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PA Health Policy Update for June 28

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

FY 2024-2025 Budget Update 

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future. 

General Assembly

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

  • The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.
  • The House of Representatives 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 194-8. The bill will now be sent to the Senate for consideration.
  • The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.
  • The Senate unanimously passed on Senate Bill 840, which 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. The bill was subsequently received in the House and referred to the Health Committee.
  • The House unanimously passed House Bill 2403, 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 unanimously passed House Bill 2400, which 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. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.
  • The House Children & Youth Committee met on Tuesday, June 25 and favorably reported 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. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.
  • The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here. 

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the proposed assessment amount, the proposed assessment methodology and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.
  • DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

Department of Health 

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.  

Stakeholder Events   

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 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 here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 28
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PA Health Policy Update for June 21

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

General Assembly

  • The state House of Representatives and Senate will reconvene for voting session next Monday, June 24. Both chambers are currently scheduled to remain in session until Monday, June 30, which is Pennsylvania’s constitutional deadline to enact a budget.
  • The House Children & Youth Committee is scheduled to meet on Tuesday, June 25 at 9:00 a.m. to consider 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 meeting will be held in Room B-31 of the Main Capitol. It will be livestreamed here.
  • The House Health Committee is scheduled to meet on Wednesday, June 26 at 9:30 a.m. to consider House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. The meeting will be held in Room G-50 of the Irvis Building. It will be livestreamed here. 

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 July 2024. 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 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. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced it will offer a virtual “Implementation, Improvement, Sustainability and Coaching of the ASAM Criteria – A How-To Science Based Approach” training in conjunction with Train for Change. The training will be offered in three series. It will teach the NIATx model for process improvement in conjunction with the ASAM Criteria Implementation Guide. Find the three series’ dates and additional information here. 

Around the State 

  • The Pennsylvania Capital-Star has reported about the state’s looming budget deadline and Senator Majority Leader Joe Pittman’s assertion that “[negotiations] could perhaps use… a kick in the pants to get moving.”
  • The New York Times has published an article about the role of pharmacy benefit managers (PBMs) and how they contribute to the cost of prescription drugs.
  • Spotlight PA has published an article about efforts to legalize recreational marijuana and the likelihood of legalization being a part of this year’s budget package.

Stakeholder Events   

DHS – Consumer Sub-MAAC – June 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 26 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – June 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 27 at 10:00 a.m. Find the agenda here and register to participate here.

2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off on PA Health Policy Update for June 21
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PA Health Policy Update for June 14

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

Governor Shapiro

Governor Shapiro signed, among other bills, Senate Bill 721 into law this week. Senate Bill 721, now known as Act 22 of 2024, establishes the Women, Infants and Children (WIC) State Advisory Board. Find additional information in this press release. 

General Assembly

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

  • The House of Representatives passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to the Senate and reported favorably from the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1783, which requires the Department of Health to develop and publish educational material about opioid-related overdose and requires the Department of Drug & Alcohol Programs to establish a grant program from the development, expansion, or improvement of recovery support services. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2127, which allows clinicians to distribute information related to postpartum depression and counseling resources. It also requires the Department of Health to publish those resources on its website. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed  House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational hearing on Senate Bill 840 and House Bill 2400, which both create an Alzheimer’s Disease and related disorders division within the Department of Aging and establish an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the hearing is viewable here.
  • The House Children & Youth Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, June 11 and favorably reported House Bill 1140, which expands access to contraceptives, and House Bill 2268, which provides coverage for speech therapy for stuttering. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, June 11 and favorably reported Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions, and Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. A recording of the meeting is viewable here.
  • The Senate Banking & Insurance Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 1664, which prohibits insurers from restricting their method of payment to solely credit card, and House Bill 1754, which requires public and private insurers to cover biomarker testing. A recording of the meeting is viewable here.
  • The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 12 and favorably reported, among other bills, Senate Bill 1251, which aligns Pennsylvania’s nursing statute with federal rules regarding accreditation. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee and the Senate Aging & Youth Committee held a combined hearing on Wednesday, June 12 regarding the status of the state’s Aging Our Way plan. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, June 12 and favorably reported the following bills.
    • House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients,
    • House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance.
    • House Bill 2363, which expands the existing Cancer Drug Repository Program to allow both health care facilities and individuals to donate prescription drugs (other than cancer drugs) to the program.

A recording of the meeting is viewable here.

  • The House Human Services Committee met on Wednesday, June 12 and favorably reported House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, June 12 and favorably reported, among other bills, House Bill 2198, which caps the fees for obtaining electronic medical records. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee met for a voting meeting on Wednesday, June 12 and favorably reported, among other bills, House Bill 2400, which 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. A recording of the meeting is viewable here.

The state House of Representatives and Senate will be in recess next week. Both chambers are scheduled to return to Harrisburg, Monday June 24.

Department of Human Services 

The Department of Human Services (DHS) has announced it is making available for public review and comment the Office of Long-Term Living’s proposed amendment for the OBRA waiver. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced it is making available for public comment and review the Office of Long-Term Living’s proposed renewal for the Community HealthChoices (CHC) waiver. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 753) regarding testing for influenza in persons with severe respiratory illness given the potential for severe human infections with influenza A(H5N1) viruses and the recent spread into dairy cattle. 

Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

2024-06-14T21:14:14+00:00June 14th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for June 14
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PA Health Policy Update for May 3

The following is an update of selected state health policy developments in Pennsylvania from April 29 – May 3.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

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

  • The House unanimously 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 the Senate.
  • The House Human Services Committee met on Monday, April 29 and favorably reported, among other bills, House Bill 1783, which requires the development of opioid-related overdose public information, and House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program. A recording of the meeting is viewable here.
  • The House Health Committee met on Tuesday, April 30 and favorably reported the following bills.
    • House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
    • House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana.
    • Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board.

A recording of the meeting is viewable here.

  • The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 30 at 10:00 a.m. regarding local Area Agencies on Aging. A recording of the meeting is viewable here.
  • The House Human Services Committee held an informational meeting on Wednesday, May 1 regarding performance-based contracting for the Department of Human Services’ Office of Developmental Programs. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session in Harrisburg next Monday, May 6 through Wednesday, May 8. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Insurance Committee will convene on Monday, May 6 at 10:00 a.m. in Room 60 of the East Wing to consider, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.

The meeting will be livestreamed here.

  • The House Labor & Industry Committee will meet on Tuesday, May 7 at 9:30 a.m. in Room 523 of the Irvis Office Building to consider House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee will hold an informational meeting on the nursing workforce crisis. The meeting will be livestreamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (PA-HAN 746) with important information about Lyme Disease and other tickborne diseases in the commonwealth. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers of additions and updates to the Medical Assistance (MA) program fee schedule.
  • DHS has provided final notice of its funding allocation for FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to qualifying acute care general hospitals enrolled in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the final annual case-mix per diem payment rates for FY 2023-2024 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin regarding the removal of lifetime employment bans for individuals convicted of certain criminal offenses in the Older Adults Protective Services Act.
  • DHS has added information to its website about the Technology Assessment Group (TAG), which reviews requests for new and emerging technologies and recommends coverage decisions for the MA program. Find the TAG’s website here.
  • DHS has announced the peer group, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities. Find additional information in this Pennsylvania Bulletin notice.

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $373.3 million, or 7.0 percent, more than anticipated. Fiscal year-to-date General Fund collections total $38.5 billion, which is $739.3 million, or 2.0 percent, above estimate. 

Around the State   

  • The Tribune-Review reported about the many professional counselors that could be approved for associate licenses soon due to the implementation of Act 4, which establishes two new license types in Pennsylvania.
  • Spotlight PA has published an article about the counties’ use of tens of millions of dollars in opioid settlement funds.
  • A news segment published by KDKA highlighted the drug shortage challenges that health care providers and patients are currently confronting in Pennsylvania and across the country.  
2024-05-03T20:07:01+00:00May 3rd, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for May 3
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PA Health Policy Update for March 29

The following is an update of selected state health policy developments in Pennsylvania from March 25 – 29.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed House Bill 1564, which provides for the creation of an associate license for marriage and family therapists and an associate license for professional counselors, into law on Thursday, March 28. It is now Act 4 of 2024. 

General Assembly

The state House of Representatives convened for a voting session this week. Following is a selection of health care policy-related legislative activity that occurred.

  • The House unanimously passed House Bill 1956, which makes certain amendments to the Patient Test Results Act. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, March 25 and favorably reported, among other bills, House Bill 1512, which provides for the coverage of telemedicine services. A recording of the meeting is viewable here.
  • The House Health Committee convened on Wednesday, March 27 at 9:00 a.m. and favorably reported a number of bills and resolutions, including the following:
    • House Bill 1633, which prohibits the use of non-compete agreements in health care employment.
    • House Bill 2084, which establishes a license for prescription drug virtual manufacturers.
    • Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. 

The House and Senate will be in recess next week. Both chambers will return to Harrisburg for voting session the week of April 8. 

Department of Health

The Department of Health (DOH) has posted a solicitation for grantees to develop and provide support to regional maternal health coalitions that will implement maternal mortality-prevention strategies recommended by the Pennsylvania Maternal Mortality Review Committee to reduce maternal mortality, particularly where there are disparities. The solicitation is viewable at eMarketplace or by clicking here.

DOH has issued a Health Advisory (PA-HAN 743) with important information about an increase in Mpox cases in Pennsylvania. The advisory includes recommendations for the prevention, screening, and treatment of Mpox.  

Department of Human Services

The Department of Human Services (DHS) has issued Provider Quick Tip #272 announcing it has experienced a delay in implementing Version 40.0 and Version 41.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled acute care general hospitals. This will affect acute care general inpatient stays with discharge dates on or after October 1, 2022. As a result of this delay, DHS will begin to mass adjust claims submitted for discharge dates October 1, 2022 through September 30, 2023 for Version 40.0, and October 1, 2023 through February 29, 2024 for Version 41.0 after February 29, 2024.

The Office of Long-Term Living (OLTL) has issued a clarification regarding the ability of Personal Assistance Service (PAS) workers to be reimbursed for transporting Community HealthChoices (CHC) participants in the community. The Commonwealth’s CHC 1915(c) Home and Community-Based Services (HCBS) Waiver addresses PAS and transportation beginning on page 81. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has released a Licensing Alert 05-2024 related to staffing regulations. DDAP has issued individual licensing alerts over time that focus on

specific regulation topics. This licensing alert will organize previous relevant, active licensing alerts, as well as provide additional guidance for Chapter 704 staffing regulations. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it has contacted individuals that had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

 Stakeholder Events  

DHS – Long-Term Services & Supports Subcommittee– April 3

The Medical Assistance Advisory Committee’s Long-Term Services & Support (LTSS) Subcommittee next meeting will be held on Wednesday, April 3 from 10:00 a.m. to 1:00 p.m. The meeting will be held virtually and in person. Register to participate here. 

DOH – Renal Disease Advisory Committee – April 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 19 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. Details on how to participate can be found in this Pennsylvania Bulletin notice.

2024-03-29T18:22:54+00:00March 29th, 2024|Governments, Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for March 29
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PA Health Policy Update for March 22

The following is an update of selected state health policy developments in Pennsylvania from March 18 – 22.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for a voting session this week. Following is a selection of health care policy-related legislative activity that occurred.

  • The House passed House Bill 1201, a consumer data privacy bill, by a vote of 139-62 on third and final consideration. The bill includes exemptions for protected health information under HIPAA and patient-identifying information related to certain research. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee held an informational meeting on Monday, March 18 to discuss House Bill 1354, which enables boards and commissions within the Department of State’s Bureau of Professional and Occupational Affairs to issue advisory opinions to licensees. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee convened for a voting meeting on Tuesday, March 19 and favorably reported House Bill 1795, which aligns state statute with federal requirements for source plasma donation centers. A recording of the meeting is viewable here.
  • The House Health Subcommittee on Health Care and Judiciary Subcommittee on Crime and Corrections held an informational meeting on Wednesday, March 20 regarding the criminal justice implications of adult-use cannabis legalization. A recording of the meeting is viewable here.
  • The House Children & Youth Committee held an informational meeting on Wednesday, March 20 to review the Office of the Child Advocate. A recording of the meeting is viewable here.
  • Rep. Patty Kim (D – Dauphin County) was appointed chairman of the House Insurance Committee. She replaces former chairman, Rep. Kevin Boyle (D – Philadelphia). Rep. Maureen Madden (D – Monroe) was subsequently appointed chairman of the House Aging & Older Adult Services Committee. 
  • The Legislative Budget & Finance Committee has released a report on the impact of “treat and release” calls on emergency medical services (EMS), specifically for patients covered by Medicaid. Find highlights from the report here and the full detailed report here. 

The state House of Representatives will convene again for voting session on Monday, March 25. The Senate is now in recess until Monday, April 8. Following is an overview of selected health care policy-related legislative activity currently scheduled next week.

  • The House Insurance Committee is scheduled to meet on Monday, March 25 at 10:00 a.m. in Room 60 of the East Wing. The committee will consider, among other bills, House Bill 1512, which provides for the coverage of telemedicine services. The meeting will be livestreamed here.
  • The House Health Committee will convene on Wednesday, March 27 at 9:00 a.m. to consider a number of bills and resolutions, including the following.
    • House Bill 1633, which prohibits the use of non-compete agreements in health care employment.
    • House Bill 2084, which establishes a license for prescription drug virtual manufacturers.
    • Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. 

Department of Health

The Department of Health (DOH) has issued a request for applications (RFA) for community health worker care coordination in four rural regions of the commonwealth, including northeast central, northwest central, northwest, and southwest. The RFA may be viewed online at eMarketplace or here.

DOH has issued a Health Advisory (PA-HAN 741) with new guidance for preventing respiratory virus diseases. 

Department of Human Services 

  • The Department of Human Services (DHS) has provided final notice of its funding allocation for FY 2023-2024 inpatient disproportionate share hospital (DSH) payments, outpatient supplemental payments, direct medical education payments, and certain DSH and supplemental payments to new hospitals. DHS is not otherwise changing the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through April 2024. 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. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it is conducting a survey related to the department’s work on regulatory reform. DDAP has requested stakeholders complete the survey, which may be found here, to help guide this initiative. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it has contacted individuals that had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events  

DHS – Consumer Sub-MAAC – March 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – March 28

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 28 at 10:00 a.m. Register to participate here.

2024-03-22T20:16:41+00:00March 22nd, 2024|Governments, Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for March 22
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PA Health Policy Update for February 9

The following is an update of selected state health policy developments in Pennsylvania from February 5 – 9.  (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro delivered his second annual budget address to a joint session of the General Assembly this week. In total, Governor Shapiro’s proposed FY 2024-2025 budget spends $48.3 billion, a $3.7 billion or 8.4 percent increase over the current fiscal year. The budget does not propose any broad-based tax increases, but it uses new revenue sources and the commonwealth’s budget surplus.

The themes outlined in Governor Shapiro’s budget address and the budget proposal’s supporting documents largely reflect a continuation of the policy priorities championed by his administration throughout its first year, including education, public safety, government reform, and economic competitiveness. Following are selected health care highlights in the budget proposal.

  • Invests $100 million in mental health funding for K-12 schools, which builds upon one-time federal funds to ensure schools have the resources to provide mental health services to students and staff.
  • Increases funding for community-based mental health services by an additional $20 million this year and calls for additional funds in successive years (up to $60 million).
  • Invests $50 million of state funding into the state’s reinsurance program to create an additional subsidy wrap for low- and middle-income Pennsylvanians that are on the cusp of being able to afford health insurance.
  • Governor Shapiro highlighted the need to reform pharmacy benefit manager (PBM) operations and called on the General Assembly to enact legislation to that effect.
  • Although the budget proposal doesn’t include specific funding for rural health, Governor Shapiro noted the need to address rural hospital closures and indicated his administration would develop a plan soon.
  • Dedicates $4 million for medical debt relief for low-income Pennsylvanians and calls for health care providers to implement transparent practices to limit medical debt.
  • Includes $1.9 million toward the creation of the Alzheimer’s Disease and Related Disorders Division at the Department of Aging.

Find additional budget documents released by the Office of the Budget below.

General Assembly 

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

  • The Senate passed House Bill 1564, which provides for the creation of an associate license for marriage and family therapists and an associate license for professional counselors, on third and final consideration. The bill will now be sent back to the House for concurrence.
  • The House Health Subcommittee on Health Care held an informational meeting on Monday, February 5 on adult-use cannabis. Find a recording of the meeting here.
  • The Senate Veterans Affairs & Emergency Preparedness Committee favorably reported, among other bills, Senate Bill 1054, which adds EMS providers as required reporters to the Overdose Information Network (ODIN) system.
  • The House Health Committee met for a voting meeting on Tuesday, February 6 and favorably reported the following bills.
  • House Bill 1853, which requires the Department of Health to meet with licensed nursing facilities under their jurisdiction to discuss and share information on survey results, patterns, trends, best practices, etc.
  • House Bill 1931, which establishes a registry of medical directors in nursing facilities, personal care homes, and assisted living residences.
  • House Bill 1956, which makes certain amendments to the Patient Test Results Act.
  • The House Human Services Committee held an informational meeting on Wednesday, February 7 examining Centers of Excellence for Opioid Use Disorder. Find a recording of the meeting here. 

Department of Human Services 

The Department of Human Services (DHS) has announced the addition and end-dating of certain procedure codes to and from the Medical Assistance (MA) program fee schedule for pharmacist services. These changes are effective for dates of service on and after March 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin with updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for opioid use disorder treatments submitted for prior authorization. 

Department of Health 

The Department of Health (DOH) Bureau of Epidemiology’s COVID-19 Infection Control and Outbreak Response team has updated the COVID-19 LTC Toolkit. 

Medicaid Continuous Coverage Unwinding

  • DHS reported that it has contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

 Stakeholder Events 

DHS – Consumer Sub-MAAC – February 21The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 21 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – February 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 22 at 10:00 a.m. Register to participate here.

2024-02-09T20:45:39+00:00February 9th, 2024|Governments, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 9
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PA Health Policy Update for November 17

The following is an update of selected state health policy developments in Pennsylvania from November 13 – 17.  (Some of the language used below is taken directly from state documents.) 

General AssemblyHouse Chamber of the State House

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

  • The House of Representatives unanimously passed Senate Bill 500, which provides Medicaid coverage for pasteurized donor human milk, as amended. The Senate subsequently concurred with the House amendments and sent it to the governor’s desk.
  • The Senate unanimously passed House Bill 507, which requires health care providers to obtain informed consent, both verbal and written, before performing a pelvic examination, a rectal examination, or a prostate examination while the patient is anesthetized or unconscious. The House subsequently concurred with the Senate amendments and sent it to the governor’s desk.
  • The Senate unanimously passed Senate Bill 668, which permits certified nurse aides to become certified medication aides (CMA) in long-term care facilities, assisted living residences, and personal care homes. Following Senate passage the bill was received in the House and referred to the Health Committee.
  • The House Human Services Committee held a meeting on Monday, November 15 and favorably reported House Bill 1650, which authorizes the establishment of a grant program for recovery houses, and House Bill 1690, which establishes a public awareness campaign about the growing threat of Xylazine.
  • The House Health Committee held a meeting on Wednesday, November 15 and favorably reported House Bill 1657, which eliminates exemptions in the state’s Clean Indoor Air Act and expands the definition of smoking to include e-cigarettes, and Senate Bill 414, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.

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 December. Find the updated calendar here.
  • DHS has announced it will add sexually transmitted infection (STI) test kits for at-home specimen collection to the Medical Assistance (MA) Program fee schedule, effective with dates of services on and after December 1, 2023. Find additional information in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health is soliciting applications from hospitals and health systems for up to $325,000 in grant funding to support care navigators in emergency departments as part of the Pennsylvania Substance Use Navigation Program. One grantee will be selected in each of four regions, based on the location of the emergency department where care will be provided, and funds can be used to build and implement health system-wide clinical capacity to screen, diagnose, and support longitudinal care for opioid use disorder and stimulant use disorder and support recovery for adults and adolescents. The RFA closes on January 16, 2024.

In anticipation of the holiday season, DOH has issued vital safety tips to avoid holiday accidents. On behalf of DeBrunner & Associates, we hope you don’t burn the turkey and wish you a very happy Thanksgiving. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 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. 

Patient Safety Authority – December 7

The Patient Safety Authority will hold a public board meeting on Thursday, December 7 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.

2023-11-17T21:07:32+00:00November 17th, 2023|Governments, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for November 17
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Private equity firm takes control

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There are many variations of passages of Lorem Ipsum available, but the majority have suffered alteration in some form, by injected humour, or randomised words which don’t look even slightly believable. If you are going to use a passage of Lorem Ipsum, you need to be sure there isn’t anything embarrassing hidden in the middle of text. All the Lorem Ipsum generators on the Internet tend to repeat predefined chunks as necessary, making this the first true generator on the Internet. It uses a dictionary of over 200 Latin words, combined with a handful of model sentence structures, to generate Lorem Ipsum which looks reasonable. The generated Lorem Ipsum is therefore always free from repetition, or non-characteristic words.

2015-07-02T16:58:15+00:00July 2nd, 2015|Financial, Governments, International|Comments Off on Private equity firm takes control
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Intellectual property disputes

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. Contrary to popular belief, Lorem Ipsum is not simply random text.

It has roots in a piece of classical Latin literature from 45 BC, making it over 2000 years old. Richard McClintock, a Latin professor at Hampden-Sydney College in Virginia, looked up one of the more obscure Latin words, consectetur, from a Lorem Ipsum passage, and going through the cites of the word in classical literature, discovered the undoubtable source.

Nemo enim ipsam voluptatem quia voluptas sit

Lorem Ipsum comes from sections 1.10.32 and 1.10.33 of “de Finibus Bonorum et Malorum” (The Extremes of Good and Evil) by Cicero, written in 45 BC. This book is a treatise on the theory of ethics, very popular during the Renaissance. The first line of Lorem Ipsum, “Lorem ipsum dolor sit amet..”, comes from a line in section 1.10.32.

There are many variations of passages of Lorem Ipsum available, but the majority have suffered alteration in some form, by injected humour, or randomised words which don’t look even slightly believable. If you are going to use a passage of Lorem Ipsum, you need to be sure there isn’t anything embarrassing hidden in the middle of text. All the Lorem Ipsum generators on the Internet tend to repeat predefined chunks as necessary, making this the first true generator on the Internet. It uses a dictionary of over 200 Latin words, combined with a handful of model sentence structures, to generate Lorem Ipsum which looks reasonable. The generated Lorem Ipsum is therefore always free from repetition, or non-characteristic words.

2015-07-02T16:56:28+00:00July 2nd, 2015|Acquisitions, Financial, Governments|Comments Off on Intellectual property disputes
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  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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