DSH hospitals Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for February 17

The following is an update of selected state health policy developments in Pennsylvania from February 11-17. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House of Representatives will convene for session on Tuesday, February 21 at 12:00 p.m. The state Senate is scheduled to return on Monday, February 27.

Department of Human Services

The fee-for-service subcommittee of the Department of Human Services (DHS) Medical Assistance Advisory Committee met on Wednesday, February 8. See the presentation made by Office of Medical Assistance officials during that meeting.
DHS’s Office of Long-Term Living offered a presentation during the February 14 meeting of the Medical Assistance Advisory Committee’s long-term services and supports subcommittee. Find that presentation here.
DHS has published a notice of its funding allocation for FY 2023 inpatient disproportionate share hospital (DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals; outpatient supplemental payments to qualifying inpatient acute-care general hospitals; direct medical education payments to qualifying inpatient acute-care general hospitals; and certain DSH and supplemental payments to new hospitals. It is not otherwise changing the qualifying criteria or payment methodology for these payments. These payments will amount to $257.76 million in total funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published a notice of its funding allocation for DSH payments to qualifying acute-care general hospital burn centers, to qualifying acute-care general hospitals providing obstetrical and neonatal services, to critical access and qualifying rural hospitals, and to qualifying acute-care general hospitals that treat a high percentage of Medical Assistance patients under 18 years of age. Together, the payments amount to $107.655 million in total state and federal funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published procedure codes and payment rates for the administration of the Pfizer and Moderna bivalent booster dose of the COVID-19 vaccines. Find the codes, the rates, and their effective dates in this Pennsylvania Bulletin notice.
DHS’s Office of Long-Term Living has informed stakeholders that the Centers for Medicare & Medicaid Services has approved renewal of the Community HealthChoices waiver, effective January 1, 2023, for five years. See the DHS message here.
DHS has published a notice announcing that it will increase fees in the Medical Assistance Program for certain ambulance transportation services in both the fee-for-service and managed care delivery systems, effective with dates of service on and after January 1, 2023. Those fees will be not less than $325 for basic life support ambulance transportation services, not less than $400 for advanced life support ambulance transportation services, and not less than $4 per loaded mile for each loaded mile beyond 20 loaded miles for ground ambulance transportation. Learn more from this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a health alert to providers advising them about a possible nation-wide increase in invasive group A streptococcal (iGAS) infections in children. This increase, however, reflects only a return to pre-pandemic levels. The alert includes information about the condition and offers guidance for clinicians and laboratories. Find the alert here.
DOH has published information about its Medical Care Availability and Reduction Error (MCARE) Act surcharge for FY 2023, a per unit assessment of approximately $156.56 payable by June 1. Learn more about the surcharge and the providers to which it applies from this Pennsylvania Bulletin notice.
DOH has published information about its Nursing Home Patient Safety Trust Fund surcharge for FY 2023. That surcharge will be $13.83 per nursing facility bed. Learn more from this Pennsylvania Bulletin notice.
DOH has published a list, as required by regulation, of hospitals that have chosen to exercise their religious or moral beliefs regarding the provision of certain contraception-related emergency services and will instead refer patients to other hospitals to receive such services. Learn more from this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week remained at the same levels as last week.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs declined 25 percent.
The CDC reports a six percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
For the week ending February 15, 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 – all the same numbers as last week.

Department of Drug and Alcohol Programs

In response to the continuing challenge health care providers are having maintaining an adequate workforce, the Department of Drug and Alcohol Programs is conducting a workforce climate survey among drug and alcohol service providers to learn about which jobs and positions are in short supply or understaffed, the challenges these providers face, what they are doing to address them, and how they think the state can help them address those challenges. Find that survey here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission has issued comments in response to regulations proposed by the State Board of Nursing that address licensure by endorsement and reactivation. Find those comments in this Pennsylvania Bulletin notice.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – February 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, February 22 at 1:00. Learn more from the meeting’s agenda and go here to register to participate.

DHS – Medical Assistance Advisory Committee Meeting – February 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 23 at 10:00. For the meeting agenda go here and to register to participate go here.

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.

jsteinbock2023-02-17T21:42:53+00:00February 17th, 2023|COVID-19, DSH hospitals, long-term care, Medicaid supplemental payments, Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

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

The Department of Human Services (DHS) has announced its intent to allocate $18.034 million in state and federal funds for FY 2023 Medicaid disproportionate share hospital payments (Medicaid DSH) to acute-care general hospitals that qualify as a trauma center. DHS also is amending the qualifying criteria and payment methodology for these payments for newly accredited trauma centers and hospitals seeking trauma center accreditation. See the announcement and learn more about the changes in the qualifying criteria and payment methodology in this Pennsylvania Bulletin notice. Public comments are due within 30 days.
DHS has issued a Medical Assistance Bulletin to inform providers about updates to the statewide Preferred Drug List (PDL) that take effect on January 9. Find the bulletin here.
DHS 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:
DHS has posted guidance for providers on procedure code/modifier combinations to be used when requesting home accessibility durable medical equipment and durable medical equipment repairs in the Medicaid fee-for-service program. Find the instructions here.
DHS is updating the Medical Assistance fee schedule for disposable breast milk collection and storage bags and breast pump replacement supplies. Learn about the new fees and new procedure codes to accompany them from this Pennsylvania Bulletin notice.
Beginning on December 16, providers will find a new question on the electronic provider enrollment application: “Will your provider agency be rendering Personal Care Services or Home Health Care Services that are subject to EVV [electronic visit verification]?” DHS has posted information for providers about what this question means and how they should approach answering it.

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.

jsteinbock2022-12-09T21:00:26+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

PA Health Policy Update for Friday, October 7

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

Behavioral Health Commission for Adult Behavioral Health

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

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

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

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

Department of Human Services

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

Department of Health

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

COVID-19: By the Numbers

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

Monkeypox

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

Pennsylvania Health Care Cost Containment Council (PHC4)

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

Centers for Medicare & Medicaid Services

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

Stakeholder Events

DHS – Long-Term Care Workforce Motivation – October 13

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

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

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

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

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

DHS – Medical Assistance Advisory Committee – October 27

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

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

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

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

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

jsteinbock2022-10-07T21:24:30+00:00October 7th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

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.

jsteinbock2022-05-13T20:36:26+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

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 – 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.

jsteinbock2022-05-06T20:29:10+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

PA Health Policy Update for the Week of January 24-28

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

General Assembly

The General Assembly enacted House Bill 253 (Act 2), providing $225 million in federal American Rescue Plan funding to support health care professionals on the frontlines of the COVID-19 pandemic in hospitals and behavioral health care facilities. The breakdown of the funding is as follows:
- $100 million for one-time payments to hospitals for making retention and recruitment payments to qualified staff.
- $110 million for one-time payments to behavioral health providers, critical access hospitals, and high Medical Assistance hospitals for making retention and recruitment payments to qualified staff.
- $15 million to be used by the Pennsylvania Higher Education Assistance Agency (PHEAA) to fund the Pennsylvania Student Loan Relief for Nurses Program.

A press release issued by Republican leaders of the General Assembly that quotes several health systems can be found here. A press released issued by Governor Wolf can be found here.

The Senate passed Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program. The bill was received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee.
The Senate Health and Human Services Committee convened this week and favorably reported the following bills.
- Senate Bill 152, which provides direction to the Department of Human Services on how to distribute funding intended for women’s health and family planning services.
- Senate Bill 956, a constitutional amendment that clarifies that there is not a right to an abortion or abortion funding in the state constitution.
- House Bill 1420, which directs the Department of Human Services to establish a public awareness campaign to provide information about the programs and services available for first responders, health care workers, and other frontline workers suffering from mental health issues related to the COVID-19 pandemic.

The Senate Aging and Youth Committee favorably reported the following bills this week.
- Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances.
- House Bill 996, which requires the departments of Human Services and Health to establish protocols to permit residents of long-term-care facilities to receive visits by a member of the clergy during a disaster emergency.
- House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

The House Professional Licensure Committee convened and favorably reported the following bills this week.
- House Bill 19, which establishes professional licensure for behavioral analysts.
- House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
- House Bill 1862, which preserves the COVID-19 regulatory waiver that authorizes physicians with an institutional license in a teaching hospital to serve patients at more than just two facilities in a health system.

Department of Human Services

The Department of Human Services (DHS) has mailed letters to hospitals potentially eligible for FY 2021-22 OB/NICU DSH payments requesting verification of their current licensure status. Courtesy electronic notification also was sent to contacts on file on January 26. To verify that they meet the criteria for inclusion in the payment program, hospitals must sign and return the attestation form to RA-pwdshpymt@pa.gov by Friday, 2/25/22. Any Pennsylvania hospitals that are currently licensed to provide obstetric or neonatal services and did not receive a notification should contact DHS at RA-pwdshpymt@pa.gov.
DHS has issued a Medical Assistance Bulletin to inform pharmacies of the addition of procedure code S5001 to the Medical Assistance Program fee schedule for dispensing oral antiviral treatments with FDA emergency use authorization for the treatment of COVID-19
and providing instructions for pharmacies on how to submit claims for dispensing these treatments. Learn more in this Medical Assistance Bulletin.
DHS has announced that it will add Aduhelm (aducanumab) and complement inhibitors to the Medical Assistance Program’s list of services and items requiring prior authorization.
DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report.” The new report includes the first look at October 2021 Medicaid managed care enrollment data.

Department of Health

The Department of Health (DOH) has posted a notice on its message board that it will provide direct access to COVID-19 therapeutics to residents of long-term-care facilities. With the recent approval of oral antiviral medications for COVID-19 (Pfizer’s Paxlovid and Merck’s molnupiravir), DOH is holding product in strategic reserve for residents of long-term-care facilities and others in congregate care settings. Paxlovid and molnupiravir are authorized for use in individuals who test positive for COVID-19 and are at high-risk for severe disease progression. Upon receipt of a request for medication, supply permitting, DOH will ship the product the same day or the next day to the requesting facility. Due to the nature of the medications, this product is only appropriate for residents within five days of the onset of symptoms. Go here to request these oral antiviral medications from DOH.
DOH has issued an update of its recommendations for return to work for health care workers with confirmed or suspected COVID-19.
DOH has updated its guidance on work restrictions for health care workers who have been exposed to COVID-19.
DOH has announced changes to hospitalization data reporting on its Corvena platform to align with federal reporting requirements. The new data fields must be completed beginning February 2 and daily thereafter. Click here to download a Word file announcing these changes and download the Corvena data dictionary here (Excel).
DOH has deployed the first state-directed health care strike team to Grand View Health in Bucks County. The team includes 10 registered nurses provided through GHR Healthcare under a contract with the Department of Health. Learn more about the strike team concept and how it works and what this group will do at Grand View Health in this Department of Health news release.
DOH has introduced two new resources to help skilled nursing facilities encourage their residents and staff to receive COVID-19 vaccines and boosters: a document on best practices and a vaccine and booster fact sheet.
DOH has adopted the new federal CDC standard for blood lead reference value (BLRV) from 5 μg/dL to 3.5 μg/dL. The department explains why it adopted this new standard and what it means in this health advisory notice.

COVID-19: By the Numbers

Daily COVID-19 case counts remain very high but fell significantly over the past week. Pennsylvania’s seven-day average yesterday (January 27) was 14,025 cases a day; a week ago (January 20) its seven-day average was 20,958 cases a day.
The number of new COVID-19-related deaths also remains very high and it rose over the past week. Pennsylvania’s seven-day average yesterday (January 27) was 166 deaths a day; a week ago (January 20) its seven-day average was 120 deaths a day.
The Department of Health reports that 27.8 percent of all staffed adult ICU beds are COVID-19 patients, down from 31.8 percent last week, and 31.3 percent of all ventilators state-wide are in use, down from 32.4 percent last week.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The decline in the number of new COVID-19 cases is reflected in a 9.9 percent decline over the past week in the number of Pennsylvanians hospitalized with the virus. The number of people on ventilators fell 15.1 percent over the past week and the number in ICUs fell 19.7 percent.
Media reports are mixed but suggest reason for optimism. Around the state,

Stakeholder Events

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m. Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m. The purpose of this 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 acting secretary on matters relating to the administration of this fund. Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Go here to participate or join by phone at 1-408-418-9388.

Traumatic Brain Injury Advisory Board – February 4

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, February 4 at 10:00 a.m. For information about the board, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan. The meeting will be held by phone. For information about how to participate, see this Pennsylvania Bulletin notice.

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m. Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

jsteinbock2022-01-28T22:39:08+00:00January 28th, 2022|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of December 13-17

The following is an update of selected state health policy developments in Pennsylvania for the week of December 13-17, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration requested support from the Federal Emergency Management Agency (FEMA) for Pennsylvania’s health care system in its continued battle against COVID-19. In particular, it has asked for staffing support for clinical and non-clinical professionals and continued pandemic response support. Learn more from this Wolf administration news release.

General Assembly

The Senate unanimously passed House Bill 1260, which expands eligibility for the PACENET prescription program from $27,500 to $33,500 for single individuals and from $35,500 to $41,500 for married couples. The bill has been sent to the governor.
The House Health Committee held an informational hearing on Monday to discuss the various COVID-19 treatment options available. House Bill 1741, which provides for prescribing and dispensing to treat COVID-19 off-label drugs approved by the FDA for other purposes, received a considerable amount of attention during the hearing. Chairman Kathy Rapp indicated the committee may move the bill in early 2022. You can view a recording of the hearing here.
The Senate Health & Human Services Committee convened on Tuesday and favorably reported the following bills:
- Senate Bill 200, which expands early intervention services for infants and mothers;
- Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health;
- Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning;
- Senate Bill 848, which creates a chief nursing officer position in the Department of Health;
- Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board;
- Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception; and,
- House Bill 118, which establishes requirements for the final disposition of fetal remains.

You can view the committee’s agenda and a video recording here.

The House Human Services Committee held an informational hearing on House Bill 1644 on Thursday. The bill directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner. The Human Services Committee also held an informational hearing on community participation supports during COVID-19 pandemic. You can view a recording of the hearing here.
The state House and Senate appropriations committees released their FY 2023 budget hearing schedules. The schedules can be viewed here.

Department of Human Services

The Department of Human Services (DHS) has updated its schedule for Remittance Advices, adding January dates and pay dates that go into early February. Find it here.
DHS has published a notice in the Pennsylvania Bulletin announcing its intention to allocate funds in FY 2021-2022 for several classes of Medicaid inpatient disproportionate share hospital (Medicaid DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals. The department does not intend to otherwise change the qualifying criteria or payment methodology for these payments. The allocations include:
- $1.057 million in total funds for DSH payments to qualifying acute-care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue, and are located in an area of the state with a disproportionate need for Medicaid services
- $1.585 million for DSH payments to qualifying acute-care general hospitals to promote access to acute-care services for Medicaid-eligible persons in less urban areas
- $18.293 million for DSH payments to Medicaid-enrolled acute-care general hospitals that qualify as a trauma center
- $111.585 million for DSH payments to qualifying Medicaid-enrolled acute-care hospitals that promote access to comprehensive inpatient services for Medicaid-eligible persons by providing an adequate supply of health care professionals who have been trained in high-volume Medicaid-enrolled hospital settings
- $9.377 million for DSH payments to qualifying acute-care general hospital burn centers
- $14.119 million for DSH payments to qualifying acute-care general hospitals providing obstetrical and neonatal services
- $0.500 million for DSH payments to qualifying teaching hospitals that provide psychiatric services to Medicaid beneficiaries
- $34.356 million for DSH payments to critical access and qualifying rural hospitals
- $0.695 million for DSH payments to qualifying acute-care general hospitals that provide surgical services to patients with cleft palate and craniofacial abnormalities
- $0.737 million for DSH payments made to qualifying Medicaid-enrolled acute-care general hospitals that provide a high volume of inpatient services to Medicaid-eligible and low-income populations
- $4.333 million for DSH payments to qualifying acute-care general hospitals that qualify as academic medical centers
- $23.946 million for DSH payments to qualifying acute-care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals
- $7.397 million for DSH payments to qualifying acute-care general hospitals that participate in an academic medical program
- $5.290 million for supplemental payments to qualifying acute-care general hospitals that provide medical and surgical ocular services to Medicaid beneficiaries
- $0.900 million for supplemental payments to qualifying acute-care general hospitals that provide a substantial portion of their inpatient services to Medicaid beneficiaries

Learn more from this Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization. Find the bulletin here.
DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization. Find the bulletin here.

Department of Health

Department of Health (DOH) acting secretary Alison Beam will leave that job at the end of the year. She will be replaced by department deputy secretary Keara Klinepeter. Learn more from this Wolf administration news release.
DOH announced that the state is opening free outdoor drive-up COVID-19 testing sites in Berks, Blair, Centre, Clinton, Jefferson, Luzerne and McKean counties. For locations and hours, see this department news release (and this separate notice for the site in Blair County).
DOH has introduced a new “post-vaccination data” web page on which it will provide data on so-called breakthrough cases of COVID-19: cases, hospitalizations, and deaths. The web page reports that from January 1 through December 6, 2021, 85 percent of reported COVID-19 cases in Pennsylvania were in unvaccinated or not fully vaccinated people; 87 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 86 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people. For additional information and a more detailed breakdown of these and other numbers, see the department’s new post-vaccination data web page.
DOH has posted a notice on its message board about the transition from the Regional Congregate Care Teams to a new program that will support response operations at long-term-care facilities that experience COVID-19 outbreaks. Find that message here.
The Independent Regulatory Review Commission (IRRC) has issued its comments on DOH’s proposed amendments of regulations governing long-term-care facilities. In addition to specific comments, the IRRC stated its agreement with many others in the regulated community that have urged DOH to reevaluate its approach of promulgating several packages of proposed regulations and instead consider submitting a comprehensive regulatory update regarding long-term care. Find the IRRC comments in this Pennsylvania Bulletin notice.
DOH has issued its monthly report detailing its nursing home inspection and sanction activities. Learn more from this department news release and the department’s November report.

COVID-19: By the Numbers

Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic. To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths remains high.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19 has risen 18 percent since December 1; the number in hospital ICUs because of COVID-19 has risen 13 percent; and the number on ventilators because of the virus has risen 16 percent since the start of the month.
This situation is reflected in the high rate of occupancy in the state’s hospitals. There currently are only 484 unoccupied adult ICU beds – 13.7 percent of the total of such beds in the state; 2106 unoccupied medical/surgical beds – 10.5 percent of such beds in the state; 34 pediatric ICU beds (9.0 percent); 191 pediatric beds (16.8 percent); and 938 airborne isolation beds (29.6).
Media reports confirm the challenges some communities and hospitals are facing, including this story in the Philadelphia Inquirer; a situation that the director of the 911 call center in Westmoreland County calls “desperate;” and reported capacity and hospital discharge problems in western and rural Pennsylvania.
DOH reports that 6.8 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters. Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that 186,000 boosters have been administered to city residents since August 13.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published Hospital Performance Report – 2020 Data, which presents volume and outcome information about a variety of medical conditions and surgical procedures performed by the state’s general acute-care hospitals. Learn more from the following resources:

a PHC4 summary of the report
the agency’s presentation of key findings
links to specific types of medical conditions and procedures
data on Medicare payments for specific treatments and procedures

jsteinbock2021-12-17T22:37:32+00:00December 17th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of December 6-10

The following is an update of selected state health policy developments in Pennsylvania for the week of December 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate Democratic Policy Committee held an informational hearing this week on substance use disorder treatment facilities. The hearing was co-hosted by senators Schwank, Tartaglione, and Muth. Panelists included individuals affected by the addiction crisis, treatment providers, and the Department of Drug and Alcohol Programs. Testimony offered at the hearing and a video recording may be found here.

The state House and Senate will return to session next week. The following are the relevant health committee hearings currently scheduled.

The House Health Committee has scheduled a hearing on Monday, December 13 at 9:00 a.m. to discuss COVID-19 treatment options. Chairman Kathy Rapp has indicated the committee will examine House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat COVID-19.
The Senate Health & Human Services Committee is scheduled to convene on Tuesday, December 14 at 11:00 a.m. to consider, among other bills, Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health; Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning; Senate Bill 848, which creates a chief nursing officer position in the Department of Health; Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board; and Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception. The committee also will consider House Bill 118, which establishes requirements for the final disposition of fetal remains.
The House Human Services Committee has scheduled an information hearing on House Bill 1644 for next Thursday, December 16 at 9:30 a.m. House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner. The Human Services Committee also has scheduled an 11:00 a.m. hearing to examine community participation supports during COVID-19 pandemic.

Department of Human Services

The Department of Human Services (DHS) has updated its list of regulations that have been suspended to facilitate the state’s response to the COVID-19 emergency. Find the updated list here.
The federal Centers for Medicare & Medicaid Services (CMS) has written to state Medicaid directors to encourage them to take advantage of a provision in the American Rescue Plan that authorizes their programs, beginning on April 1, 2022, to provide 12 months of postpartum Medicaid coverage to pregnant women enrolled in either their Medicaid or CHIP programs. Learn more from the CMS letter to state Medicaid directors. Pennsylvania announced in August that it would extend this coverage.
CMS has sent a letter to state Medicaid directors to help them understand provisions in the Consolidated Appropriations Act of 2021 that include new reporting requirements for non-disproportionate share hospitals (DSH) supplemental payments and a change in the methodology for calculating hospital-specific DSH limits. See that letter here.
DHS has issued a news release elaborating on Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act. This funding will support Medicaid’s home and community-based services system throughout the state. Learn more from this DHS news release.

Department of Health

The Department of Health (DOH) has issued a seasonal influenza update urging providers to encourage their patients to receive flu vaccines, offering treatment recommendations, and reminding providers that they are required to report flu cases to the state. Learn more in this department influenza update and reminder health alert.
DOH has updated two health alerts, PA-HAN-609 and PA-HAN-610, to clarify that the visitation guidance from the department applies only to skilled nursing facilities and that other types of facilities, such as personal care homes, assisted living facilities, and intermediate-care facilities, should seek guidance from their licensing agencies when it comes to COVID-19 visitation policies.
DOH has distributed communication that it received from the Centers for Medicare & Medicaid Services informing states that the federal government will not be enforcing the health care provider vaccination mandate while federal litigation is pending.

COVID-19: By the Numbers

Daily COVID-19 case counts remain near their highest levels since the beginning of the pandemic. To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths also remains high.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus all rose sharply in the past week.
These numbers reflect the growing rate of occupancy in the state’s hospitals. There currently are only 481 unoccupied adult ICU beds – 13.5 percent of the total of such beds in the state; 2019 unoccupied medical/surgical beds – 10 percent of such beds in the state; 29 pediatric ICU beds (7.7 percent); 234 pediatric beds (20.8 percent); and 919 airborne isolation beds (29.1).
Media reports confirm the challenges some communities and hospitals are facing, including this report on the situation at the nine hospitals that constitute Geisinger Health; this report on the situation in Allegheny County; this report on the situation in the Erie area; and this report on the situation throughout Pennsylvania.
The Department of Health reports that 6.7 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters. Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that nearly 170,000 boosters have been administered to city residents since August 13.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has established minimum qualifications for the positions of project director, facility director, clinical supervisor, counselor, and counselor assistant but these regulations permit persons to meet those qualifications with a degree in an “other related field.” In Licensing Alert 03-2021 the department lists “other related fields” that meet qualifications and notes that this list is not necessarily all-inclusive and that the department will review those degrees on a case-by-case basis. Find the licensing alert here.

The Department of Drug and Alcohol Programs has published its long-delayed, much discussed final standards for drug and alcohol recovery house licensure. Find them in this Pennsylvania Bulletin notice.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published its annual report on the financial performance of the state’s non-general acute-care hospitals, including rehabilitation hospitals, psychiatric hospitals, long-term acute-care hospitals, and specialty hospitals. Learn more from this PHC4 news release and the report itself. PHC4 also offers download data from the report in Excel format.

jsteinbock2021-12-10T21:44:43+00:00December 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

PA Health Policy Update for the Week of November 29-December 3

The following is an update of selected state health policy developments in Pennsylvania for the week of November 29 to December 3, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced a plan to spend approximately $1.2 billion in American Rescue Plan Act federal funding to support Medicaid’s home and community-based services (HCBS) system, giving more Pennsylvanians access to critical services in their communities. This temporary funding enhancement will be directed toward Medicaid-funded essential care services to seniors, adults with intellectual and physical disabilities, adults with behavioral health needs such as substance use disorder or mental illness, and children with chronic complex medical needs. The American Rescue Plan Act provides states with a temporary, one-year, 10 percent increase in the rate at which the federal government matches state spending for certain Medicaid-covered home and community-based services. To learn more about how Pennsylvania plans to spend this money, see this Wolf administration news release. For more on Pennsylvania’s plan, go here. A week after this announcement, the federal government approved the state’s plan for using this money, as the Department of Human Services reported to stakeholders.

General Assembly

The House Republican Policy Committee held a hearing this week examining the health care staffing crisis. Representatives from the Hospital & Healthsystem Association of Pennsylvania (HAP), Penn State Health, Geisinger, the Pennsylvania Health Care Association (PHCA), SEIU Healthcare, and the Pennsylvania State Nurses Association testified. Hearing testimony and a video recording may be viewed here.

Two members of the General Assembly – House majority leader Kerry Benninghoff (R-Mifflin) and Representative Mark Gillen (R-Berks) – have tested positive for COVID-19.

State Revenue Update

Revenue collections continue to exceed estimates. The Department of Revenue reported this week that Pennsylvania collected $6.6 billion in General Fund revenue in November, which was $217.9 million, or 3.4 percent, more than anticipated. For the year to date Pennsylvania has collected $18.7 billion in General Fund revenue, which is $1.0 billion, or 5.7 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin explaining that it intends to allocate $106.130 million in total funds for disproportionate share hospital payments (Medicaid DSH payments) to qualifying acute-care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the state and $88.994 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms. Go here to see the Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin updating its dental fee schedule. The update is effective as of August 23, 2021.

Department of Health

The state Supreme Court has temporarily restored the Department of Health’s (DOH) order requiring students, teachers, and staff to wear masks in Pennsylvania school districts. Read the court’s ruling here. The ruling only put a hold on Commonwealth Court’s decision to issue a stay of the order; the Supreme Court will still need to consider the governor’s appeal of the Commonwealth Court decision.

DOH has established new walk-in COVID-19 testing sites in Berks, Centre, Clinton, Crawford, Jefferson, and Susquehanna counties. Learn more from this news release.

COVID-19: By the Numbers

Daily COVID-19 case counts are on the rise in Pennsylvania. Wednesday’s 7606 new cases and Thursday’s 9143 new cases are the highest single-day totals in the state since the second week of January. To date, more than 1.75 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths remains high. To date, more than 33,000 Pennsylvanians have died from COVID-19.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which declined during the first two weeks of November, rose significantly during the last two weeks of the month. As the month came to a close, COVID-19 related hospitalizations were up 43 percent over the beginning of the month, ventilator cases were up 32 percent, and COVID-19 patients in hospital ICUs also were up 32 percent.
231,000 Pennsylvanians were recorded as completing a vaccine regimen during the month of November.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs released Policy Bulletin 21-05, which documents modifications to the Standard General Terms & Conditions, Fiscal and Operations Manual, and Substance Abuse Prevention and Treatment Block Grant (SAPTBG) provisions.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, December 8 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m. Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m. Go here for information about registering and participating.

jsteinbock2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of September 6

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The House of Representatives announced it will return to session a week early to address the Wolf administration’s implementation of a mask mandate for K-12 schools and child care facilities. The House, which was originally scheduled to return on September 27, has added September 20, 21, and 22 as voting session days.

Department of Health

The Department of Health has issued a health alert updating guidance about tuberculin skin testing for tuberculosis for individuals who have been vaccinated against COVID-19. The department no longer recommends waiting four weeks from the final COVID-19 vaccination for immune-based TB testing.
The Department of Health has published notices in the Pennsylvania Bulletin authorizing expanded scope of practice for various professionals functioning as part of an emergency medical services agency that has been licensed as a critical care transport ambulance service.
The Department of Health will offer free potassium iodide, or KI, tablets on Thursday, September 16 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants. Learn more from this department news release.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin announcing the addition of CPT codes 0003A and 0013A to the Medical Assistance Program Fee Schedule for the administration of a third dose of the Pfizer and Moderna COVID-19 vaccines. See the notice here.
The Department of Human Services has posted a notice announcing FY 2022 rates for selected services provided by the state’s Office of Mental Health and Substance Abuse Services (OMHSAS).
The Department of Human Services has announced that it will allocate $255.556 million in total funds in FY 2022 for inpatient disproportionate share hospital (Medicaid DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals, outpatient supplemental payments to qualifying inpatient acute-care general hospitals, and direct medical education payments to qualifying inpatient acute-care general hospitals. The department is not changing the state plan provisions addressing the qualifying criteria or payment methodology for these payments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has announced its intention to make COVID-19-related Medicaid DSH payments to qualified hospitals and how much it will pay hospitals based on their Medical Assistance days and their degree of Medicaid dependence. See the Pennsylvania Bulletin notice here.
The Department of Human Services is adding and end-dating procedure codes as a result of implementing the 2021 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The department also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance Program Fee Schedule, including fee adjustments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has published its latest monthly physical health managed care enrollment report. Find it here.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first report on the performance of its Pennsylvania Rural Health Model. Find that report here and go here for further information about the program.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained high this week, including the first day (today) with more than 5000 new cases since mid-April.
The number of new COVID-19-related deaths increased over the past week.
For the week ending September 9 in Pennsylvania, every county in the state is experiencing a high level of COVID-19 transmission. The CDC classifies transmission as follows:
- Low: 0-10 new cases per 100,000 residents over the past week or 0-5% positivity rate
- Moderate: 15-50 new cases per 100,000 residents over the past week or 5-8% positivity rate
- Substantial: 50-100 new cases per 100,000 residents over the past week or 8-10% positivity rate
- High: 100+ new cases per 100,000 residents over the past week or 10%+ positivity rate

The number of Pennsylvanians hospitalized because of COVID-19 has risen 17 percent since the beginning of the month, the number on ventilators has risen 14 percent, and the number in hospital intensive care units has risen 11 percent.
According to the state’s revised figures, 66.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.0 million people – up from 66.0 percent last week. Only 11,000 Philadelphians and 65,000 other Pennsylvanians (fewer than last week) completed a vaccine regimen in the past week.

Around the State

The Delaware County Board of Health is now hiring people to staff the county’s new health department, which is scheduled to begin operations in January, the Delaware County Times reports.
The city of Reading has been awarded $3.3 million by the federal government to remove lead paint from homes, according to the Reading Eagle.
The mayor of Scranton will propose legislation to the city’s council to decriminalize possession of fentanyl test strips, which are currently considered drug paraphernalia under state law. The Scranton Times-Tribune explains why.
Children ages 12 and under constituted 12 percent of Allegheny County’s COVID-19 cases in August, the county’s health director told the Pittsburgh Tribune-Review.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has rejected regulations proposed by the state’s Department of Drug and Alcohol Programs for the licensure or certification of drug and alcohol recovery houses that receive funds or referrals from the department or a federal, state, or other county agency to ensure that a drug and alcohol recovery house provides a safe environment for residents. See the commission’s explanation of its decision in this Pennsylvania Bulletin notice.

Stakeholder Events

The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm. Go here to register to participate remotely.
The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am. Go here to register to participate remotely.
The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

jsteinbock2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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