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Handicapping Medicaid Expansion in PA

Will he or won’t he?
That question is still on the minds of many as Pennsylvania Governor Tom Corbett continues neither to declare that the state will expand its Medicaid program as provided for in the Affordable Care Act nor to confirm the suspicion of most observers that he will choose not to expand the program beyond its current 2.2 million recipients.
As of right now, 12 states appear to be undecided about Medicaid expansion.  The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion.
For a closer look at the situation in Pennsylvania, including an account of which interest groups are for expansion and which are not as enthusiastic as one might expect, read this columnHarrisburg, PA capital building from the Central Penn Business Journal.

2013-02-01T06:00:35+00:00February 1st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off on Handicapping Medicaid Expansion in PA

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2013 newsletter.
Targeted to the very population that Pennsylvania’s safety-net hospitals serve, this month’s newsletter includes features on the benefits of Medicaid expansion under the Affordable Care Act, Medicaid eligibility, and the uninsured in Pennsylvania.  It also includes links to articles and features relevant to the state’s low-income population and the health care providers who serve them.
See the Pennsylvania Health Law Project’s January 2013 newsletter here.

2013-01-31T06:00:57+00:00January 31st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

PA Prepares to Boost Medicaid Primary Care Rates

Pennsylvania will soon begin paying primary care providers more for the services they deliver to their Medical Assistance patients.
Under the Affordable Care Act, state Medicaid programs are required to pay primary care providers Medicare-level fees for calendar years 2013 and 2014.  This policy was adopted as part of a broader effort to recruit more physicians to serve Medicaid patients at a time when Medicaid enrollment will increase significantly in most states.
Now, the Pennsylvania Department of Public Welfare (DPW) is presenting its plan for how it will go about implementing this federal requirement.
DPW has issued a new Medical Assistance Bulletin titled “Medical Assistance Program Fee for Select Primary Care Services and Physician Attestation Form” that identifies eligible providers and explains how they can go about receiving the enhanced payments.  That bulletin can be found here.  DPW also has issued an attestation form through which providers can assert their eligibility for the enhanced payments; that form, and directions for completing and submitting it, can be found here.

2013-01-29T06:00:39+00:00January 29th, 2013|Health care reform, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Prepares to Boost Medicaid Primary Care Rates

States Finding it Hard to Say No to Federal Medicaid Money

While many of the nation’s governors have ideological problems with many aspects of the Affordable Care Act, it appears that more of them are preparing to accept one major facet of the bill with which they particularly disagree:  Medicaid expansion.
When the law passed, the mandatory expansion of Medicaid eligibility was one of its most controversial aspects and encountered a great deal of resistance from many governors.  When the Supreme Court ruled last year that the mandate was unconstitutional, many governors indicated that they would decline the now-optional Medicaid expansion.
But as the time for implementing the Medicaid expansion draws closer, more governors are concluding that the lure of millions, and even billions, of “free” federal Medicaid matching dollars is too hard to resist.
In addition, some governors are concerned about appearances if they turn down the federal Medicaid money while a clause in the reform act would enable legal immigrants in their state to receive health insurance premium subsidies while other low-income residents remain ineligible for those subsidies and uninsured.
Pennsylvania Governor Tom Corbett has not yet announced his decision on whether the state will expand its Medicaid program but appears to be leaning against such an expansion.  The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the commonwealth.
Read about the challenges governors face in refusing the federal Medicaid money in this RealClearPolitics article and about the immigration twist on the issue in this Washington Post report.

2013-01-28T06:00:29+00:00January 28th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on States Finding it Hard to Say No to Federal Medicaid Money

Hearing Promotes Medicaid Expansion in PA

Democratic members of the state Senate Appropriations Committee held a hearing in Philadelphia to promote expansion of the state’s Medicaid (Medical Assistance) program.
Participating legislators took testimony from representatives of a number of organizations that support Medicaid expansion, which is an optional component of the Affordable Care Act.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Governor Corbett has not yet announced his decision on Medicaid expansion but is thought to be leaning against it.  The General Assembly members who held the hearing are in the minority party in the state senate.
Read more about the hearing, the issues, and the testimony offered in thisHouse Chamber of the State House Philadelphia Inquirer article.

2013-01-25T12:06:55+00:00January 25th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Hearing Promotes Medicaid Expansion in PA

PA Paves Way for Primary Care Pay Raise

The Pennsylvania Department of Public Welfare has published a notice that it will increase the fees Medical Assistance pays for selected primary care services.
The pay raise, funded 100 percent by the federal government, is part of the Affordable Care Act.
For further information about the pay raise, which physicians qualify for it, and how they can receive the pay raise, see the notice here, in the Pennsylvania Bulletin.
In addition, members of the Safety-Net Association of Pennsylvania (SNAP) have received a detailed memo outlining the terms of the Medicaid primary care pay raise.  Members who have not seen the memo and others who would like a copy can request it at info@paysafetynet.org.

2013-01-07T06:00:48+00:00January 7th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on PA Paves Way for Primary Care Pay Raise

Insurance Commissioner Explains Why PA Rejected Health Exchange

Writing in the Pottstown Mercury, Pennsylvania Insurance Commissioner Michael Consedine has outlined why the Corbett administration chose not to develop the health insurance exchange that is one of the centerpieces of the 2010 Affordable Care Act.
Mr. Consedine’s explanation mirrors that offered last month by Pennsylvania Governor Tom Corbett:  the federal government did not provide enough information and guidance to enable the state to develop its own exchange.  (Go here for a summary of Governor Corbett’s op-ed piece and a direct link to that piece.)
As a result of this decision, Pennsylvania will use a health insurance exchange developed for it by the federal government.
Read Mr. Consedine’s guest column in the Pottstown Mercury here.

2013-01-03T06:00:13+00:00January 3rd, 2013|Health care reform, Uncategorized|Comments Off on Insurance Commissioner Explains Why PA Rejected Health Exchange

GAO Finds Problems With Medicaid DSH Payments

The U.S. Government Accountability Office (GAO) is now reviewing audits of states’ Medicaid disproportionate share payments (Medicaid DSH) to hospitals and is raising questions about states’ compliance with federal requirements for those payments.
Based on its analysis of state Medicaid DSH audits, GAO found that states are making Medicaid DSH payments to hospitals that exceed those hospitals’ uncompensated care costs and are inaccurately calculating those hospital uncompensated care costs.  The GAO also found that states are not always targeting their Medicaid DSH payments to the hospitals that provide the most uncompensated care.
States are required to submit audits and data as a condition of receiving Medicaid DSH funds from the federal government.  Currently, the Centers for Medicare & Medicaid Services (CMS) is not acting on the information it receives but will begin doing so after a transition period that ends when 2014 audits are completed.  In anticipation of that time, GAO is reviewing the information CMS receives for state compliance with six federal standards for Medicaid DSH payments.
This data also may eventually be used to help implement the Medicaid DSH payment reduction mandated under the Affordable Care Act.
According to the report, Pennsylvania did not provide some of the required data, so in several instances in which the document provides specific information about individual state performance, it has nothing about Pennsylvania.  It does note, however, that in FY 2007, six hospitals in the state received Medicaid payments greater than their Medicaid costs.
Because Pennsylvania’s safety-net hospitals care for so many uninsured and low-income patients and receive higher Medicaid DSH payments than other hospitals, they are far more dependent on these payments than other hospitals and will need to watch this situation closely in the future.
Learn more about GAO’s examination of Medicaid DSH payments – why it is undertaking this review, what it found, and how its findings may be used in the future – in the report More Transparency of and Accountability for Supplemental Payments are Needed, which can be found here, on GAO’s web site.

2012-12-28T06:00:33+00:00December 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off on GAO Finds Problems With Medicaid DSH Payments

Corbett Explains ‘No’ Decision on Health Exchanges

In an op-ed piece in Sunday’s Philadelphia Inquirer, Pennsylvania Governor Tom Corbett presented the reasons he decided to let the federal government develop the state’s health insurance exchange ­– a key part of the Affordable Care Act – instead of having his own administration develop the exchange.
Read Governor Corbett’s op-ed piece here.

2012-12-24T11:08:31+00:00December 24th, 2012|Health care reform|Comments Off on Corbett Explains ‘No’ Decision on Health Exchanges

PA Welfare Secretary Testifies About Medicaid Expansion

Declaring that “We in the commonwealth have never witnessed a law so vast, with such demands on state resources, and lack of federal guidance,” Pennsylvania Department of Public Welfare Secretary Gary Alexander told the House Energy and Commerce Committee last week that while Pennsylvania has not ruled out expanding its Medicaid program in accordance with the Affordable Care Act, “Under the constraints of the health care reform law, I do not think we can afford the expansion.”
Mr. Alexander made these remarks at a hearing of the committee’s Health Subcommittee, which was taking testimony on the Medicaid expansion component of the 2010 health care reform law.
While the Kaiser Foundation on Medicaid and the Uninsured says that expansion would cost Pennsylvania $2 billion through 2022, the Corbett administration has put a $4 billion price tag on such expansion.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about Mr. Alexander’s testimony in this Pittsburgh Post-Gazette article and this Central Penn Business Journal article, which also includes a direct link to the secretary’s testimony.

2012-12-18T06:00:03+00:00December 18th, 2012|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on PA Welfare Secretary Testifies About Medicaid Expansion
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