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PA Health Policy Update for Friday, December 2

The following is an update of selected state health policy developments in Pennsylvania for the week of November 28 to December 2, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced ​the availability of more than $9 million in state grant funding for Single County Authorities to establish or expand crisis stabilization services for individuals with co-occurring mental health and substance use disorders.  Grants of up to $3 million will be awarded to eligible Single County Authorities and can be applied toward a range of activities, including construction and building infrastructure, staffing, and programming.  Learn more about how the state envisions counties using this money from this announcement from the governor’s office.

Governor-Elect Shapiro

The Shapiro-Davis transition team announced that Dana Fritz will serve as chief of staff in a new Shapiro administration.  Immediately prior to joining the incoming administration, Ms. Fritz, a long-time aide to Shapiro, served as his campaign manager.  Find additional information about the transition here.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for November.  General Fund revenue collections were $201.9 million, or 6.8 percent, below estimate for the month.  The shortfall is due, in part, to personal income tax revenue being deposited in December rather than November. Fiscal year-to-date General Fund collections total $15.7 billion, which is $183.2 million, or 1.2 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to update the qualifying criteria and payment methodology for Medicaid disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying emergency departments in acute-care general hospitals by adding references to the report used in determining the eligibility for and the payment amounts beginning FY 2022-2023.  This announcement appears to be a codification of current state policy.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that it plans to expand the Living Independence for the Elderly (LIFE) Program to serve Carbon County and Monroe County as one area and is soliciting expressions of interest in serving this area.  Learn more about the LIFE program, DHS’s intentions for Carbon and Monroe counties, and the process for pursuing an opportunity to establish a LIFE program in those counties from this Pennsylvania Bulletin notice.
  • CMS has written to states to remind them that with the passage of the Inflation Reduction Act, Medicaid and Children’s Health Insurance Program (CHIP) programs will be required to provide coverage for approved adult vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) without cost-sharing for certain enrollees beginning October 1, 2023.  Learn more from this CMS notice.
  • DHS has circulated the minutes of the October 26 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.  Find those minutes here.

Department of Health

  • The Department of Health (DOH) issued a press release announcing its plans to distribute approximately $11.7 million in federal CDC funding to help long-term-care facilities build resilience to sustain quality care.  The money will be invested for purposes such as workforce development, staff retention, and infrastructure developments that support infection prevention control and emergency preparedness.  Eligible applicants include skilled nursing facilities, personal care homes, assisted living facilities, and intermediate care facilities.  Learn more about the program and find links to additional information about it here.  The deadline for applying for funding is December 31.
  • DOH has issued a health alert informing health care providers of a recent increase in reports of mushroom poisoning received by poison control centers in the state.  The majority of these cases have involved individuals consuming wild mushrooms foraged from backyards, public parks, wooded areas, and other locations in the southeastern part of the state.  Learn more from this department health alert.
  • DOH has updated the guidelines and fees that health care providers and facilities may charge in response to requests for production of medical charts or records.  Learn more, including the new fees, from this Pennsylvania Bulletin notice.
  • In preparation for the holiday season, DOH has established ten temporary COVID-19 testing and home test distribution sites across the state.  Go here for information about the location and hours for these sites.

COVID-19:  By the Numbers                          

  • According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania and the number of new deaths has remained steady in recent weeks, with the state averaging about 1400 new daily cases and 16-20 new daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively steady as well.
  • The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of November 30, 38 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 26 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has issued “COVID-19 Disaster Emergency Report,” to provide data on the effect of the COVID-19 emergency on the financial performance of Pennsylvania hospitals and health care facilities.  According to the report, Pennsylvania hospitals and health systems reported $206 million in COVID-19 costs, between related expenses and revenue losses, for the period April-June of 2022.  Total COVID-19-related expenses and lost revenue reported by Pennsylvania hospitals and health systems through December 2021 are $7.8 billion but these figures do not reflect emergency funding provided under federal or state laws.  Learn more from this PHC4 news release and the report itself.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually.  For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

Department of Aging – Pennsylvania Long-Term Care Council – December 8

The Department of Aging’s Pennsylvania Long-Term Care Council will meet publicly on Thursday, December 8 at 10:00.  For information about how to attend in person or virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – December 8

The board of directors of the state’s Patient Safety Authority will meet virtually on Thursday, December 8 at 1:00.  Learn about how to register for and participate in this meeting from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

PA Health Policy Update for Friday, November 18

The following is an update of selected state health policy developments in Pennsylvania for the week of November 14-18, 2022.  (Some of the language used below is taken directly from state documents.)

Governor-Elect Shapiro

Governor-Elect Josh Shapiro held a press conference Wednesday, November 16 along with Governor Wolf and Lieutenant Governor-Elect Austin Davis to discuss the gubernatorial transition process.  The governor-elect announced that Akbar Hossain, who previously served as his campaign’s policy director, will be executive director of the transition.  Amanda Warren, formerly director of finance for the campaign, will serve as executive director of the inauguration.  Additional transition announcements will be made in the coming weeks.  Further information about the transition will be available here.

General Election Update

State Representative Todd Stephens (R-151) conceded to his challenger, Melissa Cerrato (D), yesterday afternoon.  Representative Stephens’ concession gives Democrats the 102 seats needed to control the state House of Representatives; Republicans have 101 seats.  The initial path forward for Democratic control is unclear, however, because of three impending vacancies in the Democratic caucus that will require special elections in early 2023.

General Assembly Update

  • The state House and Senate briefly convened for voting session this week – the final voting session of the year.  Both chambers will return to Harrisburg for the commencement of the new legislative session on January 3.
  • The Senate Health & Human Services Committee held a hearing on Tuesday to examine the Behavioral Health Commission’s recommendations for the allocation of $100 million earmarked in the FY 2023 budget.  Testimony and a recording of the hearing may be viewed here.
  • The Senate Republican and Democratic caucuses held leadership elections this week for the new legislative session.  Senator Kim Ward (R-39) was elected the state’s first female Senate President Pro Tempore.  Senator Joe Pittman (R-41) was elected majority leader and Senator Scott Martin (R-13) was chosen chairman of the Appropriations Committee.  Senator Jay Costa (D-43) was re-elected by his caucus to serve as minority leader.  A complete list of the Senate Republican leadership team can be found here and a list of the Senate Democratic leadership team can be found here.

Department of Human Services

  • As of December 5, DHS is adding a new procedure code to the Medical Assistance fee schedule for COVID-19 tests provided to Medicaid beneficiaries and removing the previous code for those tests.  Learn more from this Pennsylvania Bulletin notice.
  • DHS will increase Medical Assistance fees for certain ambulance transportation services beginning on January 1.  Learn more, including the new fees, from this Pennsylvania Bulletin notice.
  • Pennsylvania’s Independent Regulatory Review Commission has received final form rulemaking from DHS that would effectively rescind a provision in existing regulations that prohibits providers from co-locating or leasing space to another provider within a provider’s office.  This change was originally proposed in July 2021 and the commission is expected to approve the change at its December 8 meeting.  Find notice of the action in this Pennsylvania Bulletin listing.
  • Next month, DHS’s Office of Long-Term Living will submit a proposed amendment to Pennsylvania’s OBRA 1915(c) home and community-based waiver to the Centers for Medicare & Medicaid Services (CMS).  To view a side-by-side comparison of the current and revised language and to see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 OBRA Waiver Amendment” under “Additional Resources.”  For additional information about the proposed amendment and how to submit written comments, see this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
  • Next month, DHS’s Office of Long-Term Living will submit to CMS a proposed amendment to Pennsylvania’s Community HealthChoices 1915(c) home and community-based waiver.  To view a side-by-side comparison of the current and revised language and see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 Community HealthChoices (CHC) Waiver Amendment” under “Additional Resources.”  Learn more about the proposed amendment from this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
  • DHS is making available for public review and comment the Office of Long-Term Living’s proposed home and community-based services provider sites that qualified for heightened scrutiny under CMS requirements.  Learn more about the types of sites to which this requirement applies and DHS’s actions to bring them into compliance with federal standards from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania over the past week declined 18 percent while the number of deaths remains unchanged.  The state is now averaging more than 1400 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs fell 16 percent from the last week after two weeks of rising totals.
  • The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of November 18, 27 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 34 are experiencing substantial rates of community transmission; and six counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has published “Financial Analysis 2021:  Rehabilitation • Psychiatric • Long-Term Acute Care • Specialty:  An Annual Report on the Financial Health of Pennsylvania Non-GAC Hospitals.”  The report’s highlights include:

  • During FY 2021, the operating margin for rehabilitation hospitals was 9.19 percent, for psychiatric hospitals was negative 2.86 percent, for long-term acute-care hospitals was 8.98 percent, and for specialty hospitals was negative 11.76 percent.
  • During FY 2021, the total margin for rehabilitation hospitals was 12.04 percent, for psychiatric hospitals was negative 3.02 percent, for long-term acute-care hospitals was 7.76 percent, and for specialty hospitals was 9.9 percent.
  • As a group, the foregone dollar value of uncompensated care for non-general acute-care hospitals decreased 6.19 percent, or $1.1 million, from $18.7 million during FY 2020 to $17.7 million in FY 2021.  Uncompensated care as a percentage of net patient revenue in FY 2021 among non-general acute-care hospitals ranged from 0.22 percent for long-term acute-care hospitals to 1.44 percent for psychiatric hospitals.

Learn more about the PHC4 report from this news release and the report itself.  In addition, go here to download data from the report in Excel format.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually.  For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-11-18T22:22:41+00:00November 18th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, November 18

PA Health Policy Update for Friday, November 10

The following is an update of selected state health policy developments in Pennsylvania for the week of November 7-10, 2022.  (Some of the language used below is taken directly from state documents.)

2022 Election Update

While the results are not official, current Democratic Lieutenant Governor John Fetterman has defeated Republican Mehmet Oz to replace retiring U.S. Senator Pat Toomey. Pennsylvania’s congressional incumbents all won another term. The state’s two open congressional seats (PA-12 and PA-17) were captured by Summer Lee (D) and Chris Deluzio (D), respectively.

At the state level, Democrat Josh Shapiro, the state’s current Attorney General, defeated Republican State Senator Doug Mastriano and will be Pennsylvania’s next governor.

Republicans will retain control of the state Senate with 28 of the chamber’s 50 seats; they have been in the majority in the Senate since 1994.  In an unanticipated outcome, Democrats made significant gains in the state House, and as of Thursday afternoon, November 10, are in striking distance of having a majority.  A handful of House races remain too close to officially call and may be headed for a recount. Except for a four-year period from 2007 through 2010, Republicans have been in the majority in the House since 1995.

Come January, Pennsylvania will have a new governor, a vacancy at Attorney General, and nearly a quarter of the General Assembly’s members will be new so there will be changes in caucus and committee leadership.

General Assembly

As of Thursday afternoon, the state House is schedule to return to session on Monday, November 14 and the Senate is scheduled to return on Tuesday, November 15.

The Senate Health and Human Services Committee will hold a public hearing next Tuesday, November 15th at 10:00 a.m.. to review the recently released Behavioral Health Commission report. The hearing can be livestreamed here.

Department of Human Services

Department of Health

The Department of Health has written to nursing home administrators to inform them that temporary nurse aides (TNAs) hired on or before June 6, 2022 have until the end of the federal public health emergency or April 5, 2023, whichever date comes first, to successfully pass the nurse aide exams and have their name enrolled on the Nurse Aide Registry.  Find that letter here.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania continues to fall in the 1700-1800 a day range while the number of deaths is generally between 17 and 20 a day.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs because of the disease remained relatively steady over the past week.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

2022-11-14T21:35:19+00:00November 10th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, November 10

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its October 2022 Health Law News newsletter.

Included in this month’s issue are articles about:

  • the report of the state’s Behavioral Health Commission for Adult Mental Health
  • the state’s extension of post-partum Medicaid eligibility.
  • Pennsylvania’s plan to open pediatric complex care resource centers in 2023

Read about these subjects and more in the Pennsylvania Health Law Project’s October 2022 newsletter.

2022-11-04T20:55:27+00:00November 8th, 2022|Pennsylvania Medicaid|Comments Off on PA Health Law Project Newsletter

PA Health Policy Update for Friday, November 4

The following is an update of selected state health policy developments in Pennsylvania for the week of October 31 to November 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed 66 bills into law this week and vetoed one, Senate Bill 736.  The following is a selection of health care-related bills signed into law by the governor.

  • House Bill 220, which is now Act 101 of 2022, specifies that a person does not need to test positive for drugs to begin addiction treatment.
  • House Bill 1393, which is now Act 111 of 2022, seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.
  • House Bill 2293, which is now Act 128 of 2022, requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2527, which is now Act 135 of 2022, expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.
  • House Bill 2800, which is now Act 143 of 2022, amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • Senate Bill 225, which is now Act 146 of 2022, streamlines and standardizes the process for prior authorization of medical services.  The Insurance Department has issued a news release about this new law.
  • Senate Bill 522, which is now Act 150 of 2022, requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.

General Election

The 2022 general election will be held on Tuesday, November 8.  Pennsylvanians will be voting for one U.S. Senate seat, 17 U.S. House of Representatives seats, governor, half of the 50 state Senate seats, and all 203 state House seats.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals’ response to COVID-19 to reflect the October 31 expiration of the COVID-19 state regulatory waivers and flexibilities. Find the updated guidance here.  At the same time, the Department of Human Services (DHS) has updated its list of regulations that have been suspended in response to the COVID-19 public health emergency.  Find the updated list here and scroll down to see the latest regulation suspensions that have expired; they are highlighted in red.
  • DOH has issued a health advisory about the increase in the number of cases of respiratory syncytial virus (RSV) nationally and in the state.  The alert describes the virus, outlines testing and treatment recommendations, and asks providers to report laboratory-confirmed RSV cases to DOH through Pennsylvania’s electronic reportable disease surveillance system,  PA-NEDSS.  It also urges providers to report outbreaks or clusters of severe respiratory illness, regardless of etiology, to the state and local health departments.  Find the advisory here.
  • DOH has issued a news release outlining the changes in the state’s regulations for skilled nursing facilities that have been approved by Pennsylvania’s Independent Regulatory Review Commission and now await review by the state’s Attorney General.
  • DOH has released a request for applications for its Long-Term Care Quality Investment Pilot, which will distribute approximately $11.7 million in federal funds to long-term-care facilities, including skilled nursing facilities, personal care homes, assisted living facilities, and intermediate-care facilities for the purpose of building resilience.  These funds are designed to be invested in key areas such as workforce development and retention, infection prevention control, emergency preparedness, and improvements to facility infrastructure.  To apply for this funding, facilities must participate in the state’s LTC RISE program’s quality improvement projects and cannot be located in Philadelphia.  Find the state’s request for applications here and learn about LTC RISE here.  The application deadline is December 31.

Department of Human Services

  • The Department of Human Services (DHS) announced that Pennsylvania has received approval from the federal Centers for Medicare & Medicaid Services (CMS) to extend its postpartum coverage period for mothers and birthing people eligible for Medicaid because of their pregnancy from 60 days to 12 months.  Learn more from this DHS news release.
  • DHS has extended into early January of 2023 its Remittance Advice calendar for mailing checks and electronically sending Medicaid payments.  Find the updated calendar here.
  • In response to the passage and signing of House Bill 1630 (now Act 98), which addresses, among other things, the delivery of some mental health and substance use services, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders to advise them of some of the new law’s implications and to list the sections of the Pennsylvania Code the new law repeals.  Find the OMHSAS message to stakeholders here.
  • DHS has issued a Medical Assistance Bulletin advising providers who are not a recognized provider type under the Medical Assistance program that they now may enroll in the program for the purpose of billing for cost-sharing for services provided to beneficiaries who receive both Medicare and Medicaid.  This bulletin also provides information on how to complete and submit an enrollment application.  Find the bulletin here.
  • DHS has added a procedure code to the Medical Assistance fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for:

These requirements take effect on January 9, 2023.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose 12 percent after a decline of 12 percent the week before; the number of deaths rose slightly.  The state is averaging more than 1800 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs (172) is at its highest level since early March.
  • The CDC reports a modest increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a 15 percent decrease last week.
  • As of November 4, 54 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 13 are experiencing substantial rates of community transmission; and Cameron County is experiencing a moderate rates of community transmission.

Stakeholder Events

Department of Health – State Child Death Review Team – November 9

The Department of Health’s State Child Death Review Team will hold a public meeting in Harrisburg on Wednesday, November 9 at 10:00.  The state’s Child Death Review Program provides training and technical assistance to local Child Death Review teams.  This meeting will focus on suicide deaths.  For information about the location of the meeting and the Child Death Review Team, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

PA Health Policy Update for Friday, October 28

The following is an update of selected state health policy developments in Pennsylvania for the week of October 24-28, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed House Bill 1630 into law earlier today.  Act 98, as it is now known, gives the Pennsylvania Auditor General authority to audit and review pharmacy benefit managers (PBMs) that subcontract with Medicaid managed care organizations.  In addition, the bill abrogates a number of regulations to permit the following:

  • audio-only outpatient psychiatric services
  • telehealth services in outpatient drug and alcohol clinic services
  • virtual supervision for psychiatric rehabilitation services
  • physician assistants and nurse practitioners to order home care, home health services, and personal care services under the supervision of a physician

House Chamber of the State HouseGeneral Assembly

The state House and Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate unanimously passed House Bill 2293, which requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities, and sent it to the governor for his signature.
  • The Senate also unanimously passed House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and sent it to the governor for his signature.
  • The House passed Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services, on third and final consideration Wednesday.  The Senate subsequently voted to concur with the House amendments and sent it to the governor for his signature.
  • The House passed Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning, on third and final consideration Wednesday.  The Senate concurred with the House amendments and sent it to the governor for his signature.
  • The Senate passed House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA, on third and final consideration and sent it to the governor for his signature.
  • The Senate passed House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment.  The House subsequently concurred with the Senate’s amendment, which added language that enables counties to establish overdose death or suicide review teams, and sent it to the governor for his signature.
  • The Senate unanimously passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania, and sent it to the governor for his signature.
  • The Senate passed Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health.  The bill was received in the House and referred to the Health Committee.

The state House and Senate are now in recess until the week on Monday, November 14.

Department of Health

Pennsylvania’s Independent Regulatory Review Commission has approved the first significant revision of the state’s nursing home regulations since the late 1990s.  Among other things, the updated regulations call for higher levels of nurse staffing and publication of changes in the ownership of nursing homes.  The Department of Health also will have to take a more rigorous approach to determining whether it will accept or reject such transactions.  Learn more from this Philadelphia Inquirer article.  A formal notice of the adoption of these new rules should be published shortly in the Pennsylvania Bulletin.

The Department of Health has lowered the age at which individuals may request a copy of their birth certificate in Pennsylvania from 18 to 16 and introduced a new waiver to enable individuals aged 16-24 who are, or have been, involved in foster care or juvenile justice to obtain their birth certificate without the $20 fee; the same fee waiver will apply to homeless persons.  Learn more from this Department of Health news release.

Department of Human Services

  • The federal Centers for Medicare & Medicaid Services (CMS) has approved Pennsylvania’s application to extend Medicaid and CHIP eligibility for newborns and their mothers to 12 months of postpartum care, an option temporarily available to states under the American Rescue Plan.  Learn more from this CMS news release.
  • The Department of Human Services (DHS) has issued the publication “5 Things to Know About the End of the Federal Public Health Emergency.”  While the Medicaid-focused publication is primarily directed to consumers, it includes explanations providers can use when interacting with Medicaid patients and resources to which those who work with Medicaid beneficiaries can direct those clients and patients.  Find that publication here.
  • DHS has posted the presentations delivered during the October 27 meeting of the Medical Assistance Advisory Committee.  See the presentations from the:
  • DHS has closed the county assistance office in the Nicetown/Ridge Avenue area of Philadelphia and is directing residents of that area to other offices in Philadelphia.  Learn more from this DHS news release.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week declined nearly 12 percent; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a 15 percent decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • The decline in the number of reported COVID-19 cases is reflected in the rate of community transmission among Pennsylvania counties – a major shift after months of virtually all counties experiencing high rates of community transmission with scattered counties occasionally experiencing only substantial rates.  As of October 26, 34 counties are experiencing high rates of community transmission; 31 are experiencing substantial rates of community transmission; and two counties – Clarion and Snyder – are experiencing moderate rates of community transmission, the first Pennsylvania counties to see their rate decline to this level in months.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published “Common Procedures Report – October 1, 2020 through September 30, 2021 Data.”  The report shares volume and outcome information for three common orthopedic procedures – spinal fusion, total hip replacement, and total knee replacement – performed in Pennsylvania acute-care hospitals that typically perform these procedures on adults.  For further information, including a news release, data, a report summary, the report itself, and more, go here.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Trauma-Informed Care – November 3

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Jewish Healthcare Foundation a webinar on trauma-informed care for skilled nursing facilities.  The webinar will be held on Thursday, November 3 at 2:00.  Learn more about the webinar and how to participate from this notice.

PHC4 – PHC4 Council Meeting – November 3

PHC4 will hold a regular council meeting at 10:00 on Thursday, November 3.  An agenda will be available here 24 hours in advance.  The public is invited to participate; contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Management Strategies When Working With Individuals With Acquired Brain Injuries – November 10

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Jewish Healthcare Foundation a webinar on understanding basic management strategies for working with individuals with acquired brain injuries.  The

webinar will be held on Thursday, November 10 at 2:00.  Learn more about the webinar and how to participate from this notice.

2022-10-28T19:54:44+00:00October 28th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, October 28

PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21

PA Health Policy Update for Friday, October 14

The following is an update of selected state health policy developments in Pennsylvania for the week of October 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

The Wolf Administration

Governor Wolf has announced that Pennsylvania is proposing to enter a new profit-sharing agreement with its Medical Assistance physical health managed care organizations.  Under the proposed agreement, the physical health managed care organizations would be limited to three percent profits annually with the requirement to invest additional profits in approved projects and initiatives that directly benefit the health and well-being of Pennsylvanians.  The agreement would take effect for the 2023 contract year.  Learn more about the proposal from this Wolf administration news release.

General Assembly

The state Senate will return to session next week.  Monday, October 17 is a non-voting session day. Tuesday, October 18 and Wednesday, October 19 are voting session days.  The state House will continue to be in recess next week.

The Senate Health & Human Services Committee will convene on Tuesday, October 18 to consider the following bills.

  • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services (DHS) uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
  • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to an additional ten months.
  • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
  • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification. Legislative text is not currently available.
  • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
  • House Bill 1443 permits certain diagnostic laboratory services to be marketed directly to Pennsylvania consumers.
  • House Bill 1630 grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
  • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
  • House Bill 2530 ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs.

Department of Human Services

  • The Department of Human Services (DHS) has posted information for providers about an electronic submission process that will soon be available in the PROMISe portal for fee-for-service 180-day exception requests and other claims requiring documentation.  Find DHS notice here.
  • Effective October 1, Pennsylvania has increased the income threshold for applicants for the Supplemental Nutrition Assistance Program (SNAP) to 200 percent of federal poverty income guidelines.  This will make more than 420,000 Pennsylvanians and more than 174,000 households newly eligible for SNAP and an average of $63 a month to help pay for groceries.  For additional information about these changes and where to direct individuals to apply for them, see this DHS news release.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has released “Pennsylvania Behavioral Health Telehealth Phase II Roadmap,” which offers and prioritizes recommendations for short-term and long-term implementation of telehealth services in the state.

Centers for Medicare & Medicaid Services

The federal Centers for Medicare & Medicaid Services (CMS) has approved Pennsylvania’s request for a statewide waiver to extend the October 6, 2022 deadline for temporary nurse aides (TNAs) to gain certification to April 5, 2023 or until the end of the COVID-19 public health emergency (whichever comes first).  This statewide approval applies to all nursing care facilities in Pennsylvania, so individual facilities do not need to request a waiver.  For information about how temporary TNAs can pursue certification, see this notice.

To evaluate Medicaid and the Children’s Health Insurance Program (CHIP) coverage for children, states report data to CMS about program eligibility, enrollment, operations, expenditures, program goals, and more.  CMS has published CHIP data submitted to it by Pennsylvania for FY 2021.  Find that data here.

Department of Health

The Department of Health has issued a health alert giving providers interim guidance on risk assessment and management of patients who may have been exposed to the Ebola virus.  It issued this guidance after a case of Ebola was recently diagnosed in Uganda but notes that no reported or confirmed cases have been found in the U.S.  Learn more from this health advisory.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 18 percent from the previous week (which was 20 percent less than the week before that) and the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent decrease in the seven-day rolling average of new daily COVID-19 hospital admissions (after a seven point increase the previous week).
  • Sixty-two of Pennsylvania’s 67 counties are experiencing a high rate of community transmission of COVID-19.  The remaining five counties – Adams, Centre, Lebanon, Philadelphia, and Snyder – are experiencing moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) announced that the 2022 open enrollment period is under way for licensed substance use disorder treatment providers in Pennsylvania to submit their information to be included in the Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS).  Treatment facilities currently not enrolled in ATLAS may submit their information during this open enrollment period through December 30, 2022.  In addition, current enrollees may update facility information during this period.  For additional information, see this DDAP news release.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released its state ambulatory surgery center financial analysis for 2021.  Its report shows that the average total margin for ambulatory surgery centers increased 1.61 percentage points, from 23.36 percent in fiscal year 2020 to 24.97 percent in FY 2021.  The average statewide operating margin for ambulatory surgery centers increased 1.58 percentage points, from 22.29 percent in FY 2020 to 23.87 percent, in FY 2021.  Learn more from this PHC4 news release and the PHC4 report “Financial Analysis 2021:  Ambulatory Surgery Centers.”  Go here for downloadable data in Excel format (this link opens to a download).

Stakeholder Events

Department of Health – Special Supplemental Nutrition Program for Women, Infants and Children Advisory Committee – October 18

The Department of Health’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory Committee will meet virtually on October 18 at 1:00 to elect officers and discuss future suggestions and next steps for the committee.  For information about participating in the meeting and obtaining an agenda, see this Pennsylvania Bulletin notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Renal Disease Advisory Committee – October 21

The Department of Health’s Renal Disease Advisory Committee will hold its quarterly meeting in person and virtually on Friday, October 21 at 10:00.  For information about participating in the meeting, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

2022-10-14T19:19:31+00:00October 14th, 2022|COVID-19, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, October 14

PA Health Policy Update for Friday, October 7

The following is an update of selected state health policy developments in Pennsylvania for the week of October 3-7, 2022.  (Some of the language used below is taken directly from state documents.)

Behavioral Health Commission for Adult Behavioral Health

The Wolf administration has released the recommendations of its Behavioral Health Commission for Adult Behavioral Health, which was created to advise the General Assembly on how to spend $100 million in one-time federal American Rescue Plan Act funding, including to support adult behavioral health needs addressed in the state’s 2022-2023 fiscal code.  The commission recommended that the $100 million be used in the following manner:

  • $37 million to stabilize, strengthen, and expand the workforce
  • $23.5 million to improve the criminal justice and public safety systems
  • $39 million to expand capacity for services and supports
  • $500,000 for a future study of the impact of this spending

The commission’s recommendations are only advisory; the General Assembly will consider its recommendations in the coming weeks and decide if and how to appropriate the $100 million.

Find a Wolf administration news release about the report here and the report itself here.

Department of Human Services

The Department of Human Services has announced its intent to allocate funds for FY 2023 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Medical Assistance program and to provide financial relief to hospitals during the COVID-19 pandemic.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  Learn more from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its interim infection prevention and control recommendations for health care settings to reflect recent changes in federal CDC recommendations.
  • DOH  has shared information on severe manifestations of monkeypox among patients who are immunocompromised due to HIV or other conditions.  This is the same alert issued last week by the CDC.
  • DOH has added to its naloxone standing orders that enable residents and first responders to obtain naloxone products to help combat the rise of overdoses in Pennsylvania a non-prefilled syringe with two single-dose vials of liquid naloxone that is injectable.  Residents can present a copy of the state’s standing order, which can be found here, at their local pharmacy to obtain the naloxone.  The medication also is available for free for personal use through a statewide mail-based naloxone program.
  • DOH has issued an advisory about lead exposure in adults.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 20 percent from the previous week and the number of deaths fell 10 percent.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a seven percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • For the first time in several months, all, or almost all, of Pennsylvania’s 67 counties are not experiencing a high rate of community transmission.  Currently, 60 counties are still experiencing a high rate of community transmission while six counties – Forest, Centre, Lycoming, Union, Snyder, and Delaware – are experiencing “only” a substantial rate of community transmission and Philadelphia’s rate is now classified as moderate.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 26,385 confirmed cases of monkeypox in the U.S. as of October 6, up only slightly from 25,613 cases on September 29.  789 of those cases were in Pennsylvania, up from 713 a week ago.
  • As of October 3, 495 of those Pennsylvania monkeypox cases were in Philadelphia, up from 475 on September 25.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued the research brief “Hospitalizations for Opioid Overdose, 2016 – 2021” that looks at trends among state residents, ages 15 and older, who have been admitted to Pennsylvania acute-care hospitals for opioid overdoses.  Find a news release about the report here and the report itself here.

Centers for Medicare & Medicaid Services

CMS’s Center for Medicare and Medicaid Innovation has released materials presenting its evaluation of year two of the Pennsylvania Rural Health Model, which seeks to improve access to hospital services and improve population health in underserved rural communities.  New evaluation materials include a summary of the evaluation of the program’s second year; the full report; the report’s executive summary; and an appendix to the report.  Learn more about the Pennsylvania Rural Health Model, including a list of its participating hospitals, from the program’s web page.

Stakeholder Events

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

PA Health Policy Update for Friday, September 30

The following is an update of selected state health policy developments in Pennsylvania for the week of September 26-30, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that it has added CPT codes for administering COVID-19 pediatric boosters.  The new codes can be used immediately.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to advise providers of the addition of procedure codes to the Medical Assistance fee schedule for the provision of private duty nursing services, which are provided through home health agencies to beneficiaries under 21 years of age.  The additions take effect on October 1.  Find that bulletin here.
  • DHS’s Office of Long-Term Living has launched its American Rescue Plan Act of 2021 funding reporting portal.  The online portal will be available beginning on September 30, 2022 for Office of Long-Term Living providers to submit costs associated with American Rescue Plan funding distributed in 2021, as required by the state.  Learn more from this announcement of the portal’s launch and from DHS’s guide on to how to use the portal.
  • DHS has updated its data on physical health HealthChoices enrollment and participation in the Medical Assistance Transportation Program.  Find the update here.

Department of Health

  • The Department of Health (DOH) has issued new guidance for health care providers and their employees who have been exposed to or contracted COVID-19.  The first addresses the return to work for health care workers with confirmed or suspected cases of COVID-19 and the second describes work restrictions for health care workers who have been exposed to COVID-19.  Both are introduced to align state standards with recently revised guidance from the federal Centers for Disease Control and Prevention.
  • DOH has updated its definition of how it defines whether individuals are up to date on their COVID-19 vaccinations.  Go here to see the updated definition and learn about the department’s rationale for this change.
  • DOH has issued a health alert to notify providers, laboratories, infection control specialists, and local health departments about an unvaccinated adult with poliovirus infection and acute flaccid paralysis.  Wastewater testing in treatment facilities in Rockland County, New York, which is adjacent to Pennsylvania, and surrounding counties also identified related poliovirus, indicating that the virus is circulating in the community and others may become ill.  DOH urges providers to consider polio as a possible cause of sudden onset of limb, facial, oropharyngeal, or respiratory muscle weakness; to contact their local or state health department to discuss such cases; and to encourage any unvaccinated patients to receive polio vaccines.  Learn more from this health alert.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of 10-20 percent.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 191 admissions a day over the past week, a slight reduction from the previous week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Snyder County is currently experiencing “only” a substantial rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued Licensing Alert 02-22 to inform drug treatment programs about the process for establishing mobile narcotic treatment programs.  Find the alert here.

Insurance Department

The state Insurance Department has released Pennsylvania’s 2023 individual and small group Affordable Care Act health insurance rates.  The release also shares changes in the number of insurers offering coverage to Pennsylvanians and offers information about federal rate subsidies.  Learn about the newly released information and find a link to the rates and insurers themselves in this Insurance Department news release.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 25,613 confirmed cases of monkeypox in the U.S. as of September 29, up only slightly from 23,364 cases on September 21.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 25, 475 of those Pennsylvania monkeypox cases were in Philadelphia, up from 446 on September 18.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Stakeholder Events

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

2022-09-30T21:16:03+00:00September 30th, 2022|COVID-19, HealthChoices, long-term care, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for Friday, September 30
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