Governments Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for April 11

The following is an update of selected state health policy developments in Pennsylvania from April 7 – 11. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House of Representatives passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. The bill will now be sent to the Senate for consideration.

The House Aging & Older Adult Services Committee held an informational meeting on Monday, April 7 to examine potential updates to the Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.

The House Human Services Committee met on Tuesday, April 8 and favorably reported House Bill 561, which expands Act 80 to include all FDA-approved medication assisted treatment, and House Bill 1117, which updates language defining DDAP’s duties and responsibilities. A recording of the meeting is viewable here.

The House Insurance Committee met on Tuesday, April 8 and favorably reported House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. A recording of the meeting is viewable here.

The House Health Committee met on Wednesday, April 9 and favorably reported, among other legislation, the following pertinent bills. A recording of the meeting is viewable here.

- House Bill 69, which expands the existing Cancer Drug Repository program to other prescription drugs.
- House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements.
- House Bill 1104, which caps the costs of obtaining electronic medical records.

The House of Representatives and the Senate have now recessed. The House will reconvene Tuesday, April 22 and the Senate will reconvene Monday, May 5.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to remind physicians, physician assistants (PAs), and certified registered nurse practitioners (CRNPs) enrolled in Medicaid that they are able render topical fluoride varnish (TFV) services to Medicaid beneficiaries.

DHS has issued a reminder to all participating Medicaid providers of the need to complete a “MA 112 Form” after the birth of a child to a mother enrolled in Medicaid in order to notify the mother’s respective county assistance office (CAO). The “MA 112 Form” should be completed and submitted within three working days of the child’s birth.

DHS has published final notice of its funding allocation for FY 2024-25 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to Medicaid-enrolled, qualifying inpatient acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice.

Around the State

CBS News has published an article about the continued challenges facing Crozer Health in Delaware County. An attorney for Prospect Medical Holdings, the parent company of Crozer, indicated Crozer would start transitioning certain service lines to other providers.

Pennsylvania’s home care industry and its need for additional funding was the focus of an article by Politics PA this week.

The Pennsylvania Capital-Star has published an article about increasing measles cases in the state and some counties’ lagging vaccination rates.

Stakeholder Meetings

DOH – WIC State Advisory Board – April 22

The WIC State Advisory Board will hold a public meeting on April 22 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. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

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.

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Renal Disease Advisory Committee – April 25

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 25 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-04-11T22:36:44+00:00April 11th, 2025|Governments, Medical Assistance Bulletin, Pennsylvania Bulletin|Comments Off

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 March 28

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

Special Election Update

Two special elections occurred this week on Tuesday, March 25 to fill vacancies in the state House of Representatives and Senate. Democrat Dan Goughnour won the special election to represent House District 35, which was vacated after the passing of Representative Matt Gergely. His election sustains the Democratic one-vote majority in the House. In a surprising outcome, Democrat Jim Malone narrowly defeated Republican Josh Parsons to replace the Senate seat formerly held by Ryan Aument who resigned to work for U.S. Senator Dave McCormick. Malone’s election will narrow the Republican majority in the Senate to 27-23.

General Assembly

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

The House of Representatives passed a package of bills that seek to codify federal Affordable Care Act (ACA) patient protections in state statute.

- House Bill 404, which enables an adult child to receive insurance coverage until age 26.
- House Bill 535, which prohibits annual and lifetime coverage limits.
- House Bill 618, which prohibits the denial of health insurance coverage due to pre-existing conditions.
- House Bill 755, which maintains access to preventative health care services.

The House Aging & Older Adult Services Committee met on Monday, March 24 and favorably reported, in addition to other legislation, House Bill 372, which requires the Department of Aging to publicly release a compliance report on the Area Agencies on Aging (AAAs).

The House Labor & Industry Committee met on Tuesday, March 25 and favorably reported, among other bills, House Bill 926, which seeks to prevent health care workplace violence by placing several requirements on health care facilities.

The Senate Judiciary Committee met on Tuesday, March 25 and favorably reported, among other bills, Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, and Senate Bill 326, which amends the Controlled Substance, Drug Device, and Cosmetic Act to automatically schedule a controlled substance when one is added by the federal government and removes the Secretary of Health’s ability to reschedule a controlled substance.

The Senate will reconvene on Monday, March 31 through Wednesday, April 2. The House of Representatives is now recessed until Monday, April 7.

Department of Human Services

The Department of Human Services (DHS) has issued an updated Pennsylvania Medicaid Managed Care Directory.

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

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) 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.

IRRC has announced it received the following final form rulemaking which will be considered at its May 15 meeting.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of a report on Cancer Surgery Volume, giving stakeholders insight into cancer surgeries performed at hospitals and ambulatory/outpatient settings.

Around the State

The New York Times has written an article about Democrat Jim Malone’s surprising victory in a district that strongly supported President Trump in the 2024 election. Spotlight PA also published an article about this story.

The Pennsylvania Capital-Star has written an article about a package of bills that passed the state House of Representatives this week codifying federal Affordable Care Act (ACA) protections in state statute.

Fox43 has published a piece about unions representing Pennsylvania nurses and their efforts to pass legislation addressing workplace violence.

Stakeholder Meetings

DOH – Special Pharmaceutical Benefits Program Advisory Committee – April 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, April 24 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Medical Marijuana Advisory Board – 2025 Meeting Schedule

The Medical Marijuana Advisory Board has provided notice in the Pennsylvania Bulletin of its upcoming meeting dates. Meetings will be held from 10:30 a.m. to 12:30 p.m. on each day listed in the Capitol Media Center, Room 1, East Wing, Harrisburg, PA 17126, with an option for board members to participate virtually.

PA Safety Net Admin2025-03-28T19:22:00+00:00March 28th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for March 21

The following is an update of selected state health policy developments in Pennsylvania from March 17 – 21. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House of Representatives passed House Bill 157, which establishes the Rural Health Care Grant Program to provide grants to entities in rural counties and designated medically underserved areas to pay for the education debt of certain health care practitioners. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 60, which allows pharmacies to make a one-time transfer of a prescription for a controlled substance to another pharmacy without requiring a new prescription. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 33, which implements greater oversight of medical marijuana labs and product testing. The bill will now be sent to the Senate for consideration.

The House Insurance Committee met on Monday, March 17 and favorably reported the following package of bills, which seek to codify the federal Affordable Care Act (ACA) patient protections in state statute.

- House Bill 404, which enables an adult child to receive insurance coverage until 26.
- House Bill 535, which prohibits annual and lifetime coverage limits.
- House Bill 618, which prohibits the denial of health insurance coverage due to pre-existing conditions.
- House Bill 755, which maintains access to preventative health care services.

The House Aging & Older Adult Services Committee held an informational hearing on Tuesday, March 18 about the Department of Aging’s newly launched oversight program of the Area Agency on Aging (AAA) network. A recording of the hearing is viewable here.

The House Human Services Committee held an informational hearing on House Bill 561, which expands Act 80 of 2015 to include all forms of FDA-approved medications for the treatment of substance use disorder (SUD). A recording of the hearing is viewable here.

The House Majority Policy Committee held an informational hearing on Wednesday, March 19 examining sustainable long-term care. Testimony offered to the committee is viewable here and a recording of the hearing is viewable here.

The Senate Majority Policy Committee held an informational hearing on improving access to quality health care through technological innovation. Testimony offered to the committee and a recording of the hearing is viewable here.

The state House of Representatives and the Senate will convene in Harrisburg for voting session next Monday, March 24 through Wednesday, March 26.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through April. Find the updated calendar here.

Department of Insurance

The Pennsylvania Department of Insurance (PID) has published a Consumer Price Index for All Urban Consumers (CPI-U) adjustment, which is utilized as a benchmark for the maximum benefit for autism services required to be covered by an insurer. The CPI-U adjustment for policies issued or renewed in calendar year 2026 is a 2.9 percent increase, which results in a maximum benefit of $51,908. The department does not expect this to have any impact on the coverage of autism services in the commonwealth. Find additional information in this Pennsylvania Bulletin notice.

Department of Aging

The Department of Aging has announced the rollout of its new platform to increase transparency and accountability of Pennsylvania’s Area Agency on Aging (AAA) network – Comprehensive Agency Performance Evaluation (CAPE). In addition, the department will begin publicly posting performance results on its website for the first cohort of AAAs to be monitored under CAPE.

Around the State

The Pittsburgh Post-Gazette published an article about the reopening of Sharon Regional Medical Center and legislation being considered in the General Assembly focused on rural health and health care mergers and acquisitions.

Spotlight PA has written an article about hospital charity care programs and their lack of standardization, which was the focus of a recent Health Affairs article.

Legislative efforts to provide more assistance for health care practitioners’ student loan repayment was the focus of an article published by The Center Square.

Harold Brubaker has written an article for The Philadelphia Inquirer about the most recent emergency court hearing held on efforts to keep Crozer Health open in Delaware County.

Stakeholder Meetings

DHS – Consumer Sub-MAAC – March 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – March 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2025-03-21T20:37:58+00:00March 21st, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for March 14

The following is an update of selected state health policy developments in Pennsylvania from March 10 – 14. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate Democratic Policy Committees held a joint hearing on health care access and the impact of hospital closures this week. The hearing was held in Delaware County and largely focused on the current challenges at Crozer Health/Prospect Medical Holdings. A recording of the hearing and written testimony are viewable here.

The House of Representatives will convene for session Monday, March 17 through Wednesday, March 19. The Senate is recessed until Monday, March 24.

Department of Health

The Department of Health (DOH) has issued a notice in the Pennsylvania Bulletin with the procedure that the department will follow in assessing and collecting the MCARE surcharge for FY 2024-25.

Department of Human Services

The Department of Human Services (DHS) has announced the final annual case-mix per diem payment rates for Fiscal Year 2024-25 for non-public and county nursing facilities that participate in the Medical Assistance (MA) program. The final annual per diem rates are available on DHS’ website here.

DHS has announced the peer groups, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities. Find additional details in this Pennsylvania Bulletin notice.

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

Department of Drug & Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has issued a Licensing Alert to notify licensed narcotic treatment programs (NTPs) that DDAP has aligned with 42 CFR part 8 to allow an NTP to utilize telehealth for an initial exam and initiate FDA-approved medications for opioid use disorder treatment.

Around the State

Spotlight PA has published an article about legislative efforts in Pennsylvania to alleviate medical debt.

The continued challenges related to keeping Crozer Chester Medical Center and Taylor Hospital in Delaware County open were covered by The Pennsylvania Capital-Star in this article.

WHYY has reported about Philadelphia’s first confirmed case of measles, unrelated to the recent case in Montgomery County.

Stakeholder Meetings

DOH – Health Policy Board – March 21

The Health Policy Board of the Department of Health will meet on Friday, March 21 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 25

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Tuesday, March 25 from 10:00 a.m. until 12:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – March 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – March 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2025-03-14T20:47:35+00:00March 14th, 2025|Governments, 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 November 15

The following is an update of selected state health policy developments in Pennsylvania November 4 – 15. (Some of the language used below is taken directly from state documents).

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it approved an amendment to Pennsylvania’s section 1115 Medicaid demonstration waiver to provide continuous Medicaid eligibility for children until the age of six, and 12 months of continuous eligibility for individuals aged 19 through 64 leaving incarceration, who meet certain high-risk criteria. Find additional information about Pennsylvania’s section 1115 demonstration amendment approval here.

General Assembly

The state House of Representatives and Senate briefly convened for voting session this week to conclude legislative business for the 2023-2024 session and elect caucus leadership for the upcoming 2025-2026 legislative session. Following is the comprehensive list of each caucus’ leadership team.

* Denotes majority party.

Department of Human Services

The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it released an updated Psychiatric Outpatient Clinic Regulatory Compliance Guide (RCG). The changes made were primarily to language and updates based on comments received from stakeholders on the original document issued in 2021. OMHSAS has been working on developing RCGs for each licensed level of care. The RCG is designed to be a tool for providers, OMHSAS staff, and the public to better understand pertinent regulations. The guide is a companion piece to 55 Pa. Code Chapter 5200.

The Department of Human Services (DHS) has issued an updated Pennsylvania Medicaid Managed Care Directory.

DHS has issued a Medical Assistance Bulletin entitled Statewide Preferred Drug List (PDL) Updates – Pharmacy Services.

DHS has issued several Medical Assistance bulletins with updated handbook pages that include the requirements for prior authorization for various pharmacy services. Following is a comprehensive list of prior authorization bulletins recently issued by DHS.

Department of Health

The Department of Health (DOH) has published notice of the Secretary of Health’s decision not to effectuate the recommendation of the Medical Marijuana Advisory Board that certified registered nurse practitioners (CRNPs) and podiatrists be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana. Find the notice regarding CRNPs here and podiatrists here.

Insurance Department

The Pennsylvania Insurance Department (PID) has released a comprehensive study of the accuracy of health insurer provider directories. The report highlights persistent inaccuracies in health insurer provider directories that can delay care, hinder scheduling, or result in surprise out-of-network charges. PID is planning to initiate stakeholder outreach to gather input and develop solutions that reduce inaccuracies in provider directories. Find additional information in this press release.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has released its Economic and Budget Outlooks for FYs 2024-2025 to 2029-2030. This annual fiscal outlook report, which includes projections of state revenues and expenditures, also considers economic and demographic trends that will impact tax revenues and expenditures over the next five fiscal years. Find the IFO’s presentation here and its full report here.

Office of Administration

The Office of Administration has recently announced the launch of a new resource page on PA.gov that makes it easier for residents, businesses, non-profits, and local government entities to find and apply to various grant programs from state agencies. Find additional information in this press release.

Around the State

The Hill has published an article about Governor Shapiro’s national political prospects following the 2024 election.

WHYY has written an article about this year’s open enrollment for health insurance coverage in 2025. The Pittsburgh Post-Gazette has also written about open enrollment and the potential for premiums to increase.

An article published by the Patriot-News highlights the continued partisan split in Harrisburg for the upcoming 2025-2026 legislative session. The Pennsylvania Capital-Star also wrote about this dynamic but noted House Democrats’ hope for greater cooperation with the Republican Senate.

Stakeholder Events

DOH – Newborn Screening Advisory Committee – November 21

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 21 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual conference. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-11-15T20:57:21+00:00November 15th, 2024|Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|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 25

The following is an update of selected state health policy developments in Pennsylvania October 21 – 25. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House of Representatives passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system and implements the recommendations from Act 70 of 2022. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives voted to concur with the Senate’s amendment to House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill has been presented to Governor Shapiro for his signature.

The Senate voted to concur with the House’s amendments to Senate Bill 267, which adds urgent care centers to the list of safe haven locations for newborn children. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives passed House Bill 2533, which creates a 988 public education campaign.

The House of Representatives passed House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills. The bill will now be sent to the Senate for consideration.

The House Children & Youth Committee met on Tuesday, October 22 and favorably reported House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system. A recording of the hearing is viewable here.

The House Children & Youth Committee also met on Wednesday, October 23 for an informational meeting on the CCAP Complex Case Task Force report and the DHS Blueprint report. A recording of the hearing is viewable here.

The Senate Aging & Youth and Banking & Insurance Committees held 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. A recording of the hearing is viewable here.

This was the last voting session prior to the November 5 General Election. The House and Senate will return to Harrisburg following the election on November 12 and 13, respectively.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through November. Find the updated calendar here.

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

Department of Health

The Department of Health (DOH) has announced it is investing $3.2 million to combat the drug-related overdose epidemic through 13 organizations that will help residents connect with services and care, including receiving overdose prevention and reversal tools, treatment options, drug checking equipment, and educational services. Find additional information in this press release.

DOH has updated the electronic reporting system used to report deaths to the department under the Vital Statistics Law. For information on how to enroll in the new electronic system and frequently asked questions, see this fact sheet.

Around the State

The Pennsylvania Capital-Star has written an article about the waning days of the 2023-2024 legislative session, its accomplishments and unresolved issues.

ABC 27 has reported on bills recently signed into law by Governor Shapiro, including numerous health care bills.

St. Christopher’s Hospital for Children is receiving an additional $30 million in support over two years from a coalition of Philadelphia health care organizations, which was highlighted in an article written by Harold Brubaker for the Philadelphia Inquirer.

Harold Brubaker has also written an article about the rate of insurance denials among plans on the state’s health insurance marketplace, Pennie. Independence Blue Cross had the highest claim denial rate at 20.06 percent.

Stakeholder Events

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.

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.

PA Safety Net Admin2024-10-25T19:47:48+00:00October 25th, 2024|Advocacy, Governments, 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

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