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PA Health Policy Update for February 10

The following is an update of selected state health policy developments in Pennsylvania from February 4-10.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • Three special elections were held this week to fill vacancies in the state House of Representatives.  Matt Gergley (D) was elected to represent the 35th legislative district, where he will take the seat formerly held by Lieutenant Governor Austin Davis.  Abigail Salisbury (D) was elected to represent the 34th legislative district, replacing former Representative Summer Lee, who was elected to Congress in November.  Joe McAndrew (D) was elected to represent the 32nd legislative district, filling the seat left vacant by the death of Tony DeLuca.  When the three members are sworn in later this month Democrats will have 102 seats in the House and Republicans will have 100 after Senator-elect Linda Schlegel Culver resigns her House seat to be sworn in to the state Senate.
  • The state House has scheduled additional session days and the chamber will return to session on Monday, February 21. Click here to view the updated calendar.
  • Republican members of the state House Appropriations Committee held a roundtable discussion this week with several Medicaid managed care organizations (MCOs). Go here to learn more about the event and see a list of the MCO participants.

Department of Human Services

The Department of Human Services (DHS) has posted information about new medical group provider access to the PROMISe provider internet portal for the reactivation or revalidation of changes of group members.  Starting on February 24, active provider groups that need to reactivate, revalidate, or make changes to group members will be able to log onto the portal with their active group credentials.  Learn more from this DHS notice.

Department of Health

The Department of Health has issued a health advisory informing providers of an outbreak of highly drug-resistant pseudomonas aeruginosa associated with artificial tears products.  No such cases have been reported in Pennsylvania.  Learn more about the outbreak, the condition, and how to identify and treat it from this Department of Health advisory.  Providers who diagnose the condition are asked to report it to the state or their local health department.

The Department of Health has proposed adding mucopolysaccharidosis type II disorder (MPS II) to the supplemental conditions mandated for screening and follow-up as part of the state’s newborn screening program as of July 1.  Learn more about the condition and how to submit written comments in response to this proposed addition to the screening program from this Pennsylvania Bulletin notice.  Comments are due within 30 days of the notice’s February 11 official publication.

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported daily in Pennsylvania rose slightly over the past week and the number of new daily deaths declined slightly.  Both figures fall within the general range for the state in recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs with the virus fell slightly over the past week and the number on ventilators declined 31 percent.
  • The CDC reports no change over the past week in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
  • For the week ending February 8, five Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 16 counties experienced a substantial rate of community transmission; and the remaining 46 counties experienced a high rate of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded $9 million in grants to four county agencies to establish or expand crisis stabilization services for individuals with co-occurring mental health and substance use disorders.  Learn more about the grant recipients and how they are expected to use the money from this department news release.

Stakeholder Events

Department of Health – Preventative Health and Health Services Block Grant Advisory Committee Meeting – February 13

The Department of Health’s Preventative Health Services Block Grant Advisory Committee will meet in Harrisburg on Monday, February 13 at 1:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Health – WIC Advisory Board – February 14

The Department of Health’s WIC Advisory Board will meet virtually on Tuesday, February 14 at 1:00 to gather suggestions of strategies for increasing participation in and improving the WIC program.  For information about how to obtain the meeting agenda and participate, see this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee Meeting – March 1

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00.  For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-02-10T21:59:36+00:00February 10th, 2023|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 10
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PA Health Policy Update for February 3

The following is an update of selected state health policy developments in Pennsylvania from January 28 to February 3.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro has signed an executive order seeking to improve the state’s licensing, permitting, and certification processes, launching a review of how long it takes agencies to process applications and how workers and businesses apply online.  This executive order seeks to establish definitive dates for when applicants for licenses, permits, and certificated will hear back from the state, and if applicants do not receive a response by that date, the agency responsible will refund their application fee.  Learn more from this news release from the governor’s office and from the executive order.

General Assembly

State Representative Lynda Schlegel Culver won a special election this week to replace former state Senator John Gordner, who resigned to become counsel to Senate President Kim Ward.  Senator-elect Culver will represent the 27th district, which includes all of Columbia, Montour, Northumberland, and Snyder counties and part of Luzerne County.  Once she resigns from her state House seat a special election will be scheduled to replace her.

Department of Human Services

  • The Department of Human Services (DHS) has notified hospitals with accredited Level I, II, III, or IV trauma centers of the required annual attestation for inclusion in the FY 2022-23 Trauma DSH Program.  The deadline to submit completed attestations is February 24.  Potentially eligible trauma centers that have not been notified should contact DHS at RA pwdshpymt@pa.gov.  Questions regarding the attestation form and the Trauma DSH Program also should be directed to this address.
  • DHS has posted information for providers on how to check the status of their electronic Medical Assistance provider enrollment application and what to do if their application was returned for additional information.  Find it here.
  • DHS has posted information for group providers on how to reactivate, revalidate, or make
    changes to group members.  Find it here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has announced a grant program through which qualified entities may apply for funding to invest in technology and training for behavioral health telehealth providers.  The state has allocated $4 million for one-time grants of up to $50,000 for providers that meet a number of criteria, including having fewer than 50 employees and at least 51 percent of their clients enrolled in Medicaid.  Learn more about the program, eligibility criteria, and how to apply from this OMHSAS notice.  Applications will be accepted until December 31 or until the $4 million is exhausted.
  • DHS has posted the presentations offered during the January 26 meeting of the Medical Assistance Advisory Committee.  See presentations from the:

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported daily in Pennsylvania declined over the past week and the number of new daily deaths returned to the usual range for COVID-19-related deaths in recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on a ventilator because of the virus, and in hospital ICUs with COVID-19 all declined slightly over the past week.
  • The CDC reports an 11 percent decrease in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • For the week ending February 2, one Pennsylvania county – Cameron – experienced a low rate of community transmission of COVID-19; seven counties experienced a moderate rate of community transmission; eight counties experienced a substantial rate of community transmission; and the remaining 49 counties experienced a high rate of community transmission.

Insurance Department

The Insurance Department is conducting a medical professional liability insurance study to determine whether sufficient capacity exists to increase the basic coverage limits of insurance required by the Medical Care Availability and Reduction of Error (MCARE) Act.  Learn more about the issues the study will address from this Pennsylvania Bulletin notice.  Stakeholder comments are due by March 4.

Stakeholder Events

Department of Health – Preventative Health and Health Services Block Grant Advisory Committee Meeting – February 13

The Department of Health’s Preventative Health Services Block Grant Advisory Committee will meet in Harrisburg on Monday, February 13 at 1:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee Meeting – March 1

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00.  For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-02-03T20:51:28+00:00February 3rd, 2023|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 3
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PA Health Policy Update for January 27

The following is an update of selected state health policy developments in Pennsylvania from January 21-27.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • The Legislative Budget and Finance Committee (LBFC) met this week and approved the release of a report entitled “Prescription Drug Pricing Under the Medical Assistance Managed Care Program.”  Act 120 of 2020 directed LBFC to conduct a study analyzing prescription drug pricing in the Medical Assistance managed care program; review reimbursement practices by PBMs (pharmacy benefit managers) to pharmacies and to PBMs by MCOs; investigate and compare reimbursement rates by PBMs to independent pharmacies and to chain pharmacies; and study state laws and best practices adopted by other states regarding PBMs and pharmacy reimbursement.  Find the report here.
  • Although the House has not adopted a rules package or formally established standing committees for the 2023-2024 legislation session, the Republican caucus announced its selections for committee chairs this week.  Representatives Kathy Rapp and Tina Pickett will remain Republican chairs of the Health Committee and the Insurance Committee, respectively, while Doyle Heffley will be the new Republican chair of the Human Services Committee.  In addition, Representative Carl Metzger will be the Republican chair of the Professional Licensure Committee, Steven Mentzer will be the Republican chair of the Aging & Older Adult Services Committee, and Linda Schlegel Culver will be the Republican chair of the Children & Youth Committee.  Find the full list of Republican committee chairs here.
  • The state House Democratic Policy Committee convened in Pittsburgh for an informational hearing examining the health care staffing crisis.  Find the meeting agenda and testimony offered during the hearing here.

Department of Human Services

  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin providing guidance for the implementation of Act 65 of 2020, which governs who can provide consent for voluntary mental health treatment of minors who are 14 years of age and less than 18 years of age in both inpatient and outpatient settings.  Act 65 also addresses which individuals may grant consent for the release of a minor’s medical records.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has increased fees for certain ambulance transportation services on the Medical Assistance fee schedule effective with dates of service on or after January 1, 2023.  Find that bulletin here.
  • DHS has published final notice of the assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the Nursing Facility Assessment Program for FY 2023.  Learn more about which types of facilities to which the assessment applies and how much their 2023 assessment will be from this Pennsylvania Bulletin notice.
  • At the January 26 meeting of the Medical Assistance Advisory Committee, DHS’s Office of Long-Term Living offered a presentation on the efforts of the managed care plans that serve Community HealthChoices members to redetermine the eligibility of their current participants in the wake of the upcoming end of continuous Medicaid eligibility and vaccination rates among Community HealthChoices participants.  Find that presentation here.
  • DHS has updated its physical health managed care enrollment report.

Department of Health

Pennsylvania’s Executive Board has approved a reorganization of the Department of Health.  Find an organizational chart that reflects this reorganization in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania held steady over the past week, remaining higher than prior to Thanksgiving, and the number of new daily deaths rose more than 50 percent over the past week after a decline of 50 percent the week before.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined seven percent last week after a 14 percent decline the previous week; the number on a ventilator because of the virus remained steady; and the number in hospital ICUs fell 15 percent after a six percent decline the week before.
  • The CDC reports a slight decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 25, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; 15 counties are experiencing a substantial rate of community transmission; and the remaining 48 counties are experiencing high rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-01-27T21:38:47+00:00January 27th, 2023|COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 27
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PA Health Policy Update for January 20

The following is an update of selected state health policy developments in Pennsylvania from January 14-20.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

  • Josh Shapiro was sworn in as Pennsylvania’s 48th governor on Tuesday.  Much of the governor’s inaugural speech focused on preserving democracy.  He also highlighted the need for unity and emphasized bringing people together.  Find a transcript of the governor’s speech here.
  • On Wednesday Governor Shapiro issued his first executive order, which prioritizes work experience, skill, and competency for state jobs and highlights that 92 percent of the state’s jobs do not require a four-year college degree.
  • Information about the Shapiro administration’s health-related agency nominees can be found here and a complete list of the Shapiro administration appointments made to date can be found here.

General Assembly

The state Senate convened for voting session this week and the House briefly convened for non-voting session.  Both chambers are now recessed.  The Senate is scheduled to return on Monday, February 27 while the House has yet to release a session calendar.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin rescinding Medical Assistance Bulletin 01-22-78, titled “340B Drug Pricing Program – Dispensing 340B Purchased Drugs,” which was issued on December 22, 2022.  Instead, Medical Assistance Bulletin 99-13-08, titled “340B Drug Pricing Program Provider Requirements and Billing Instructions – Pharmacy Services,” remains in effect.  Go here to see the new bulletin rescinding the December 22 version.
  • DHS has extended its calendar for Remittance Advice (RA) notifications and the delivery of electronic payments and checks into early March.  Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has added CPT codes 0124A, 0154A (Pfizer) and 0134A, 0144A (Moderna) to its fee schedule for the administration of a bivalent booster dose COVID-19 vaccine.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders informing them that it has extended until March 31 its requirement that providers capture consent to treat, service verifications, and approval of treatment plans for Medicaid-funded behavioral health services delivered via telehealth.  At the end of this period providers must have an electronic capability to secure auditable electronic signatures for consent and service verification.  Learn more from OMHSAS’s message to stakeholders.
  • DHS has informed stakeholders that Jennifer (Jen) Smith has joined the department as deputy secretary for OMHSAS.  Smith previously served as Secretary of the Department of Drug and Alcohol Programs.  Learn more from DHS’s message to stakeholders.
  • DHS has posted information about an electronic submission process for Medicaid fee-for-service 180-day exception requests and other claims requiring documentation that will soon be available in the PROMISE portal.  Find that information here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its peer groups, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities.  DHS used these peer groups, peer group medians, and peer group prices to determine case-mix rates for non-public nursing facilities for FY 2023.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published its final annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Learn about those rates from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its telemedicine interpretive guidance for hospitals.  Find the updated guidance here.
  • DOH has updated its FAQ on innovative care models for hospitals.  Find the updated FAQ here.  The changes, which address critical access hospitals and small rural hospitals, are highlighted in red.
  • DOH has updated its criteria and guidance for establishing an outpatient emergency department.  The changes, which address critical access hospitals, small rural hospitals, and rural emergency hospitals, are highlighted in red.  Find the updated guidance here.
  • DOH also has updated its matrix on how facilities can qualify as an innovative hospital model.  Find the updated matrix here.   Changes again are highlighted in red.
  • DOH has issued guidance requiring prospective new owners of skilled nursing facilities to inform facility residents, representatives, and employees of the possibility of a change of ownership of the facility.  Learn more from this DOH guidance.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania declined 27 percent over the past week and the number of new daily deaths, after a 50 percent increase a week ago, returned this week to its level of recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined nearly 14 percent last week after an 11 percent decline the previous week; the number on a ventilator because of the virus rose nine percent; and the number in hospital ICUs fell six percent.
  • The CDC reports a five percent decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 18, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; eight counties are experiencing a substantial rate of community transmission; and the remaining 55 counties are experiencing high rates of community transmission.

Health Care Cost Containment Council (PHC4)

PHC4 is beginning the verification process for hospital self-pay records for fiscal year 2021.  Its self-pay data reconciliation web application on the PHC4 portal enables hospitals to reconcile their self-pay records, which eventually will be provided to DHS to be used as a part of its calculation of the extraordinary expense portion under Act 77 (the state’s 2001 tobacco settlement law).  Find PHC4’s letter to hospitals here and the portal for self-pay records here.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – January 26

The Patient Safety Authority will meet virtually on Thursday, January 26 at 1:00.  For information about how to participate in this meeting, see this Pennsylvania Bulletin notice.  Registration is required.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

2023-01-20T21:47:06+00:00January 20th, 2023|340b, COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 20
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PA Health Policy Update for January 13

The following is an update of selected state health policy developments in Pennsylvania from January 7-13.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-Elect Josh Shapiro announced the nomination of several cabinet-level officials this week, including Dr. Valerie Arkoosh as Secretary of the Department of Human Services, Dr. Debra Bogen as Secretary of the Department of Health, Dr. Latika Davis-Jones as Secretary of the Department of Drug and Alcohol Programs, Mr. Jason Kavulich as Secretary of the Department of Aging, and Mr. Michael Humphreys as Insurance Commissioner.  All of these nominees are subject to confirmation by the state Senate.  Find additional information about the health-related agency nominees’ respective backgrounds here and a complete list of the Shapiro-Davis administration appointments made to date here.

Governor-Elect Josh Shapiro and Lieutenant Governor-Elect Austin Davis will be sworn into office next Tuesday, January 17 at 12:00 p.m.

General Assembly

The state House and Senate both convened this week for a special session to consider a constitutional amendment extending the statute of limitations for victims of sexual abuse to file civil claims.  The Senate passed Senate Bill 1 by a vote of 28-20; the bill includes three proposed constitutional amendments.  In addition to extending the statute of limitations, Senate Bill 1 also requires voters to present a valid form of ID before voting in an election and prevents the governor from vetoing the General Assembly’s disapproval of a regulation.  After convening on Monday, the House recessed without agreement.  Speaker Rozzi subsequently appointed a committee of six House members (three Republicans and three Democrats) to negotiate a path forward.

The state Senate is scheduled to return to session Tuesday, January 17 at 10:00 a.m.

Department of Human Services

  • The Department of Human Services (DHS) has updated its web page addressing the unwinding of continuous Medicaid and CHIP eligibility established by the Families First Coronavirus Response Act to reflect federal legislation that will launch a path toward bringing that continuous eligibility to an end:  specifically, the federal Consolidated Appropriations Act of 2023 set April 1, 2023 as the end of continuous coverage for Medical Assistance and CHIP.  After April 1, DHS will return to normal eligibility processes.  This means that all Medical Assistance and CHIP recipients must complete an annual renewal to see if they are still eligible for coverage.  Learn more from DHS’s web page addressing the unwinding of continuous Medicaid and CHIP eligibility.
  • DHS will hold a COMPASS Community Partner technical assistance call on Tuesday, January 24 at 1:00 that may address this subject, among other matters.  Go here to register (the registration deadline is January 17) and to submit questions to be addressed during the meeting.
  • DHS has published a co-location regulatory change that has been under development since 2021.  The purpose of change is to eliminate a prohibition against providers leasing or renting space, shelves, or equipment within a provider’s office to another provider or from allowing the paid or unpaid staff of a provider to be placed in another provider’s office.  As the published announcement explains, “Developments in the health care industry have emphasized the need for integrated health care.  The Department recognizes the benefits of integrated care and deletes this subsection to support the enrollment in the Medical Assistance (MA) Program of providers that share space (co-locating providers).  By expanding provider qualifications to include co-locating providers, the Department seeks to support more coordinated and integrated care within the MA Program.”  Learn more from this Pennsylvania Bulletin notice.
  • DHS has released quarterly licensing and enforcement activity data for its five licensing offices that oversee providers of long-term care, child care, behavioral health care, day activity programs, and residential care for individuals with intellectual disabilities and autism.  Learn more about the outcome of these licensing and enforcement efforts from this DHS news release.

Centers for Medicare & Medicaid Services

CMS has shared a presentation with states addressing how they can work with Medicaid managed care plans to review the eligibility of current Medicaid beneficiaries once the continuous eligibility requirement for current Medicaid participants ends on April 1.  Learn more from the CMS presentation “Strategic Approaches to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations.”

Department of Health

The Department of Health (DOH) has issued a health advisory informing providers that as of January 1 it has introduced a new surveillance case definition for multisystem inflammatory syndrome in children (MIS-C) for reporting cases of MIS-C.  Providers are required to report cases that meet the new criteria to their local health department.  Learn more from this health advisory.

DOH and Berks County will be the nation’s first to test a new federal COVID-19 Home Test to Treat Pilot Program run by the National Institute of Health (NIH) and HHS’s Administration for Strategic Preparedness and Response (ASPR).  Learn more about the program from this DOH news release.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania declined slightly over the past week but the number of new daily deaths rose nearly 50 percent over the high end of the death rate in recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined nearly 11 percent over the past week; the number on a ventilator because of the virus fell 20 percent; and the number in hospital ICUs held steady.
  • The CDC reports a five percent decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 11, four Pennsylvania counties – Forest, McKean, Potter, and Sullivan – are experiencing a low rate of community transmission of COVID-19; nine counties are experiencing a substantial rate of community transmission; and the remaining 54 counties are experiencing high rates of community transmission.

Department of Drug and Alcohol Programs

Information bulletins that have been removed are:

Stakeholder Events

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – January 18

The Department of Health’s Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, January 18 at 9:00.  Interested parties may attend in person or virtually.  Learn more about the committee, where the meeting will be held, and how to participate virtually from this Pennsylvania Bulletin notice.

Department of Health – Renal Disease Advisory Committee – January 20

The Department of  Health’s Renal Disease Advisory Committee will meet in Harrisburg on Friday, January 20 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – COMPASS Community Partner Technical Assistance Call – January 24

DHS will hold a COMPASS Community Partner technical assistance call on Tuesday, January 24 at 1:00.  Go here to register (the registration deadline is January 17) and to submit questions to be addressed during the meeting.

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – January 26

The Patient Safety Authority will meet virtually on Thursday, January 26 at 1:00.  For information about how to participate in this meeting, see this Pennsylvania Bulletin notice.  Registration is required.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

2023-01-13T20:52:23+00:00January 13th, 2023|COVID-19, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 13
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PA Health Policy Update for January 6

The following is an update of selected state health policy developments in Pennsylvania from December 23 through January 6.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Josh Shapiro announced the appointment of his first cabinet-level officials this week, including Akbar Hossain, who will serve as Secretary of Policy and Planning, and Mike Vereb, who will be Secretary of Legislative Affairs.  Hossain is currently the transition team’s executive director and prior to that served as the Shapiro campaign’s policy director.  Vereb, a long-time advisor to Shapiro, previously worked as legislative affairs director for the Office of the Attorney General. Governor-elect Shapiro also announced the appointment of his deputy chiefs of staff.  Lindsey Mauldin, who currently works for Planned Parenthood Pennsylvania, will be Deputy Chief of Staff for Health and Human Services.  Prior to joining Planned Parenthood, Mauldin coordinated Pennsylvania’s COVID-19 pandemic response efforts.  A complete list of the Shapiro-Davis administration appointments made to date may be viewed here.

General Assembly

The General Assembly convened on Tuesday, January 3 to swear in members of the House and Senate and the respective chambers’ presiding officers.  The Senate made history by electing Senator Kim Ward (R-Westmoreland) President Pro Tempore; she is the first woman to hold the position.  Senator Ward also was sworn in as Lieutenant Governor, a position she will hold until Lieutenant Governor-Elect Austin Davis is sworn in on January 17.  After what appeared to be an impasse choosing a Speaker of the state House, Representative Mark Rozzi (D-Berks) was elected by a vote of 115 to 85 to serve as Speaker.  Sixteen Republicans joined Democrats in voting for Rozzi, who committed to being an independent Speaker and not to caucus with either party.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for December.  General Fund revenue collections were $319.9 million, or 8.6 percent, above estimate for the month.  Fiscal year-to-date General Fund collections total $19.7 billion, which is $503.1 million, or 2.6 percent, above estimate.

Centers for Medicare & Medicaid Services

  • CMS has issued guidance on a way for states to address unmet health-related social needs for Medicaid beneficiaries.  This option will help states offer alternative benefits, such as housing and nutrition assistance, through the use of a service or setting that is provided to an enrollee in lieu of a service or setting covered under their state’s Medicaid plan to address a range of unmet health-related social needs to help enrollees maintain their coverage and improve their health outcomes.  Learn more from this CMS news release and this letter from CMS to state Medicaid directors.
  • CMS has issued guidance that creates an easier path to specialty care for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.  For the first time, state Medicaid and CHIP programs will be able to pay specialists directly when a beneficiary’s primary health care provider asks for advice.  For example, if a pediatrician consults with a specialty behavioral health provider about a specific patient’s needs, both providers may be reimbursed for their care – even if the patient is not present.  This move to pay for interprofessional consultations seeks to link routine care with specialty care, enabling more people to benefit from practitioners with specialized knowledge.  Learn more from this CMS news release and the guidance letter CMS sent to state Medicaid directors about this subject.
  • CMS has sent a letter to state Medicaid programs that provides a detailed description of the configuration/implementation plan, testing plan, and testing results that states will need to submit to the federal government when the public health emergency and continuous Medicaid enrollment condition end.  This document seeks to help states understand systems readiness artifacts that are routinely submitted to CMS’s state systems team during IT project and certification reviews.  See the CMS letter here.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform providers that it will reinstate provider enrollment requirements that were in place prior to the COVID-19 public health emergency, including an enrollment application fee, fingerprint-based background checks, and site visits for providers.  Providers temporarily enrolled in the program during the public health emergency who did not satisfy enrollment requirements that were suspended at the time now must satisfy those requirements.  This policy takes effect on February 27.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform providers about the procedures for dispensing 340B drugs to Medical Assistance beneficiaries and about implementation of the Medical Assistance program’s 340B drug exclusion list.  The policies took effect on January 1.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin to inform peer support service providers and Medicaid behavioral health managed care organizations that peer support services identified in beneficiaries’ individual service plans may be provided during transit.  The policy took effect on December 28.  The bulletin also includes revised provider handbook pages.  Find the bulletin here.
  • DHS has updated its COMPASS Community Partners web page with new information about steps that can be taken to help people retain health care coverage after the COVID-19 public health emergency ends, including a new FAQ and an updated public health emergency toolkit.  Learn more about COMPASS Community Partners and these new developments from this message from DHS.
  • DHS has added a new procedure code to the Medical Assistance program fee schedule for a second nurse to shadow a nurse providing private duty/shift nursing to beneficiaries under 21 years of age, effective with dates of service on and after January 1.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a summary of the December 8 meeting of the Medical Assistance Advisory Committee.  Find it here.
  • DHS has updated its telephone directory for those seeking assistance with different Medical Assistance-related issues.  Find the updated directory here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its physical health Medicaid managed care enrollment report for November.

Department of Health

  • The Department of Health has written to long-term-care facilities to inform them that it will no longer provide short-term crisis staffing support or staffing support for test swabbing missions as of January 14.  It also encourages those facilities to engage with their local LTC RISE partner, which will continue to provide COVID-19 outbreak response consultative support.  Learn more from the department’s letter to long-term-care facilities.
  • The Childhood Blood Lead Test Act signed into law on November 3 took effect on January 2.  The act provides for blood lead assessment and testing of certain children and pregnant women by health care providers; imposes duties on the Department of Health; and requires certain health insurance policies to cover blood lead tests.  Learn more about the new law from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose 21 percent over the past week.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 is the highest it has been since last February 22; the number on a ventilator because of the virus is the highest it has been since March 9; and the number in hospital ICUs is greater than it has been since March 4.
  • The CDC reports a 15 percent increase in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 since December 21.
  • As of January 5, one Pennsylvania county – Cameron – is experiencing a low rate of community transmission; 12 counties are experiencing a substantial rate of community transition; and the remaining 54 counties are experiencing high rates of community transmission of COVID-19.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin informing single- county authorities, substance use disorder treatment providers, and other substance use disorder treatment-related organizations that they may be asked to serve on a death review team and that they may be asked to provide records as part of a death review team’s duties.  Find the bulletin here.

The Department of Drug and Alcohol Programs announced an open enrollment period last October 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.  This open enrollment period has been extended, and will now continue through January 13.  Go here to see the original notice of the open enrollment period and here to see the department’s recent communication on this subject.

Insurance Department

An Insurance Department examination of Capital Blue Cross has identified concerns with claims processing, including claims being denied for lack of prior authorization when prior authorization had already been obtained, and a coordination of benefits issue that has since been updated.  The examination also reported additional Unfair Insurance Practices Act violations involving unclear communication with members.  The exam also found mental health parity violations.  Learn more about why the department conducted the review, what it found, and how it is addressing the problems it identified from this news release.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – January 12

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, January 12 at 10:00.  For additional information about the session, see this Pennsylvania Bulletin notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – January 18

The Department of Health’s Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, January 18 at 9:00.  Interested parties may attend in person or virtually.  Learn more about the committee, where the meeting will be held, and how to participate virtually from this Pennsylvania Bulletin notice.

Department of Health – Renal Disease Advisory Committee – January 20

The Department of  Health’s Renal Disease Advisory Committee will meet in Harrisburg on Friday, January 20 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

 

2023-01-06T21:54:53+00:00January 6th, 2023|340b, COVID-19, Federal Medicaid issues, health equity, Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 6
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PA Health Policy Update for Friday, December 23

The following is an update of selected state health policy developments in Pennsylvania for the week of December 19-23, 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 informing providers about new procedures for dispensing 340B-purchased drugs to Medical Assistance beneficiaries and about the implementation of the program’s 340B drug exclusion list.  Find the bulletin here.  Find the policies this new bulletin replaces here.
  • DHS has extended its schedule for sending Remittance Advice documents, Medicaid payment checks, and electronic transfers of payments into early February.  Find the updated schedule here.
  • DHS has announced that it will add several prescription drugs to the Medical Assistance program’s list of services and items requiring prior authorization:  corticotropin; targeted systemic immunomodulators for atopic dermatitis, designated as preferred on the program’s preferred drug list (PDL); PCSK9 inhibitor lipotropics, designated as preferred on the PDL; and obesity treatment agents designated as preferred on the PDL.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has posted revisions of the participating drug company list for the Medicaid drug rebate program.
  • DHS has announced its intent to allocate funds in FY 2023 for several classes of inpatient disproportionate share hospital (DSH) payments (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  See the announcement, including information about the different purposes for which Medicaid DSH payments will be made, in this Pennsylvania Bulletin notice.
  • DHS has circulated the following materials from the December 7 meeting of the Medical Assistance Advisory Committee meeting.

Department of Health

  • The Department of Health (DOH) has announced that Pennsylvania will receive $98 million in federal funding to enhance public health infrastructure, including staffing, health planning, and equity and data modernization efforts.  A portion of the funding, from the CDC’s Public Health Infrastructure grant program will be allocated to 10 county and municipal health departments.   Learn more from this Department of Health news release.
  • DOH has issued a health advisory informing providers to be aware of possible increases in group A streptococcal infections.  The alert also informs providers about symptoms, testing, and treatment; provides instructions for laboratories that identify cases; and reminds providers and laboratories that they are required to report such cases to DOH.  Find the alert here.
  • DOH has issued a health advisory with interim guidance for clinicians on how to prioritize antiviral flu treatment at a time when there is limited availability of the drug oseltamivir (Tamiflu).  Find the advisory here.
  • DOH has revised long-term-care nursing facility regulations recently approved by the Independent Regulatory Review Commission to correct typographic errors.  Find the revised, final regulations in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs remained steady over the past week but the number on ventilators rose 17 percent.
  • The CDC reports no change over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 21, 46 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 15 were experiencing substantial rates of community transmission; and six counties were experiencing a moderate rate of community transmission.
  • As 2022 draws to a close, Pennsylvania has now experienced 3.4 million confirmed, reported cases of COVID-19 and suffered nearly 49,000 deaths from the virus.
2022-12-23T21:11:29+00:00December 23rd, 2022|COVID-19, long-term care, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 23
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PA Health Policy Update for Friday, December 16

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

Department of Human Services

The Department of Human Services has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information that will be needed, as of January 9, to evaluate the medical necessity of prescriptions for:

Department of Health

  • The Department of Health (DOH) is working to implement Act 128 of 2022, which requires temporary health care services agencies to register with DOH.  Under the act, temporary health care services agencies are agencies that provide temporary health care personnel (RNs, LPNs, nurse aides, or direct care staff) to long-term-care nursing facilities, personal care homes, or assisted living residences.  DOH has developed a survey for long-term-care facility administrators so it can compile information about temporary health care services agencies operating in Pennsylvania.  Long-term-care facility officials can go here to complete the brief survey.
  • DOH has issued an alert advising providers of an outbreak of measles in neighboring Ohio, informing providers about the symptoms they should look for among possible measles patients and how to prevent, test for, and treat measles.  The alert also reminds providers that they are required to report measles cases to the state.  Learn more from this health alert.
  • DOH has issued an alert updating providers on its latest guidance for treating COVID-19.  The alert notes that the most common strains of the virus cannot be treated by the monoclonal antibodies that were effective against earlier strains and that the federal government currently authorizes no such products for use in treating COVID-19 patients.  Despite this, selected anti-viral therapeutics are still available to treat such patients.  Learn more from this health alert.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs rose, but just slightly, over the past week.
  • The CDC reports a modest increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 14, 52 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 14 were experiencing substantial rates of community transmission; and one county was experiencing a moderate rate of community transmission.  This represents deterioration from the previous week, when 39 Pennsylvania counties experienced high rates of community transmission of COVID-19, 25 experienced substantial rates of community transmission, and three experienced moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs recommends that businesses that provide addiction treatment and supports consider training employees and volunteers regularly on preparing for and responding to an active shooter incident.  Learn more from this message from the department to stakeholders.

Pennsylvania Health Care Cost Containment Council

PHC4 has released “Hospital Performance Report – October 2020 through September 2021 Data,” which presents information about the performance of Pennsylvania acute-care hospitals for 13 common medical conditions.  Among the factors reported are hospital-specific mortality, 30-day readmission ratings, case volume, and hospital charges for patients between October 1, 2020 and September 30, 2021.  The report also looks at changes in statewide rates over time.  For additional information see PHC4’s news release; a report summary; an introduction to the report; a summary of key findings; downloadable data sets; technical notes; and data about Medicare payments.

2022-12-16T21:54:49+00:00December 16th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for Friday, December 16
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End of PHE Could Cut Kids From PA Medicaid Rolls

When the formal COVID-19 public health emergency ends, as many as one out of every four Pennsylvania children enrolled in Medicaid could lose their state-sponsored health insurance, according to new research by the Pennsylvania Partnership for Children.

During the PHE, the number of uninsured children in the state fell from 4.6 percent to 4.4 percent, but some of that improvement could be reversed as the state begins to redetermine the eligibility of more than 3.5 million people currently on the state’s Medicaid rolls after a more than two-year hiatus in eligibility reviews.  Today, more than 1.4 million children in Pennsylvania are enrolled in Medicaid or CHIP.

Even with the PHE-inspired improvements, 5.5 percent of children in the state who qualify for some kind of free or subsidized health insurance remain uninsured, according to the research.

Uninsured children, like the uninsured population at large, are far more likely than not to be treated by Pennsylvania’s safety-net hospitals such as those that belong to the Safety-Net Association of Pennsylvania (SNAP).  As a result, any reduction in the rate of uninsured children would have a correspondingly damaging effect on the financial health of those safety-net hospitals – and potentially, on the residents of the medically vulnerable communities those hospitals serve.

Learn more about how the end of the PHE may affect health care coverage for Pennsylvania children in the Pennsylvania Capital-Star article “Report:  Ranks of uninsured Pa. kids dropped during pandemic.”

2022-12-14T15:26:58+00:00December 14th, 2022|COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on End of PHE Could Cut Kids From PA Medicaid Rolls
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PA Health Policy Update for Friday, December 9

The following is an update of selected state health policy developments in Pennsylvania for the week of December 5-9, 2022.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Shapiro announced that he will appoint Uri Monson, the chief financial officer of the School District of Philadelphia, as Budget Secretary.  He also announced Jennifer Selber will be appointed General Counsel and Larry Hailsham, Jr. will be Executive Deputy Chief of Staff.  Selber currently serves as the Executive Deputy Attorney General of Pennsylvania in charge of the criminal division and Hailsham most recently served as the Shapiro campaign’s political director.

General Assembly

  • Democrats and Republicans continue to struggle over control of the state House. On Wednesday Representative Joanna McClinton (D-Philadelphia) was sworn in during an unannounced ceremony as majority leader.  Republicans swiftly denounced the swearing-in as an “illegitimate power grab.”  In addition, Representative Summer Lee (D-Allegheny County) and Representative Austin Davis (D-Allegheny County) formally submitted their resignations on Wednesday.  At the same time they won re-election to those seats Ms. Summer was elected to Congress and Mr. Davis was elected Lieutenant Governor.  Their resignations, along with the passing of Representative Tony DeLuca (D-Allegheny County), make the current breakdown in the state House 101 Republicans and 99 Democrats.
  • The state Senate released its 2023 session calendar through June.  The calendar can be viewed here.

Department of Human Services

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose nearly 30 percent in the past week, an increase possibly attributable to social gatherings over the Thanksgiving holiday.  The number of new deaths remains within the usual range for recent months.
  • 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 unchanged.
  • The CDC reports a 22 percent increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 7, 39 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 25 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.  This is almost identical to the previous week.

Department of Drug and Alcohol Programs

  • The Department of Drug and Alcohol Programs has issued an information bulletin explaining that as a result of a new Pennsylvania law passed last month, private and public treatment and rehabilitation facilities may not deny addiction treatment to individuals based solely on a negative result on a drug test.  This policy takes effect on January 1.  Learn more from this information bulletin.
  • The Department of Drug and Alcohol Programs has announced that it has awarded nearly $19 million in grant funding through its substance use disorder loan repayment program to help substance use disorder treatment professionals repay their outstanding qualifying educational loans.  More than 280 practitioners, including case managers, counselors, licensed social workers, physician assistants, and registered nurses, shared in the funding.  Learn more from this department news release.

State Board of Nursing

The State Board of Nursing proposes amending its process for reactivating nursing licenses.  Learn more from this Pennsylvania Bulletin notice.  Public comments on the proposed changes are due within 30 days.

2022-12-09T21:00:26+00:00December 9th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 9
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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