital readmissions reduction program, according to a new study.
According to the study,

Both patient dual-eligible status and a hospital’s dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations.

Because they care for so many more low-income patients than the typical hospital, Pennsylvania’s safety-net hospitals are especially vulnerable to the Medicare hospital readmissions reduction program’s financial penalties.
The study, “The Medicare Hospital Readmissions Reduction Program: Potential Unintended Consequences for Hospitals Serving Vulnerable Populations,” was published recently in Health Services Research and can be found here.

PA Safety Net Admin2014-01-22T06:00:20+00:00January 22nd, 2014|Affordable Care Act|Comments Off

Changes in Medicaid Fee Schedule

The Pennsylvania Department of Public Welfare has announced changes in its Medical Assistance fee schedule. Those changes, published in the January 18 edition of the Pennsylvania Bulletin, can be found here.

PA Safety Net Admin2014-01-21T06:00:39+00:00January 21st, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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