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

PA Health Law Project Issues Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Among the issues addressed in the letter are the prospects for Medicaid expansion in Pennsylvania and increased state oversight of the state’s private Medicaid managed care organizations. The newsletter also describes an effort by the U.S. Department of Health and Human Services to encourage all qualified health plans offered through health insurance exchanges to include “essential community providers” in their provider networks.
Find the newsletter here , on the web site of the Pennsylvania Health Law Project.

PA Safety Net Admin2013-06-20T06:00:15+00:00June 20th, 2013|Pennsylvania Medicaid policy|Comments Off

MedPAC: Readmissions Penalties Unfairly Target Safety-Net Hospitals

Medicare penalties for hospital readmissions are inappropriately hurting hospitals that serve especially large numbers of low-income patients.
That was the message MedPAC conveyed to Congress last week.
The agency, which advises Congress on Medicare reimbursement matters, expressed concern earlier this year about the effect of Medicare’s hospital readmissions reduction program on safety-net hospitals, and it articulated that concern more formally in its June report to Congress.
As reported by Kaiser Health News,

MedPAC found that hospitals where fewer than 3 percent of Medicare patients were low income received an average penalty of 0.21 percent. Hospitals where more than 18 percent of Medicare patients were low income had an average penalty more than twice that, 0.45 percent.

As an alternative to the current approach, MedPAC has proposed setting readmission rate targets for hospitals and then exempting from penalties hospitals that meet their targets.
Read more about MedPAC’s report to Congress in this Kaiser Health News article or read the entire MedPAC report, Report to the Congress: Medicare and the Health Care Delivery System, which can be found here, on MedPAC’s web site.

PA Safety Net Admin2013-06-19T06:00:51+00:00June 19th, 2013|Uncategorized|Comments Off

Administration Identifies Medicaid Expansion Obstacles

Corbett administration officials took advantage of a recent public briefing on Medicaid expansion to explain that the governor wants to expand the state’s Medicaid program but is seeking flexibility in how to do so that the Obama administration will not provide.
In particular, the administration wants to establish work requirements for new recipients, adjust benefits, and carve out a greater role for private health insurers.
The administration continues to negotiate these and other Medicaid expansion-related issues with federal officials.
Read more about the issues that the Corbett administration is attempting to address and the response of advocates of Medicaid expansion in this Harrisburg Patriot-News article .

PA Safety Net Admin2013-06-17T06:00:07+00:00June 17th, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

A Graphic Look at Medicaid Expansion

The Stateline web site features a number of new, excellent graphs that depict various aspects of Affordable Care Act-inspired Medicaid expansion.
The graphs show where expansion is moving forward, where it has been rejected, and where decisions have yet to be made; where Americans get their health insurance today; who might be eligible for Medicaid; and the cost of Medicaid expansion.
Find the graphs here , on the Stateline web site.

PA Safety Net Admin2013-06-12T06:00:12+00:00June 12th, 2013|Health care reform|Comments Off

Budget Bill Proposed in PA House

The chairman of the Pennsylvania House Appropriations Committee has introduced a bill proposing a budget for the state’s 2014 fiscal year.
House Bill 1437, sponsored by Rep. Bill Adolph (R-Delaware), calls for $100 million less spending than the $28.4 billion budget proposed by Governor Tom Corbett in February.
The bill also includes a number of differences in proposed spending for Medicaid and Department of Health programs.
For a summary of the bill, with an emphasis on provisions with the greatest interest to Pennsylvania’s safety-net hospitals, please hit the “contact us” link at the top of this screen.

State Budget

PA Safety Net Admin2013-05-31T06:00:08+00:00May 31st, 2013|Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget|Comments Off

PA Announces Plans for Increased Medicaid Fees

The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014. The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act.
A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here.
The revised fee schedule with the new, higher fees can be found here .

PA Safety Net Admin2013-05-29T06:00:17+00:00May 29th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Says Fiscal Office Understates Cost of Medicaid Expansion

The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.

PA Safety Net Admin2013-05-22T06:00:40+00:00May 22nd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Uncategorized|Comments Off

Medicaid Pay Raise Isn’t Reaching Docs

The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians.
Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients.
The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions. Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014.
Five months into 2013, however, only Maryland, Massachusetts, Nevada, and Michigan are making the higher payments.
Pennsylvania is among the states still not making the enhanced Medicaid payments, but state officials have promised further information about their plans in the coming days.
Learn more about the thinking behind the pay raise and why most states still are not paying it in this Washington Post article.

PA Safety Net Admin2013-05-21T06:00:54+00:00May 21st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Seeks Fair Share for Fair Care

Pennsylvania is asking the federal government to continue full funding of the health insurance program for hard-to-insure people created under the Affordable Care Act.
PA Fair Care currently provides health insurance for 6900 Pennsylvanians with medical conditions that usually make health insurance too expensive for them to purchase. The federal government allocated $5 billion for the program, but even though nation-wide enrollment is less than one-third of what the Obama administration estimated, the program has expended most of its initial appropriation and the federal government has asked states to stop enrolling new members and shift existing members into the federal version of the program or risk liability for costs the federal government will no longer subsidize.
Read more about PA Fair Care, why the program is in trouble, and what the state and federal government are trying to do about it in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2013-05-20T06:00:44+00:00May 20th, 2013|Uncategorized|Comments Off

DPW Secretary: Medicaid Expansion No Sooner Than 2015

Even if Pennsylvania decides to go ahead and expand its Medicaid program, such expansion is unlikely before January of 2015, according to the state official who would be responsible for leading that expansion.
State officials still have not decided whether the state will expand its program as envisioned under the Affordable Care Act, but even if they decide to expand, Department of Public Welfare acting secretary Beverly Mackereth has indicated that the work involved in such an undertaking makes it unlikely that expansion could begin until January of 2015.
Currently, state officials are negotiating possible terms of expansion with the U.S. Department of Health and Human Services. A decision on expansion most likely depends on the outcome of those negotiations.
Read more about Secretary Mackereth’s comments about a possible expansion time-frame and the issues that still need to be addressed in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2013-05-15T06:00:22+00:00May 15th, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

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