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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its June 2022 newsletter.

Included in this month’s edition are articles about:

  • Changes in HealthChoices managed care plans that take effect on September 1.
  • The July 1 transition to Tempus as the financial management services vendor for Community HealthChoices, which means Tempus will take over paying direct care workers hired by Community HealthChoices participants as part of that program’s self-directed care model.
  • A reduction of the deadline for requesting a fair hearing in response to Medicaid eligibility rejection or termination from the program from 90 days, which it has been since the start of the COVID-19 emergency, back to the 30 days it was before that time.  This change is retroactive to May.
  • A lifting of the pandemic-driven suspension of the need for prior authorization for shift nursing services for Medicaid beneficiaries under the age of 21, which will take effect on November 1.

Read about these subjects and more in the June 2022 edition of Health Law News, the Pennsylvania Health Law Project’s newsletter.

2022-07-06T21:19:51+00:00July 7th, 2022|COVID-19, HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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PA Health Policy Update for Friday, July 1

The following is an update of selected state health policy developments in Pennsylvania for the week of June 27 to July 1, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

As of 2:00 p.m. on Friday, July 1, Governor Wolf and the General Assembly continue to work on finalizing Pennsylvania’s FY 2023 budget.  Despite indications that a framework for a budget agreement has been reached, the state missed its June 30 deadline to enact a spending plan.  The General Assembly is scheduled to return to session next Tuesday, July 5 to continue its work. The short-term impact of not having a budget by July 1 will be minimal; the state is obligated to maintain essential operations and cover Medicaid expenditures, state employee payroll, and debt payments.

Harrisburg, PA capital buildingGeneral Assembly

The state House and Senate cancelled session this weekend and are schedule to return to session on Tuesday, July 5.  Depending on the outcome of budget negotiations and the progress of budget-related legislation, they may have to add additional session days next week.

  • The Senate passed House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • The Senate passed Senate Bill 225 on third and final consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.  The bill was sent to the House and referred to the Insurance Committee for consideration.
  • The House passed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.
  • The House passed Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers in Pennsylvania with those permitted by the federal Centers for Medicare & Medicaid Services (CMS), on third and final consideration.  Since the bill was amended, it was sent back to the Senate for concurrence.
  • The House passed House Bill 2679 on third and final consideration.  The bill, which was subsequently sent to the Senate for consideration, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five years of age and older.
  • The House unanimously voted to concur with Senate amendments to House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.  The bill will now be sent to the governor for his signature.
  • The House passed House Bill 2293 on third consideration and final passage and sent it to the Senate for consideration.  This bill requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.

Governor Wolf

Governor Wolf has signed into law House Bill 2401, which extends regulatory waivers that went into effect over the course of the COVID-19 pandemic.  This extension will permit many waivers to remain in place until October 31, 2022 unless the waivers are related to federal exemptions.  Waivers related to federal exemptions will remain in place until the last day of the federal public health emergency or the last day the federal exemptions are authorized, whichever is later.  House Bill 2401 also makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.  Learn more from this Wolf administration news release.

Governor Wolf has signed Senate Bill 709, which establishes the CMV Education and Newborn Screening Act and requires the Department of Health to make available on its website certain information regarding cytomegalovirus (CMV), one of the most common viral infections that infants are born with in this country.  Health care providers will be required to provide parents or guardians of newborns with information on CMV and to offer a screening or referral within 21 days if the newborn child fails the initial newborn hearing screening.  Learn more from this Wolf administration news release and Senate Bill 709 (now Act 29).

Department of Human Services

  • In response to the COVID-19 emergency, the federal Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in April of 2020 issued an exemption to opioid treatment programs from the requirement to perform an in-person physical evaluation for any patient who will be treated by such programs with buprenorphine if a program physician, primary care physician, or an authorized health care professional under the supervision of a program physician determines that an adequate evaluation of the patient can be accomplished via telehealth.  Based on positive response to this practice, SAMHSA is extending this flexibility for one year from the formal end of the COVID-19 public health emergency.  Learn more from SAMHSA’s guidance.
  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services has issued a bulletin to update its guidelines for payment of behavioral health services delivered using telehealth technology.  Find the bulletin here and attachments here and here.  The new guidelines take effect immediately.
  • DHS’s Breast & Cervical Cancer Prevention & Treatment Program provides eligible individuals treatment for confirmed cases of breast and cervical cancer or pre-cancerous conditions of the breast or cervix.  DHS has posted a notice to providers reminding them how to determine whether patients may be eligible for services under the program and, if they are, how they can enroll in the program.  Find that notice here.
  • DHS has issued a Medical Assistance Bulletin informing providers that as of November 1 it will reinstate the prior authorization requirements for shift care services provided to beneficiaries under the age of 21 in the Medical Assistance fee-for-service program.  Medical Assistance managed care organizations may reinstate the prior authorization requirements for these services provided to children under the age of 21.  Providers rendering services in the managed care delivery system should contact the appropriate managed care organization regarding any questions about prior authorization requirements.  Learn more from this Medical Assistance Bulletin.
  • DHS has announced a funding opportunity for home and community-based service (HCBS) providers to improve and strengthen HCBS programs and services to better serve HCBS participants.  Under the program DHS will provide up to $40,000 for each approved request to help HCBS providers implement a series of specific types of service improvement projects.  Funding is limited to providers of services through the Community HealthChoices and OBRA 1915(c) waivers for activities that supplement HCBS services rather than supplant existing services.  Learn more about the funding program and the specific types of projects DHS is interested in supporting from this DHS news release.  For more detailed information, see this DHS description of the program, the funding guidelines, and how to apply.  Applications will be accepted until December 31 or whenever the $38 million allocated for this purpose has been committed.  All awarded funds must be spent by July 1, 2023.
  • DHS is seeking partners to help it through the public health emergency unwinding process during which people will need to re-establish their eligibility for Medical Assistance benefits.  Specifically, it seeks individuals and organizations that will help guide current Medical Assistance beneficiaries through the eligibility renewal process or direct them to other resources for possible health care coverage.  Learn more about what DHS seeks and how to participate in this undertaking from this DHS message.
  • DHS has decreased from 90 to 30 days the period of time individuals have to request a hearing appealing a Medicaid termination or denial.  The time limit previously was 30 days, was extended to 90 days at the start of the COVID-19 public health emergency, and has now been restored to 30 days.  Find the notice in this DHS memo (on page 7, in red).
  • DHS and the Department of Transportation have been awarded a $750,000 grant from the Federal Transit Administration to expand its Find My Ride online tool, Pennsylvania’s “one-stop shop” for access to human services transportation.  The program was developed collaboratively with transit agencies and streamlines the application process for the five largest transportation assistance programs in the state, including the Senior Share Ride program, the Medical Assistance Transportation Program, ADA complementary paratransit, the Persons with Disabilities Program, and the Free Transit Program.  The program enables third parties, such as family members or health care providers, to apply for services on behalf of riders.  Learn more from this Wolf administration news release.

Insurance Department

The Insurance Department has received a federal grant as part of the State Flexibility to Stabilize the Market Grant Program Cycle II.  One of the proposed projects includes studying the availability of providers in various specialties and geographic areas.  The goal of this study is to understand areas of need based on the current availability of providers to accept new patients and the amount of time it takes to get an appointment with these providers and to assess network adequacy considerations based on the findings.  The Insurance Department is seeking public comment from organizations, consumer advocates, providers, and consumers about their experience with getting appointments or finding available specialists.  Learn more about the project and the areas of medical specialty the analysis may consider, and on which the department is interested in comments, in this Pennsylvania Bulletin notice.  Comments are due by August 5.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder.  Last year the program awarded $599,000 to 12 organizations and this year the Department of Drug and Alcohol Programs plans to award approximately three to five grants of up to $600,000 each to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.  Learn more about this funding opportunity from this department news release and a program overview that describes eligible applicants and outlines the application process.  Applications are due by July 29 for projects that begin on October 1 and end by September 30, 2023.

COVID-19:  By the Numbers

  • After four weeks of falling case counts the number of new reported COVID-19 cases rose over the past week.
  • During this past week, Pennsylvania’s total of COVID-19 cases since the beginning of the pandemic rose past three million.
  • COVID-19-related deaths rose slightly during the week.
  • The number of Pennsylvanians hospitalized with COVID-19 remained steady over the past week but the number in hospital intensive care units and on ventilators declined.
  • Thirty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 55 counties last week.  Four counties experienced a moderate rate of community transmission and the remaining 18 experienced a substantial rate.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 7

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 to help nursing facility staff recognize expressions of behavior among residents living with dementia.  The webinar will be held on Thursday, July 7 at 2:00.  Learn more about the webinar and how to participate from this notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

2022-07-01T20:16:07+00:00July 1st, 2022|COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 1
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PA Health Policy Update for Friday, June 24

The following is an update of selected state health policy developments in Pennsylvania for the week of June 20-24, 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 in Harrisburg.  Originally scheduled to be in session all week, the House and Senate cancelled session Thursday and Friday while legislative leaders and the governor continue to negotiate an FY 2023 spending plan.  Both chambers will back in session next week to attempt to finalize the budget by the state’s June 30 constitutionally-mandated deadline.
  • The Senate unanimously concurred with House amendments to Senate Bill 709 and sent it to Governor Wolf for his signature.  This bill establishes the CMV Education and Newborn Testing Act to create public awareness of cytomegalovirus and provide for CMV screening for certain newborns.
  • The Senate unanimously passed Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.  The bill now goes to the House for consideration.
  • The Senate adopted Senate Resolution 288, which authorizes the Joint State Government Commission to research the impact of the pandemic on the staffing needs of long-term-care facilities.
  • The House unanimously passed House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.  The bill was received in the Senate and referred to the Judiciary Committee for consideration.
  • The House unanimously passed House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by FDA.  The bill was received in the Senate and referred to the Judiciary Committee.
  • The House passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill was received in the Senate and referred to the Judiciary Committee.
  • The House Human Services Committee favorably reported House Bill 107, which would require Medicaid managed care organizations to enter into an agreement with the Department of Human Services to enable the department to recoup any Medicaid funds that were spent on “provider-preventable conditions,” and House Bill 109, which increases the penalties for making a false claim against the state’s Medicaid program.
  • The House Judiciary Committee favorably reported House Bill 2660, which is a proposed constitutional amendment that would establish the General Assembly’s sole authority to establish in statute the rules regarding venue in civil lawsuits.
  • The Senate Health & Human Services Committee favorably reported House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  The committee also unanimously reported House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.
  • The Senate Consumer Protection & Professional Licensure Committee reported Senate Bill 485, which seeks to improve access to physical therapy services, and Senate Bill 511, which authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
  • The Senate amended Senate Bill 225 on second consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.
  • Representative Wendy Thomas and Human Services Committee Chairman Frank Farry held a press conference to highlight House Bill 2686, which seeks to improve access to mental health care in Pennsylvania through the Behavioral Collaborative Care Model.  The legislation would provide grant funding to support the model’s implementation in physician practices.

Free COVID-19 Vaccines

Following the extension of authorization to administer COVID-19 vaccines to children six months of age and older, the federal Centers for Medicare & Medicaid Services (CMS) has announced that children ages six months to five years with Medicaid and CHIP coverage are eligible for COVID-19 vaccinations without cost-sharing.  Learn more about these free vaccines, and others who are eligible for free vaccines, from this CMS news release.

Department of Human Services

  • The Department of Human Services (DHS) has announced that the plan selection period for physical health HealthChoices will run from June 22 through August 16.  This selection period comes ahead of implementation of new physical health managed care agreements that will take effect on September 1.  The new agreements will result in some consumers having to choose a new physical health plan, and all consumers can review options and select a new health plan if they would like to make a change.  Notices are being mailed to all Medicaid recipients enrolled in a physical health managed care plan.  The letter explains whether or not a person’s current plan will continue to be available after September 1, all options for plans in their region, important dates, and how to choose or change their plan.  Approximately 500,000 current HealthChoices participants will have to select a new physical health plan by August 16 or be automatically assigned due to the agreement changes.  Learn more about the plan selection period and find links to additional resources from this DHS news release.
  • DHS has extended its calendar of remittance advice notifications, check mailings, and electronic funds transfers into early August.  Find the updated calendar here.
  • DHS has updated its list of drug companies that participate in the federal Medicaid drug rebate program.  For a drug product to be compensable through the Medical Assistance program the company that markets the product must participate in the Federal Medicaid Drug Rebate Program.
  • DHS’s Medical Assistance Advisory Committee met on Thursday, June 23.  Learn about the committee’s deliberations from presentations offered by:
  • DHS’s Medical Assistance Advisory Committee’s consumer subcommittee met on Wednesday, June 22.  Learn about the committee’s deliberations from presentations offered during the meeting by DHS’s Office of Medical Assistance Programs and its Office of Long-Term Living.
  • DHS has published a notice announcing the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2023.  Find that notice here.
  • DHS has announced its intent to amend Pennsylvania’s Title XIX State Plan to update the Medical Assistance payment methodology and standards for payment of Medical Assistance-covered nursing facility services in FY 2023 to authorize the continued use of a budget adjustment factor in setting payment rates for nursing facility services.  Learn more about this proposal in this Pennsylvania Bulletin notice.
  • DHS has published its proposed annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Find that notice here.

Department of Health

The Department of Health has issued a health alert updating its recommendations for identifying cases of monkeypox, testing for the disease, and counseling patients.  Find the updated guidance here.

The Department of Health has issued a health alert informing providers and public health officials that the first mosquito pools of the season to test positive for West Nile virus in Pennsylvania have been found in Montgomery, Philadelphia, Bucks, and Cumberland counties and that the risk of West Nile infection is likely to remain elevated over the next several months.  The alert reviews symptoms of West Nile virus and when and how to test for the virus.  Find the alert here.

Pennsylvania Rural Health Model

The Pennsylvania Rural Health Model is a federal program that seeks to test whether care delivery transformation in conjunction with hospital global budgets increase rural Pennsylvanians’ access to high-quality care and improve their health while also reducing the growth of hospital expenditures across payers, including Medicare, and improving the financial viability of rural Pennsylvania hospitals to improve health outcomes of and maintain continued access to care for Pennsylvania’s rural residents.  Eighteen Pennsylvania hospitals participate in this program.  CMS’s Center for Medicare and Medicaid Innovation has just published an evaluation of the program’s second year of operations.  Find that evaluation report here and go here for other information about the program, including a list of the participating hospitals.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the expansion of ATLAS, the Addiction Treatment Locator, Assessment, and Standards platform, to Pennsylvania.  ATLAS evaluates addiction treatment facilities’ use of evidence-based best practices and offers a dashboard that enables those seeking assistance to search for and compare facilities using various criteria.  Learn more about ATLAS’s expansion to Pennsylvania in this Department of Drug and Alcohol Programs new release and on the ATLAS web site.  The news release notes that in the fall of this year there will be an open enrollment period for facilities that missed the first deadline for inclusion in ATLAS.

COVID-19:  By the Numbers

  • For the fourth consecutive week COVID-19 case counts in Pennsylvania fell, declining from a seven-day average of 2897 on June 15 to 1761 on June 22, a 39 percent decline.
  • The seven-day average of COVID-19-related deaths fell by more than half, from 24 to 11, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units remained relatively unchanged over the past week.
  • Fifty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 56 counties last week.  Two counties experienced a moderate rate of community transmission and the remaining ten experienced a substantial rate.

Stakeholder Events

Department of Health – Public Health Advisory Council – June 27

The Department of Health’s Public Health Advisory Council will meet virtually on Monday, June 27 at 2:00.  The purpose of the meeting is to discuss the Preventive Health and Health Services Block Grant Federal Fiscal Year 2022 work plan.  For additional information about the meeting and how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

 

2022-06-24T20:48:16+00:00June 24th, 2022|COVID-19, Federal Medicaid issues, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for Friday, June 24
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PA Health Policy Update for Friday, June 17

The following is an update of selected state health policy developments in Pennsylvania for the week of June 13-17, 2022.  (Some of the language used below is taken directly from state documents.)

Bookshelf with law booksGeneral Assembly

  • The state House and Senate convened for voting session this week in Harrisburg.
  • The Senate passed on final consideration Senate Bill 967, which creates the Women, Infants, and Children State Advisory Board.  The bill will now be sent to the House for consideration.
  • The House passed Senate Bill 709 on third consideration and final passage.  This bill establishes the CMV Education and Newborn Testing Act to create public awareness of cytomegalovirus and provide for CMV screening for certain newborns.  The bill will now be sent back to the Senate for concurrence.
  • The House also passed Senate Bill 915, which is the capital budget bill, on third consideration and final passage.  This will be sent back to the Senate for concurrence as well.
  • The House Health Committee convened on Monday, June 13 and favorably reported, among others, the following health care-related bills:
    • House Bill 2357, the Kratom Consumer Protection Act, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2579, which seeks to increase the number of EMTs and paramedics in Pennsylvania by requiring the Department of Health to develop state-specific examinations for EMTs, EMRs, and paramedics and no longer rely on the National Registry exam.
    • House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.
  • House Bill 2604 was subsequently amended on the House floor during second consideration.  The amendment, which makes certain changes and adds a definition of “health system,” was agreed to by stakeholders and the Department of Health.
  • The House Insurance Committee convened on Tuesday, June 14 and favorably reported Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.
  • The House Veterans Affairs & Emergency Preparedness Committee met on Wednesday, June 15 and favorably reported, among other bills, Senate Bill 861 which enters Pennsylvania into the EMS Compact.
  • The state House and Senate will convene next Monday (6/20) through Friday (6/24) for voting session.

Department of Human Services

  • The Department of Human Services has issued a Medical Assistance Bulletin to notify dentists, federally qualified health centers, and rural health clinics that Medical Assistance will pay for teledentistry, effective with dates of service on and after May 2, 2022, and to announce that procedure codes for counseling services have been added to the MA program fee schedule.  Find the bulletin here.
  • The Department of Human Services has posted the contract into which it has entered HealthChoices physical health managed care organizations effective January 1, 2022.  Find that contract here.

COVID-19:  By the Numbers

  • For the third consecutive week COVID-19 case counts fell, declining from a seven-day average of 3223 on June 8 to 2143 on June 15, a 34 percent decline.
  • The seven-day average of COVID-19-related deaths also fell, from 23 to 16, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units all declined over past week.
  • Fifty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 65 counties last week.  Two counties experienced moderate rates of community transmission and nine experienced a substantial rate.

Stakeholder Events

Rural Health Redesign Center Authority – June 21

The board of the Pennsylvania Rural Health Redesign Center Authority will meet virtually on Tuesday, June 21 at 10:00.  Learn more about the board and how to participate in this meet from this Pennsylvania Bulletin notice.

Department of Health – Preventative Health and Health Services Block Grant Application for Federal Fiscal Year 2022; Public Hearing – June 21

The Department of Health is making available copies of its proposed Preventive Health and Health Services Block Grant Application for federal FY 2022.  This block grant application shall serve as the state’s request to the U.S. Department of Health and Human Services for block grant funding to address the Healthy People 2030 Health Status Objectives.  A public hearing will be held virtually on June 21 at 10:00.  Learn more about the hearing, how to participate, and how to obtain a copy of the grant funding application from this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – June 21

The Department of Health’s Health Research Advisory Committee will meet virtually on Tuesday, June 21 at noon.  The purpose of the meeting is to vote on 2022 priorities and to plan for future health research priorities.  For information about how to join the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – June 22

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, June 22 at 1:00.  For information about how to join the meeting, go here.

Department of Human Services – Medical Assistance Advisory Committee – June 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, June 23 at 10:00.  Go here to register to join the meeting.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

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 “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

Patient Safety Authority – June 23

The board of the Patient Safety Authority will meet virtually on Thursday, June 23 at 1:00.   Registration is required.  Learn about how to participate in the meeting from this Pennsylvania Bulletin notice.

Department of Health – Public Health Advisory Council – June 27

The Department of Health’s Public Health Advisory Council will meet virtually on Monday, June 27 at 2:00.  The purpose of the meeting is to discuss the Preventive Health and Health Services Block Grant Federal Fiscal Year 2022 work plan.  For additional information about the meeting and how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

2022-06-17T21:32:45+00:00June 17th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, June 17
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PA Health Policy Update for Friday, June 3

The following is an update of selected state health policy developments in Pennsylvania for the week of May 31 to June 3, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state House and Senate will return to Harrisburg for session the week of June 6.  The Senate will be in session on Monday (6/6), Tuesday (6/7), and Wednesday (6/8).  The House will be in session on Tuesday (6/7), Wednesday (6/8), and Thursday (6/9).
  • The House Health Committee will hold a joint hearing with the Environmental Resources & Energy Committee on “Oil and gas byproducts:  powering modern medicine and our healthcare system.”  The hearing will take place on Tuesday, June 7 at 10:00 a.m.
  • The House Insurance Committee will hold an informational meeting on Wednesday, June 8 at 10:00 a.m. to examine cybersecurity and insurance data security.
  • The Senate Health & Human Services Committee will meet on Tuesday, June 7 at 10:30 a.m. to consider the following bills.
    • Senate Bill 571, which establishes a uniform time-frame for distribution of SNAP benefits.
    • Senate Bill 1198, which seeks to promote and improve the availability of and access to assisted living residences.
    • Senate Bill 1202, which requires health insurers to cover the use of medically prescribed pasteurized donor human milk in inpatient and outpatient settings for children under the age of 12 months.
    • House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.

Revenue Collection Update

The Independent Fiscal Office (IFO) has released its Monthly Revenue Update for May. General Fund revenue collection exceeded estimate by $459.1 million for the month.  For the fiscal year to date Pennsylvania has received $5.5 billion more than projected.  The IFO reported that increased revenue collections continue to be driven by strong sales and use tax, personal income tax,  and corporate net income tax payments.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added a CPT code to the MA fee schedule for the administration of a third dose of the Pfizer pediatric COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes to the MA fee schedule for the administration of Pfizer’s ready-to-use novel COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • The managed care delivery system subcommittee of DHS’s Medical Assistance Advisory Committee has posted a draft file note summarizing its May 12 public meeting.  Find that draft here.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has released a new tool states can use to prepare for the eventual end of the COVID-19 public health emergency and return to normal Medicaid and CHIP eligibility and enrollment operations.  This tool highlights the ten fundamental actions states need to complete to prepare for unwinding when the Medicaid continuous enrollment requirement ends.  Find it here.

CMS has issued a letter to state Medicaid programs updating its 2022 SSI and spousal impoverishment standards.  These measures affect financial eligibility rules (the “spousal impoverishment rules”) that apply when married individuals seek coverage of certain long-term services and supports.  Find the letter and the new standards here.

Department of Health

The Department of Health is working with Philadelphia’s Department of Public Health to confirm and investigate what appears to be the first case of monkeypox in Pennsylvania and one of only 21 currently suspected in the U.S.  Learn more from this Philadelphia Department of Public Health news release.

The Department of Health’s Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities of modifications of the reporting process for skilled nursing facilities with ongoing outbreaks of COVID-19.  Find that notice here.

COVID-19:  By the Numbers

  • For the first time in more than two months daily COVID-19 case counts fell, declining from a seven-day average of 4238 on May 25 to 3552 on June 1.
  • The seven-day average of COVID-19-related deaths fell by more than half, from 36 to 15, over the same period of time.
  • Despite the decline in new cases, the number of Pennsylvanians hospitalized with COVID-19 rose, but only slightly (three percent) over the past week.
  • The number of these patients on ventilators and hospital intensive care units held steady over the past week.
  • Sixty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19; Juniata County was the exception, with a substantial rate of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded a grant of $1.4 million to continue the Pennsylvania Perinatal Quality Collaborative’s work in improving perinatal health outcomes.  Learn more about the grant, the program, and the grant recipient from this department news release.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has issued comments on proposed regulations governing long-term-care facilities that were published on March 19.  See these comments in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Care Delivery System Subcommittee – June 9

The Medical Assistance Advisory Committee’s managed care delivery system subcommittee will meet virtually on Thursday, June 9 at 10:00.  Go here for the meeting agenda and information about how to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 9

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 special population webinar on polypharmacy challenges in nursing homes on Thursday, June 9 at 2:00.  The webinar is especially targeted for skilled nursing facility medical directors, directors of nursing, pharmacy staff, and recreational therapy.  To learn more about the virtual webinar and how to participate, go here.

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

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

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

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 “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

2022-06-03T20:40:29+00:00June 3rd, 2022|COVID-19, Federal Medicaid issues, long-term care, 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, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for Friday, June 3
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PA Health Policy Update for Friday, May 27

The following is an update of selected state health policy developments in Pennsylvania for the week of May 23-27, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The Senate unanimously passed House Bill 889, which authorizes the State Board of Nursing to approve graduates of international nursing education programs to sit for the RN licensure examination provided that such international programs are determined to be equivalent to that which is required in Pennsylvania.  The bill will now be sent to the governor.
  • The Senate passed Senate Bill 848 by a vote of 35-12.  This legislation creates a Chief Nursing Officer position in the Department of Health.  The bill will now be sent to the House for consideration.
  • The House unanimously passed House Bill 1644, which directs the Department of Human Services to develop an escalation process to place Medicaid patients with behavioral health or long-term-care needs in an appropriate care setting.  The bill now will be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2530, which ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs.  The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee favorably reported House Bill 2585, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting a bid.
  • The Senate Banking & Insurance Committee favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
  • The Legislative Budget and Finance Committee released a report on the Pennsylvania CARE Act (Act 20 of 2016) and its impact on patient outcomes.  Find the report’s highlights here and the full report here.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has revised its revenue estimate for the current fiscal year, increasing it to $47.7 billion, a $5.8 billion increase over its initial estimate.  According to the IFO, revenue in most categories, including corporate net income tax, sales tax, and personal income tax, exceeded projections.  The IFO also cautioned that the state will likely see reduced revenue collections in future years.  Find the IFO’s full report here and a PowerPoint presentation of its initial FY 2023 revenue estimate here.

Office of the Attorney General

The Office of the Attorney General released a report on the significant increase in fentanyl importation and use across the commonwealth.  The report highlights the Bureau of Narcotics Investigations’ seizure of more fentanyl in the first three months of 2022 than it seized in all of 2021.  The report recommends weighing the costs and benefits of legalizing fentanyl test strips to combat the increase in overdoses and continuing to make access to substance use disorder treatment a priority. Find the full report viewed here.

Department of Human Services

Department of Health

  • The Department of Health (DOH) has issued an alert updating previously released information about monkeypox in the U.S. and elsewhere and offering information for clinicians and the public, including links to additional resources.  Find the alert here.
  • DOH has notified skilled nursing facilities that they will no longer be permitted to hire temporary nurse aides after June 6, 2022 due to the expiration of a CMS waiver related to the COVID-19 pandemic.  That waiver enabled nursing facilities to hire nursing assistants who had not yet passed the skills and written portions of the state nurse aide examination.  In addition, nurse aides hired under the waiver must pass the skills and written portions of the state nurse aide examination by October 6 or they cannot continue to work in that capacity.  Go here to read the letter explaining this change.
  • DOH has published its final set of proposed amendments to the state’s long-term-care facility regulations.  Learn more about the changes that have been proposed and the process DHS intends to use to move from proposed to final regulations from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the ninth consecutive week, rising seven percent, from a seven-day average of 3971 new daily cases on May 18 to 4238 new daily cases on May 25.
  • The seven-day average of COVID-19-related deaths tripled, from 12 to 36.
  • The growing number of COVID-19 cases in the state led to an 11 percent increase in COVID-19-related hospitalizations in the past week.
  • The number of these patients on ventilators, on the other hand, declined 19 percent over the past week while the number in hospital intensive care units rose 12 percent.
  • Sixty-four of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, leaving three counties experiencing “only” a substantial rate of community transmission.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published a new report on the number of cancer-related surgeries performed in Pennsylvania during the state’s 2021 fiscal year.  Go here to learn about the report and find a link to the report itself.

Stakeholder Events

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss upcoming changes.  Go here to register to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

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 “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

2022-05-27T20:41:50+00:00May 27th, 2022|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for Friday, May 27
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PA Health Policy Update for the Week of May 16-20

The following is an update of selected state health policy developments in Pennsylvania for the week of May 16-20, 2022.  (Some of the language used below is taken directly from state documents.)

Primary Election

Pennsylvania’s 2022 primary election was held on Tuesday, May 17.  State Senator Doug Mastriano secured the Republican nomination for governor and will face Attorney General Josh Shapiro, who ran unopposed for the Democratic nomination.  In upsets, it appears the Republican chairmen of the appropriations committees in the state House and Senate may have both lost their bids for renomination.  A complete list of the unofficial election results can be viewed here.  Please note that some races are still too close to call.

General Assembly

  • The state House and Senate will be in session next Monday (5/23), Tuesday (5/24), and Wednesday (5/25).
  • The House Insurance Committee will meet on Monday, May 23 at the “call of the chair” to consider House Bill 2585, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting a bid.
  • The Legislative Budget and Finance Committee will convene on Wednesday, May 25 at 9:00 a.m. to release a report on the impact of the Pennsylvania CARE Act.
  • The House Consumer Affairs Committee is scheduled to meet on Wednesday, May 25 at 10:00 a.m. to hold a public hearing on House Bill 2202, which addresses consumer data privacy.  The bill requires large organizations and personal information aggregators to share more information with consumers about what personal data they gather, track, and sell.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar for delivering Remittance Advice and corresponding checks and electronic transfers to extend into early July.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS), in cooperation with the Pennsylvania Commission on Crime and Delinquency, will award $130,000 in grants to support the training and use of crisis intervention teams throughout the state.  The grants are available to eligible Pennsylvania counties and municipalities to support new or expanded crisis intervention programs to support costs associated with training emergency and response personnel, certification of coordinators, and participation and completion of train-the-trainer curriculum.  Learn more from this notice.  Applications are due by June 28.
  • The consumer subcommittee of DHS’s Medical Assistance Advisory Committee has posted the minutes of its meetings of March 23 and April 27.

Department of Health

  • The Department of Health (DOH) has issued a health alert on Lyme disease and other tick-borne diseases, noting that it has identified recent sustained increases in tick bite-related emergency department visits in nearly all regions of the state.  The alert includes surveillance data, information about diagnosis and treatment, laboratory information, and more along with resources for further information and a link to a department webinar on the problem.  Learn more from this DOH health alert.
  • DOH has issued a health alert informing providers of the current iodinated contrast media shortage, explaining the situation, alternatives to using such media, ideas for conservation of supplies currently on hand, and links to additional resources.  Learn more from this DOH health alert.
  • DOH has issued a health alert to inform providers about monkeypox, the first case of which was recently diagnosed in the U.S.  The alert includes general guidance on the diagnosis and treatment of monkeypox, offers a link to additional information, and urges providers to report any cases they diagnose to DOH.  Learn more from this DOH health alert.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the eighth consecutive week, rising 26 percent, from a seven-day average of 3140 new daily cases on May 11 to 3971 new daily cases on May 18.
  • The seven-day average of COVID-19-related deaths (12) remains unchanged.
  • The growing number of COVID-19 cases in the state led to a 27 percent increase in COVID-19-related hospitalizations in the past week.
  • The number of these patients on ventilators rose 77 percent over the past week while the number in hospital intensive care units rose 40 percent.  Despite these significant increases, the actual numbers of patients on ventilators and in hospital ICUs is modest compared to earlier in the pandemic.
  • Fifty-seven of Pennsylvania’s 67 counties are experiencing high rates of community transmission of COVID-19.  Of the remaining 10 counties, three (Mifflin, Snyder, and Somerset) are experiencing a moderate rate and seven (Blair, Fayette, Fulton, Greene, Huntingdon, Jefferson, and Juniata) are experiencing a substantial rate of community transmission.

Stakeholder Events

DHS, Department of Health, Department of Veterans Affairs – PA Cares Training Summit – May 24

Pennsylvania’s departments of Human Services, Health, and Veterans Affairs, in cooperation with the five branches of the U.S. armed forces, will hold a “PA Cares Training Summit 2022” on Tuesday, May 24 at 8:00 a.m.  The event will focus on considerations that are needed to promote wellness in the lives of service members, veterans, and their families.  The target audience is professionals in the field and includes but is not limited to community mental health and substance abuse agencies, social workers, professional counselors, nurses, psychiatrists, psychologists, clergy/pastoral or spiritual practitioners, and the staff of Pennsylvania veterans centers.  Learn more about the event, its agenda, the presenters, and how to participate from this program announcement.  Participation is limited to the first 300 people who register.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – May 25

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

Department of Health – Statewide HIV Planning Group – May 25 and 26

The Department of Health’s Statewide HIV Planning Group will hold a public meeting in Harrisburg, on Wednesday, May 25 and Thursday, May 26 from 9:00 to 4:30 on both days.  The purpose of these meetings is to conduct an integrated prevention and care HIV planning process in which the Department of Health works in partnership with the community and stakeholders to enhance access to HIV prevention, care and treatment services.  Interested parties also may participate virtually.  For additional information, including the location of the meeting and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – May 26

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, May 26 at 10:00.  Go here to register to participate and go here to see the meeting’s agenda.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – May 26

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 reducing avoidable hospitalizations from nursing facilities by improving processes and outcomes for vaccination and immunization in nursing facilities.  The webinar is especially targeted to infection control nurses and medical directors of nursing facilities and managed care organizations.  The webinar will be held on Thursday, May 26 at 2:00.  For further information about the webinar and how to participate, go here.

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss upcoming changes.  Go here to register to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

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 “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

2022-05-20T21:20:50+00:00May 20th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for the Week of May 16-20
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PA Health Policy Update for the Week of May 9-13

The following is an update of selected state health policy developments in Pennsylvania for the week of May 9-13, 2022.  (Some of the language used below is taken directly from state documents.)

Primary Election

Pennsylvania’s 2022 primary election will be held on Tuesday, May 17.  Registered Republicans and Democrats will have an opportunity to select which candidates will represent their parties in the general election for local and statewide races, including governor, lieutenant governor, U.S. senator, U.S. representative, state senator, and state House representative.

General Assembly

The Joint State Government Commission issued a report this week regarding nurse licensure in the commonwealth.  House Resolution 142 directed the Joint State Government Commission to conduct a review of the State Board of Nursing, specifically the “authorization to test” process and how it might be improved.  Among other recommendations, the report highlights the need for additional staff at the state Board of Nursing, improved processing of licensure applications, and revision of the criminal background check process.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers of the addition of CPT codes M0222 and M0223 to the program’s fee schedule for the administration of the monoclonal antibody bebtelovimab for treatment of COVID-19 effective February 11, 2022.  Find that bulletin here.
  • DHS has published a Medical Assistance Bulletin to issue its 2022 immunization schedule for Medical Assistance beneficiaries ages 18 years or younger.  Find the bulletin here.
  • DHS has published a final notice of its funding allocation for FY 2022 for several classes of inpatient disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying inpatient acute-care general hospitals.  The funding allocation is for DSH and supplemental payments for inpatient care, critical access hospitals, burn centers, obstetric and neonatal services, academic medical centers, physician practice plans, autism intervention, and trauma centers.  DHS is not changing the qualifying criteria or payment methodology for these payments and the notice does not list allocations to individual recipients.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a flyer explaining how individuals and organizations can obtain doses of Naloxone, the life-saving medication used in the event of a suspected opioid overdose.
  • DHS has posted the minutes of the April 28 meeting of its Medical Assistance Advisory Committee.
  • The federal Centers for Medicare & Medicaid Services (CMS) has released a “State Health Official Letter” to provide guidance to states on coverage and payment for stand-alone vaccine counseling in Medicaid and CHIP.  In the letter, CMS explains that it is interpreting the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit to require the provision of stand-alone vaccine counseling to eligible beneficiaries.  This guidance links the mandatory COVID-19 vaccine and vaccine administration coverage and reimbursement under the American Rescue Plan with the health education requirement under Medicaid’s EPSDT benefit.  Learn more from the CMS letter to state health officials.
  • CMS has published its reassignment of Medicaid provider claims final rule.  This rule reinterprets the scope of the general requirement that state payments for Medicaid services must generally be made directly to the individual practitioner or institution providing services or to the beneficiary in the case of a class of practitioners for which the Medicaid program is the primary source of revenue.  Specifically, this final rule explicitly authorizes states to make payments to third parties on behalf of individual practitioners for practitioners’ health insurance and welfare benefits, skills training, and other benefits customary for employees if the individual practitioner consents to such payments on their behalf.  This rule is generally viewed as an effort to aid home health care workers.  See the final rule here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the seventh consecutive week – this week, significantly.  The state’s seven-day average of new cases rose 65 percent, from 1874 on May 5 to 3101 on May 12.
  • The seven-day average of COVID-19-related deaths rose from ten on May 6 to 12 on May 12.
  • The growing number of COVID-19 cases in the state has led to a large but not proportional increase in COVID-19-related hospitalizations:  after consecutive weeks of 22 percent increases in hospitalizations, COVID-19-related hospitalizations rose 24 percent in the past week.
  • The number of these patients on ventilators remained unchanged over the past week while the number in hospital intensive care units rose 14 percent.
  • The significant increase in the number of new COVID-19 cases in Pennsylvania has resulted in significant changes in the status of community transmission of the virus in the state’s 67 counties.  Currently, no counties are experiencing a low rate of community transmission and only four counties (Mifflin, Perry, Snyder, and Somerset) are experiencing a moderate rate; nine counties (Blair, Fayette, Franklin, Fulton, Greene, Huntingdon, Jefferson, Juniata, and Philadelphia) experienced a substantial rate of community transmission; and the remaining 54 counties are currently experiencing a high rate of community transmission of COVID-19.

Stakeholder Events

Department of Health – Health Research Advisory Committee – May 18

The Department of Health’s Health Research Advisory Committee will meet virtually on Wednesday, May 18 to hold a formal vote on upcoming priorities.  For information about how to participate in the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s 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 the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS, Department of Health, Department of Veterans Affairs – PA Cares Training Summit – May 24

Pennsylvania’s departments of Human Services, Health, and Veterans Affairs, in cooperation with the five branches of the U.S. armed forces, will hold a “PA Cares Training Summit 2022” on Tuesday, May 24 at 8:00 a.m.  The event will focus on considerations that are needed to promote wellness in the lives of service members, veterans, and their families.  The target audience is professionals in the field and includes but is not limited to community mental health and substance abuse agencies, social workers, professional counselors, nurses, psychiatrists, psychologists, clergy/pastoral or spiritual practitioners, and the staff of Pennsylvania veterans centers.  Learn more about the event, its agenda, the presenters, and how to participate from this program announcement.  Participation is limited to the first 300 people who register.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – May 25

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

Department of Health – Statewide HIV Planning Group – May 25 and 26

The Department of Health’s Statewide HIV Planning Group will hold a public meeting in Harrisburg, on Wednesday, May 25 and Thursday, May 26 from 9:00 to 4:30 on both days.  The purpose of these meetings is to conduct an integrated prevention and care HIV planning process in which the Department of Health works in partnership with the community and stakeholders to enhance access to HIV prevention, care and treatment services.  Interested parties also may participate virtually.  For additional information, including the location of the meeting and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – May 26

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, May 26 at 10:00.  Go here to register to participate.

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss upcoming changes.  Go here to register to participate.

2022-05-13T20:36:26+00:00May 13th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for the Week of May 9-13
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PA Health Policy Update for the Week of May 2-6

The following is an update of selected state health policy developments in Pennsylvania for the week of May 2-6, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The Center for Rural Pennsylvania, a legislative agency of the state’s General Assembly, has issued a report on access to mental health services in rural Pennsylvania that identifies barriers and challenges to obtaining mental health care in rural areas and offers proposals for addressing them, including expanding and funding telehealth services.  Learn more from the report “Access to Mental Health Services in Rural Pennsylvania.”

The House Democratic Policy Committee held an informational hearing this week examining the opioid epidemic.  Find the hearing’s agenda and testimony here.

Revenue Collection Update

Pennsylvania’s General Fund revenue collections in April totaled $6.5 billion, which is $1.8 billion, or 38.7 percent, above estimate.  Fiscal year-to-date General Fund revenue collections are $4.5 billion, or 12.4 percent, above estimate.  Governor Wolf issued a press release noting that April’s revenue collection was the most ever collected by the state in a single month.

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2022 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  Specifically, DHS intends to allocate $9.510 million in total funds for DSH payments to qualifying acute-care general hospitals that provide a high volume of services to the Medicaid population to promote continued access to inpatient and ancillary outpatient services and to support academic medical programs that provide integrated, patient-centered medical services; to allocate $5.917 million in total funds for DSH payments to qualifying acute-care general hospitals to promote the availability of professional medical services to Medicaid populations in less urbanized areas by supporting medical education and academic medical programs; and to allocate $40.163 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high percentage of Medicaid patients under 18 years of age.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to clarify its guidelines for the delivery of services via telemedicine through the Medical Assistance program’s fee-for-service delivery system.  The bulletin applies to all providers enrolled in the Medical Assistance program.  Providers rendering such services under the managed care delivery system should address coverage and payment questions for the delivery of services via telemedicine to the appropriate managed care organization.  Find the bulletin here.
  • DHS has shared presentations offered at the April 28 meeting of the Medical Assistance Advisory Committee (MAAC) by:
  • DHS has posted a draft file note of the April 14 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

Department of Health

The Department of Health has issued a health alert updating its vaccine recommendations for hepatitis A and B.

The Department of Health has issued a health alert about failure to disinfect assisted blood glucose monitors between uses posing a risk for blood-borne pathogen transmission.  The alert describes the problem, offers suggestions for how to prevent it, and points providers to resources for further information.  Find the alert here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the sixth consecutive week.  The state’s seven-day average of new cases rose eight percent, from 1734 on April 28 to 1834 on May 5.
  • The seven-day average of COVID-19-related deaths rose from nine on April 28 to 13 on May 5.
  • The growing number of COVID-19 cases in the state has led to a corresponding increase in COVID-19-related hospitalizations, with Pennsylvania experiencing a 22 percent increase in COVID-19-related hospitalizations for the second consecutive week.
  • While the number of these patients on ventilators rose 20 percent over the past week and the number in hospital ICUs rose 33 percent, the actual number of such patients remains modest in comparison to times earlier in the pandemic when the daily case counts were comparable.
  • During the past week 35 Pennsylvania counties, up from 22 last week, experienced high rates of community transmission of COVID-19; two counties, one fewer than last week, experienced a low rate of transmission; 21 counties, down from 22 last week, experienced a substantial rate of community transmission; and the remaining nine counties experienced a moderate rate.

Department of State

The Department of State has announced that the professional licensing waivers it issued under the COVID-19 disaster declaration will begin expiring in phases starting on May 23, with all waivers scheduled to expire by June 30.  Go here for a list of the department’s waivers and their expiration dates.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00.  To register to participate, go here.

Department of Human Services – Medical Assistance Advisory Committee Managed Care Delivery System Subcommittee – May 12

The managed care delivery system subcommittee of the Medical Assistance Advisory Committee will meet virtually on Thursday, May 12 at 10:00.  For an agenda for the meeting and information about how to participate, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 12

DHS’s 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 special population webinar on avoiding hospitalizations from nursing facilities on Thursday, May 12 at 2:00.  Recommended nursing home participants are admissions coordinators, directors of nursing, and social services staff.  For more information about the webinar and how to register, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s 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 the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS – Office of Medical Assistance Programs – Gun Violence Roundtable – date in May to be determined 

DHS’s Office of Medical Assistance Programs will convene a roundtable in May to discuss gun violence as a public health issue and to explore public health strategies that can be used by Medicaid managed care organizations to prevent and respond to gun violence.  A save-the-date will be sent out in the next week or so and the managed care organizations will be given a list of questions to come prepared to discuss.  An opportunity to present on current and planned initiatives, as well as challenges and limitations, will be offered to each managed care organization.

 

2022-05-06T20:29:10+00:00May 6th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for the Week of May 2-6
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PA Health Law Project Newsletter

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

Included in this month’s issue are articles about:

  • the extension of post-partum coverage for Medicaid-covered mothers to 12 months
  • changes in Community HealthChoices as a result of its shift to a new financial management services provider
  • a new option for Medicaid and SNAP beneficiaries to receive text messages from the state about their benefits
  • Medicare coverage of over-the-counter COVID-19 tests
  • a new requirement that Community HealthChoices plans operate complex care units

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

2022-04-29T19:20:23+00:00May 3rd, 2022|COVID-19, long-term care, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Law Project Newsletter
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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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