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PA Health Policy Update for April 4

The following is an update of selected state health policy developments in Pennsylvania from March 31 – April 4. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration has announced it joined a multi-state lawsuit against the Trump administration’s decision to cancel more than $500 million in public health grant funding that supported programs in the Department of Health, Department of Human Services, and the Department of Drug & Alcohol Programs. Find a copy of the lawsuit here and additional information in this press release.

General Assembly

The state Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity.

The Senate passed Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, by a vote of 38-11. The bill will now be sent to the House of Representatives for consideration.

The Senate Institutional Sustainability & Innovation Committee held an informational hearing on Tuesday, April 1 examining the commonwealth’s life science sector and Pennsylvania’s innovation economy. A recording of the hearing is and testimony offered to the committee is viewable here.

The Senate Health & Human Services Committee held a voting meeting on Tuesday, April 1 and favorably reported, among other bills, Senate Bill 115, which provides skills competency examination opportunities to individuals seeking employment as a direct caregiver in lieu of successfully obtaining a high school diploma or GED equivalency, and Senate Bill 411, which implements a statewide stroke registry.

The Senate has now recessed until Monday, May 5. The state House of Representatives will reconvene Monday, April 7 through Wednesday, April 9.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS is implementing an alternative payment methodology for federally qualified health centers (FQHCs) and rural health clinics (RHCs) for a supplemental payment at the Medicaid fee schedule rate for a long-acting reversible contraceptive (LARC) device and its insertion, or the removal of a LARC device.

DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death. Find the notice here.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $70.0 million, or 1.1 percent, more than anticipated. Fiscal year-to-date General Fund collections total $33.2 billion, which is $34.3 million, or 0.1 percent, below estimate.

Board of Pharmacy ission,

The State Board of Pharmacy has published a notice in the Pennsylvania Bulletin of the current income levels necessary for participation in the Cancer Drug Repository program.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin that it has received the following final form rulemaking which will be considered at its May 15 meeting.

IRRC has also published a notice in the Pennsylvania Bulletin announcing it has issued comments to the State Board of Nursing regarding its proposed rule on nursing education programs issued January 25, 2025. Find IRRC’s comments here.

Around the State

The Philadelphia Inquirer has published an article about Independence Blue Cross’, the largest health insurer in southeastern Pennsylvania, reported financial loss in 2024 due, in part, to Medicare and Medicaid rates.

Governor Shapiro’s decision to join a multi-state lawsuit against the Trump administration’s decision to cancel public health grant funding was reported by the Pennsylvania Capital-Star.

The Pennsylvania Capital-Star also published an article about the potential impact Medicaid cuts at the federal level may have on rural health care access.

Spotlight PA has published an article about the Department of Aging’s decision to revise a policy that previously required the tracking of the cause of death for every adult who died during an active abuse or neglect investigation.

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here.

PHC4 – Meeting Schedule

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Payment Data Advisory Group meeting for April 10 at 1:00 p.m., a Data Systems Committee meeting for April 15 at 10:00 a.m., an Education Committee meeting for April 23 at 10:00 a.m., and a Council meeting for May 1, 2025, at 10:00 a.m. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-04-04T20:41:43+00:00April 4th, 2025|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for February 28

The following is an update of selected state health policy developments in Pennsylvania from February 24 – 28. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro has announced that all $2.1 billion in Congressionally-appropriated federal funding identified in the administration’s lawsuit against the federal government has been unfrozen.

General Assembly

The state House of Representatives and Senate continued their hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.

The Department of Aging appeared before the Senate Appropriations Committee on Tuesday, February 25. A recording of that hearing is viewable here.

The Department of Aging also appeared before the House Appropriations Committee on Thursday, February 27. A recording of that hearing is viewable here.

The House of Representatives and Senate will continue budget hearings next week. The Department of Human Services will appear before the House Appropriations Committee on Tuesday, March 4 and the Senate Appropriations Committee on Wednesday, March 5. The House Appropriations Committee’s full hearing schedule is viewable here and the Senate Appropriations Committee’s full hearing schedule is viewable here.

The House Health Committee has scheduled an informational meeting next week on Monday, March 3 at 1:00 p.m. to explore the practice of community health workers. The meeting will be held in Room 60 of East Wing.

The House Human Services Committee has also scheduled a meeting for next week on Wednesday, March 5 at 10:00 a.m. in Room G-50 of the Irvis Building to consider the following bills.

House Bill 269, which requires the Department of Health, in consultation with the Department of Drug & Alcohol Programs, to develop opioid overdose public education materials.

House Bill 640, which updates the annual reporting requirements for the Department of Drug & Alcohol Protections.

House Bill 749, which requires the Department of Human Services to conduct a study of Pennsylvania’s SNAP payment distribution.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin announcing its intent to allocate funds in FY 2024-25 for a new supplemental payment to qualifying rural hospitals in a county of the fourth, fifth, six, seventh, or eighth class. The total amount of funding available (state and federal) is $36.7 million. Find additional details in the bulletin notice.

DHS has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of January.

DHS has published a Provider Quick Tip (176) to inform presumptive eligibility providers that the income guidelines used to determine presumptive eligibility for pregnant women have been updated effective January 1, 2025.

DHS has also issued an updated Provider Quick Tip (121) to remind all enrolled provider types who dispense hearing aid supplies to Medical Assistance (MA) beneficiaries to submit a copy of their renewed Department of Health certification to MA Provider Enrollment by March 16, 2025.

Department of Health

The Department of Health (DOH) has announced the 2024-25 MCARE surcharge letters and invoices will be emailed to nursing home administrators on or about March 3. Included in each email attachment will be a statement with the amount due to DOH by June 1, 2025.

Around the State

The Philadelphia Inquirer has published an article detailing the $20 million Crozer Health’s independent receiver, FTI Consulting, is receiving.

WESA in Pittsburgh has written an article about Medicaid cuts being considered in Congress and their potential impact on Pennsylvania. CBS News similarly covered this story.

Private equity’s role in the Pennsylvania and Philadelphia health care markets are the focus of an article published by WHYY.

Stakeholder Meetings

DHS – LTSS Subcommittee – March 7

The Department of Human Services (DHS) Medicaid Long-Term Services and Supports Subcommittee will hold a public meeting on Thursday, March 7 at 10:00 a.m. The meeting is being held virtually. Find additional information and details on how to participate here.

PA Safety Net Admin2025-02-28T21:58:30+00:00February 28th, 2025|Financial, Governments, Meetings and notices|Comments Off

PA Health Policy Update for December 6

The following is an update of selected state health policy developments in Pennsylvania November 25 – December 6. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration has held two recent roundtable discussions with maternal health stakeholders to inform the development of the administration’s Maternal Health Strategic Plan, which will address high rates of maternal mortality and ensure pregnant women in Pennsylvania receive necessary prenatal and postpartum care. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate have released their respective 2025 session calendars. Find the House’s calendar here and the Senate’s calendar here.

Department of Human Services

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of October.

Department of Health

The Department of Health (DOH) has released a Respiratory Virus Outbreak Toolkit for long-term care facilities, including personal care homes and assisted living residences. The purpose of the toolkit is to provide recommendations for facilities before and during a respiratory virus outbreak.

DOH has published guidelines and fees that a health care provider or facility may charge in response to a request for production of medical charts or records. Find additional information in this Pennsylvania Bulletin notice. This notice updates the prior notice published on December 9, 2023.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in November, which was $87.2 million, or 2.9 percent, less than anticipated. Fiscal year-to-date General Fund collections total $16.4 billion, which is $9.9 million, or 0.1 percent, below estimate.

Around the State

With the conclusion of the 2023-2024 legislative session, City & State Pennsylvania has published an article highlighting the session’s accomplishments, as well as its unfinished business.

NBC’s local affiliate 21 WFMJ has reported on efforts to keep Sharon Regional Medical Center open.

Spotlight PA has published an article about the range of health care workers who provide maternal care in Pennsylvania and their various roles.

Stakeholder Events

Patient Safety Authority – December 12

The Patient Safety Authority Board will meet on Thursday, December 12 at 1:00 p.m. The meeting will be held virtually. Find details on how to participate here and a draft agenda here.

Department of Aging – Pharmaceutical Assistance Board – December 16

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 16 from 2:00 to 3:30 p.m. For connection information or any questions, please contact Megan McDaniel (memcdaniel@pa.gov).

PA Safety Net Admin2024-12-06T20:21:33+00:00December 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for November 1

The following is an update of selected state health policy developments in Pennsylvania October 28 – November 1. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro signed the following bills into law this week.

House Bill 1608, now known as Act 115 of 2024, which extends Medicaid coverage to doula services and creates a doula advisory board.
House Bill 2185, now known as Act 117 of 2024, which requires the Department of Health to develop type 1 diabetes informational materials for parents and guardians.
House Bill 2381, now known as Act 119 of 2024, which enables the licensing boards or commissions under Department of State to promulgate one-time, temporary regulations necessary for the implementation of each licensure compact enacted by the General Assembly.
Senate Bill 365, now known as Act 121 of 2024, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage.
Senate Bill 920, now known as Act 122 of 2024, which establishes a statewide sexual assault evidence tracking system.
Senate Bill 267, now known as Act 134 of 2024, which adds urgent care centers to the list of safe haven locations for newborn children.
Senate Bill 1080, now known as Act 137 of 2024, which allows licensed practical nurses to make death pronouncements in the hospice setting.

General Assembly

The state House of Representatives and Senate are currently recessed until after the November 5 General Election.

Department of Human Services

The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2024-2025 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance enrolled, qualifying inpatient general acute care hospitals. DHS does not intend to change the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has published its proposed Psychiatric Residential Treatment regulations in the Pennsylvania Bulletin. These proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

DHS has published a Medical Assistance Bulletin with updates to the PROMISe™ Provider Handbook 837 for Medical Assistance enrolled federally qualified health centers (FQHCs) and rural health clinics (RHCs).

The Office of Medical Assistance Programs (OMAP) has announced it will be hosting several upcoming community health worker (CHW) listening sessions throughout November and December in order to gather information that will help DHS’ strategic plan for CHWs. Find a schedule of the listening sessions as well as details on how to participate here.

DHS has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule and Coding Matrix. This bulletin applies to all providers enrolled in the Medical Assistance program who provide EPSDT screens for Medical Assistance beneficiaries.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on October 24.

Insurance Department

The Pennsylvania Insurance Department has published a notice in the Pennsylvania Bulletin that the Medical Care Availability and Reduction of Error (MCARE) assessment for all basic insurance coverage and self-insured participating health care providers for calendar year 2025 will be 29 percent applied to the prevailing primary premium for each participating health care provider.

Board of Medicine

The State Board of Medicine has published its final-form rulemaking related to licensure by endorsement. The regulations are effective upon publication in the Pennsylvania Bulletin. Find the final-form regulations here.

Office of the Attorney General

The Office of the Attorney General (OAG) has filed a civil suit against Prospect Medical Holdings, which owns Crozer Health System, over breach of contract. OAG has alleged Prospect has broken its 2016 court-approved “asset purchase agreement” by closing facilities and diverting funding from the sale of real estate to shareholders and investors. The lawsuit seeks a preliminary injunction to preserve Crozer’s existing services, and the appointment of a receiver to manage the Crozer Health System until another buyer can be identified. Find additional details in this press release.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate.

Around the State

Spotlight PA has published an article written by Stephen Caruso about a slate of bills to improve maternal health care in Pennsylvania.

WHYY has written an article about Attorney General Michelle Henry’s decision to sue Prospect Medical Holdings over Crozer Health System.

City & State Pennsylvania has published an article about Pennsylvania’s health insurance marketplace, Pennie, as the open enrollment period nears.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – November 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, November 7. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – November 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Planning Committee – November 20

The Statewide HIV Planning Committee will hold public meetings at the Hilton Harrisburg (One North 2nd Street, Harrisburg, PA 17101) on Wednesday, November 20 from 9:00 a.m. to 5:00 p.m. and on Thursday, November 21 from 9:00 a.m. to 4:30 p.m. The meeting will also be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Spinal Cord Research Advisory Committee – November 18

The Spinal Cord Research Advisory Committee will hold a public meeting on Monday, November 18 from 10:30 a.m. to 11:30 a.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-11-01T20:14:07+00:00November 1st, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for October 18

The following is an update of selected state health policy developments in Pennsylvania October 14 – 18. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro has signed the following bills into law this week.

House Bill 155, now known as Act 96 of 2024, removes the requirement that direct care workers be interviewed in-person for a position.
House Bill 2084, now known as Act 101 of 2024, establishes a license for prescription drug virtual manufacturers.
House Bill 2127, now known as Act 102 of 2024, allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources.
Senate Bill 668, now known as Act 109 of 2024, permits certified nurse aides to become certified medication aides in long-term care facilities, assisted living residences, and personal care homes.
Senate Bill 840, now known as Act 111 of 2024, creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.

General Assembly

The state House of Representatives and Senate are scheduled to return to Harrisburg on Monday, October 21 for session. This is the last scheduled session week prior to the November 5 General Election.

The House Children & Youth Committee will meet on Tuesday, October 22 at 10:00 a.m. in Room 515 of the Irvis Office Building to consider House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system.

The House Children & Youth Committee will also meet on Wednesday, October 23 at 10:00 a.m. in Room 515 of the Irvis Office Building for an informational meeting the CCAP Complex Case Task Force report and the DHS Blueprint report.

The Senate Aging & Youth and Banking & Insurance Committees will hold a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. The meeting will be held in Hearing Room 1 of the North Office Building.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that DHS will continue the alternative payment methodology and pay the Medical Assistance (MA) program fee schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit.

DHS has shared the agenda for the next Medical Assistance Advisory Committee (MAAC) meeting on Thursday, October 24. Find additional details on how to participate in Stakeholder Events below.

DHS has changed the provider application URL domain name. The new URL is: https://promise.dhs.pa.gov/portal/provider/Home/tabid/135/Default.aspx.

Department of Health

The Department of Health (DOH) has reminded long-term care providers that its annual questionnaire of long-term care facilities must be completed and submitted to the department electronically by Friday, October 25, 2024. Any questions regarding the questionnaire may be directed to RA-dohbhssurveys@pa.gov.

Around the State

Spotlight PA published an article about the increasing number of long-term care facility closures in the commonwealth.

Pennsylvania pharmacists are receiving less money for drugs dispensed to Medicaid patients, the Pennsylvania Capital-Star reports.

Stakeholder Events

DHS – Consumer Sub-MAAC – October 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 23 at 1:00 p.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DHS – Medical Assistance Advisory Committee – October 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 24 at 10:00 a.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-10-21T20:36:11+00:00October 18th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20. (Some of the language used below is taken directly from state documents).

Governor Shapiro

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release.

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.

The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.

The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice.

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here.

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State

Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.

The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.

The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field.

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for September 6

The following is an update of selected state health policy developments in Pennsylvania from September 2 – 6. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives has changed September 23, 24, and 25 to non-voting session days and added October 7, 8, and 9 as voting session days.

The House and Senate are currently recessed until Monday, September 30 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding new procedure codes based on clinical review, provider requests, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the FDA. DHS is also making changes to prior authorization requirements as a result of clinical review. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced updates to the Family Planning Services program fee schedule, effective for dates of service on and after July 1, 2024. Find additional information, including the procedure codes, in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has announced it is conducting its annual questionnaire of long-term care facilities for the data reporting period of July 1, 2023 through June 30, 2024. The mandatory questionnaire must be completed and electronically submitted to DOH by Friday, October 25. If a long-term care facility did not receive an email on September 4^th with a link to the questionnaire, please contact Aicha Hassane Noma at ahassaneno@pa.gov or email RA-dohbhssurveys@pa.gov.

Secretary of Health Dr. Debra Bogen visited the Meadville Area Ambulance Service this week to discuss the administration’s ongoing emergency medical services (EMS) recruitment and retention efforts and other investments in EMS professionals across Pennsylvania, including the expansion of a PILOT program to introduce high school students to the EMS profession and the launch of a $1 million tuition assistance program. Find additional information in this press release.

DOH has announced it is extending the deadline for the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) Provider Readiness Survey to September 20. The survey can be accessed here.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $53.9 million, or 1.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $5.9 billion, which is $53.9 million, or 0.9 percent, above estimate.

Around the State

Spotlight PA has published an article about the state Supreme Court and a number of cases related to abortion, gun control, and climate change that are awaiting decisions.

An article published in The Center Square highlights the concerning closure of several independent pharmacies and the Auditor General’s recently released PBM audit for Medicaid prescription drug benefits.

PennLive has reported on recent polling of Pennsylvania voters that shows Vice President Harris and former President Donald Trump are in a close race. The article also highlights polling for the Pennsylvania U.S. Senate race between incumbent Senator Bob Casey and challenger David McCormick.

Stakeholder Events

DOH – WIC State Advisory Board Meeting – September 10

The Department of Health has issued a correction notice in the Pennsylvania Bulletin with a revised link to join the board’s meeting scheduled for Tuesday, September 10 at 1:00 p.m.

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority Board – September 19

The Patient Safety Authority has announced a meeting of the authority’s board to be held virtually on Thursday, September 19 at 1:00 p.m. The meeting is open to the public. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-09-06T20:01:48+00:00September 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for August 2

The following is an update of selected state health policy developments in Pennsylvania from July 29 – August 2. (Some of the language used below is taken directly from state documents).

General Assembly

The House Republican Policy Committee held an informational hearing on Thursday, August 1 about health care options for small businesses. The agenda and written testimony are viewable here. Find a recording of the hearing here.

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has published its report on Medicaid managed care enrollment in Pennsylvania for the month of June.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 762) with information, including treatment recommendations, about medetomidine, a potent non-opioid veterinary sedative, that has been detected in the illicit drug supply.

DOH has also issued a Health Advisory (PA-HAN 763) regarding an increasing number of emerging substances, including designer benzodiazepines, nitazines, tianeptine, and carfentanil, circulating in the illicit drug supply.

DOH has announced its annual long term care facility questionnaire will launch on September 1 and will seek to collect data for the state fiscal year timeframe of July 1, 2023 through June 30, 2024. An email with the questionnaire and log-in information for each facility will be sent to the email contact on file. As a reminder, completion of the questionnaire is mandatory. If a facility doesn’t receive the email on September 1, please contact Aicha Hassane Noma via email at ahassaneno@pag.gov.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $3 billion in General Fund revenue in July, the first month of the 2024-25 fiscal year. July collection data does not include a comparison against anticipated amounts because revenue estimates for each month are not yet finalized.

Around the State

WHYY has published an article about a recent Commonwealth Fund survey report that found fewer than half of people who experienced insurance denials fought them due to a lack of knowledge about their right to do so. The article also highlights the Pennsylvania Insurance Department’s independent review program.

The Times-Tribune has written about Community Health Systems’ (CHS) plan to sell its three hospitals in Northeastern Pennsylvania to the newly formed non-profit health system Woodbridge Healthcare.

Harold Brubaker has written an article in The Philadelphia Inquirer about Thomas Jefferson University’s completed acquisition of Lehigh Valley Health Network.

Amid continued speculation about whether Governor Josh Shapiro will be the running mate of Vice President Kamala Harris, Newsweek has published an article about Shapiro’s last-minute schedule changes this coming weekend.

PA Safety Net Admin2024-08-02T20:27:51+00:00August 2nd, 2024|Financial, Governments|Comments Off

PA Health Policy Update for July 12

The following is an update of selected state health policy developments in Pennsylvania from July 8 – 12. (Some of the language used below is taken directly from state documents).

FY 2024-2025 Budget Update

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.

The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.

The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.

The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.

The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.

The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration.

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024.

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee.

Centers for Medicare and Medicaid Services

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics. In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas. For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking.

Stakeholder Events

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Safety Net Admin2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for July 5

The following is an update of selected state health policy developments in Pennsylvania from July 1 – 5. (Some of the language used below is taken directly from state documents).

FY 2024-2025 Budget Update

The Commonwealth of Pennsylvania is five days into the new Fiscal Year (FY) and still doesn’t have an enacted budget, but legislative leaders remain optimistic that an agreement will be reached in the near term. The state House of Representatives and Senate, who recessed briefly for the Fourth of July, are currently scheduled to return on Saturday, July 6 to continue work on the FY 2024-2025 budget and its related bills.

Governor Shapiro

Governor Shapiro signed House Bill 1754 into law on Monday. Now known as Act 39 of 2024, this legislation requires public and private insurers to cover biomarker testing. Find additional information in this press release.

On Wednesday Governor Shapiro signed Senate Bill 739 into law. Now known as Act 42 of 2024, this piece of legislation provides for coverage of telemedicine services. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate held voting session Monday, July 1 through Wednesday, July 3. The following is an overview of selected health care-related legislative activity that occurred.

The Senate confirmed Dr. Debra Bogen as Secretary of the Department of Health by a vote of 42 – 8 on Monday, July 1. Dr. Bogen has been serving as Acting Secretary since the beginning of the Shapiro administration. Find additional information in this press release.

The Senate passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to Governor Shapiro for his signature.

The Senate passed House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent back to the House for concurrence.

The Senate passed Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill was received in the House and referred to the Health Committee.

The House of Representatives passed House Bill 2429, which establishes an inmate reentry program operated by the Department of Human Services to provide substance use disorder treatment and case management services prior an inmate’s release from a correctional institution. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2175, which creates a permanent Office of Child Advocate. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. The bill will now be sent to the Senate for consideration.

The House and Senate are currently scheduled to return to Harrisburg for voting session Saturday, July 6.

Department of Human Services

The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) for nursing facilities. Find the list and additional information in this Pennsylvania Bulletin notice.

DHS has published two notices in the Pennsylvania Bulletin related to the implementation and reauthorization of the Philadelphia hospital assessment, including the establishment of a new class of supplemental payments and the discontinuation of certain DSH and supplemental payments.

- DSH and Supplemental Payments to Qualifying Hospitals
- Supplemental Payments to Qualifying Hospitals

DHS has published updates to the Medical Assistance (MA) program fee schedule for ophthalmology services, effective for dates of service on and after August 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued a number of Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health

The Department of Health (DOH) has requested providers who operate mobile clinics complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania ended Fiscal Year (FY) 2023-2024 with $45.5 billion in General Fund collections. That total is $862.9 million, or 1.9 percent, above estimate.

Stakeholder Events

DOH – WIC Advisory Board – July 9

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory will meet on July 9 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-07-08T20:21:52+00:00July 5th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

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