jsteinbock, Author at Safety-Net Association of Pennsylvania

PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for voting session this week. The following is an overview of certain health-related legislative activity.

The House of Representatives unanimously passed 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 bill was received in the Senate and referred to the Aging & Youth Committee.
The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic. The bill was received in the Senate and referred to the Health & Human Services Committee.
The House 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. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania. A recording of the hearing and witness testimony may be viewed here.
The Senate Banking & Insurance Committee favorably reported 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, and Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page. Go here to learn more.
DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered. This policy took effect on September 20. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix. The update took effect on September 19. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered. Go here to learn more.
DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax. The update is effective as of July 13. Find that bulletin here.
DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2. Find that notice here.
DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1. Find that notice here.
DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the state’s nursing facility assessment program beginning in FY 2023. Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers. Learn more from this Pennsylvania Bulletin notice.
DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding. The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead. Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

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 about 10 percent.
To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
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 195 admissions a day over the past week.
Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19. Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26. Find that notice here.
The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15. 713 of those cases were in Pennsylvania, up from 684 a week ago.
As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia. 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 released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures: coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement. The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay. It also documents case volumes, hospital charges, and statewide trends and offers other statistics. To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00. The meeting will be held virtually. An agenda will be available here 24 hours in advance. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

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 – 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.

jsteinbock2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, September 16

The following is an update of selected state health policy developments in Pennsylvania for the week of September 12-16, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for voting session this week. The following is an overview of selected health-related legislative activity.

The House unanimously passed House Bill 1630, which grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers in Medicaid. The bill was received in the Senate and referred to the Health & Human Services Committee.
The House unanimously passed House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits. The bill will now be sent to the Senate.
The House Insurance Committee favorably reported Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners’ model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
The House Professional Licensure Committee favorably reported 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 House Republican Policy Committee held an informational meeting on Monday to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred. A recording of the meeting and testimony submitted to the committee may be viewed here.
The House Human Services Committee favorably reported House Bill 2686, as amended, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
The House Children & Youth Committee held an informational meeting this week to examine “Child & Adolescent Fatality Trends & Community Responses.” A video recording of the hearing may be viewed here.

The state House and Senate will be in session next Monday (9/19), Tuesday (9/20), and Wednesday (9/21). The following is an overview of selected health-related committee meetings next week.

The House Insurance Committee will convene on Tuesday, September 20 at 10:00 a.m. to consider Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
The Senate Health & Human Services Committee will hold an informational hearing on Tuesday, September 20 at 11:00 a.m. on the tick crisis in Pennsylvania.
The House and Senate Democratic Policy Committees will hold a joint hearing on Friday, September 23 to discuss Senate Bill 860 and House Bill 1848 and the need for Pennsylvania to establish a statewide rape-kit tracking system.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers of updates to the Medical Assistance program fee schedule for adult vaccines. Find the bulletin here.
DHS has extended its calendar for remittance advice (RA) electronic transfer and mailing dates into November. Find the updated calendar here.
DHS has published information about improvements in how providers can update their enrollment summary in the state’s PROMISe provider internet portal. Find the notice here.
DHS has revised its list of drug companies participating in the state’s Medicaid drug rebate program. Find the updated list here.
In July, DHS proposed new regulations governing the delivery of psychiatric rehabilitation services, and in particular, on the use of telehealth in the delivery of those services. Now, Pennsylvania’s Independent Regulatory Review Commission has published its analysis of the proposed regulation and shared comments submitted by stakeholders in response to the proposed changes. Find the commission’s analysis and stakeholder comments in this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin to announce that it has issued an updated School-Based ACCESS Program provider handbook. Find that bulletin and the updated handbook here.
DHS has posted a notice announcing to stakeholders that it has not yet calculated Medicaid hospice rates for FY 2023 and explaining its process for completing those calculations and notifying affected parties. Find that notice here.

Behavioral Health Commission for Adult Mental Health

The Behavioral Health Commission for Adult Mental Health created to develop recommendations for how to allocate $100 million appropriated for adult mental health purposes in the state’s FY 2023 budget held its fourth public meeting this week. The first part of the meeting focused on workforce development issues, with participants identifying the biggest challenges in workforce development as recruitment, retention, licensing, lack of funding for loan repayment and salary increases, lack of career pathways and pipelines, and burnout.

After additional discussion, commission members decided they should organize their spending recommendations into four categories: workforce ($37 million of the $100 million available), expanding services ($36.7 million), criminal justice ($23.3 million), and other ($3 million); they also discussed priorities within each category. The commission’s final report and recommendations should be presented to the legislature next week but no money will be spent until the General Assembly, which will only meet a few more days this year, specifically authorizes it. Learn more about the Behavioral Health Commission for Adult Mental Health from its section of the DHS web site.

Department of Health

The Department of Health has notified licensed providers that although the CDC now considers individuals up to date with their COVID-19 vaccinations only if they have had a dose of the new bivalent booster shot, providers should continue to consider individuals up to date if they have received either a monovalent or bivalent booster shot on the recommended schedule. Learn more from the Department of Health’s letter to providers.

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.
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, 74.5 percent of Pennsylvanians five years of age and older are now vaccinated.
Sixty-five of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19. Delaware and Philadelphia counties are currently experiencing “only” substantial rates.

Monkeypox

The CDC has posted an updated map showing the distribution of 23,117 confirmed cases of monkeypox in the U.S. as of September 15, up from 21,504 cases on September 1. 684 of those cases were in Pennsylvania, up from 624 a week ago.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs is offering online training on substance use disorder confidentiality. This updated training incorporates changes based on passage of Pennsylvania Act 33, the Pennsylvania Drug and Alcohol Abuse Control Act, in July. Learn how to receive the training from this Department of Drug and Alcohol Programs notice. Participants can earn PCB continuing education credits.

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00. Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00. For information about how to participate, see this Pennsylvania Bulletin notice.

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

The Rare Disease Advisory Council will hold a stakeholder summit on Thursday, September 22. The summit will feature panels on gene therapy, newborn screening, and the results of the council’s Patient Needs Assessment Survey. Learn more about the stakeholder summit here.

Department of Human Services – Special Populations/Dementia Issues September 22

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 facilities can help community members understand what dementia is, how it affects people, and how individuals can make a difference in the lives of those touched by dementia. The webinar, to be held on Thursday, September 22 at 2:00, is especially recommended for community liaisons, non-clinical teams, nurse educators, service coordinators, and volunteers. Learn more from this webinar 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.

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.

jsteinbock2022-09-16T21:36:30+00:00September 16th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, September 9

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-9, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House will return to session on Monday, September 12. The following is an overview of certain health-related committee meetings next week.

The House Insurance Committee will meet on Monday, September 12 at 11:00 to consider Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
The House Professional Licensure Committee will convene on Monday, September 12 at 11:00 to consider, among other measures, 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 House Republican Policy Committee will hold an informational hearing on Monday, September 12 at 11:00 to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.
The House Human Services Committee will meet on Monday, September 12 at 11:15 to consider House Bill 2686, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
The House Children & Youth Committee will hold an informational meeting on Wednesday, September 14 at 10:00 to examine “Child & Adolescent Fatality Trends & Community Responses.”

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to notify dentists of updates to the Medical Assistance program dental fee schedule and the program’s Dental PROMISe™ Provider Handbook. Find the bulletin here.

The Department of Human Services has updated its Pennsylvania Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health has written to administrators of long-term-care facilities to encourage them to participate in the state’s Long-term Care Resiliency Infrastructure Supports & Empowerment (LTC-RISE) initiative as a strategy to build workforce resiliency and combat burnout that has resulted from the pandemic. Find the letter to administrators here and learn more about LTC-RISE and find contact information for LTC-RISE programs serving individual Pennsylvania regions here.

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.
The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
All 67 Pennsylvania counties continue to have a high rate of community transmission of COVID-19.

Monkeypox

The CDC has posted an updated map showing the distribution of 21,504 confirmed cases of monkeypox in the U.S. as of September 8, up from 19,465 cases on September 1. 624 of those cases were in Pennsylvania, up from 561 a week ago.
As of September 6, 380 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago. Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

DHS – Assessing and Managing Key Conditions in Long-Term Care – September 15

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 enhancing skills to assess and manage key conditions in long-term care. The webinar, to be held on Thursday, September 15 at 2:00, will feature best practices from nursing facilities across the state. This webinar also offers continuing education units for RNs, MDs, and social workers. Learn more about the webinar and how to participate from this announcement.

Pennsylvania Cancer Control, Prevention and Research Advisory Board – September 15

The Pennsylvania Cancer Control, Prevention and Research Advisory Board will meet virtually on Thursday, September 15 at 8:30. In addition, the Pennsylvania Cancer Coalition and the Data Advisory Committee will be holding their meetings at this time. The purpose of these meetings is to discuss board updates and Pennsylvania Cancer Plan implementation activities. Learn how to participate virtually from this Pennsylvania Bulletin notice.

DHS – Behavioral Health Commission for Adult Mental Health – September 16

DHS’s Behavioral Health Commission for Adult Mental Health will meet on Friday, September 16 at 9:00. Interested parties can attend in person (in Harrisburg) or virtually. Go here for information on how to participate in the meeting.