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PA Health Policy Update for the Week of March 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of March 14-18, 2022.  (Some of the language used below is taken directly from state documents.)

Redistricting Update

The Pennsylvania Supreme Court has denied several appeals of the Legislative Reapportionment Commission’s (LRC) final state legislative district maps.  The maps will now be in place for the next decade.  The Supreme Court also modified the election calendar for petition circulation so legislative candidates will circulate petitions from March 18 to March 28.

General Assembly

  • The General Assembly concluded its FY 2023 budget hearings this week.  The Department of Drug and Alcohol Programs’ presentation before the Appropriations Committee on Wednesday was the last health-related budget hearing.  A recording of the hearing can be found here.  If you would like to view any of the past budget hearings, you can find the Senate hearings here and the House hearings here.
  • The state House of Representatives cancelled voting session next week because of the modified election calendar for petition circulation.  The House and Senate will return to session the week on March 28.

Department of Health

  • The Department of Health (DOH) has asked hospitals to complete a survey from the Legislative Budget and Finance Committee on the designation of a family caregiver for hospital inpatients.  For information about the survey and a link to the survey itself, go here.  DOH and the committee ask hospitals to complete the survey by March 31.
  • DOH has published the third of four planned packages of proposed amendments of the state’s nursing home regulations.  These proposals address matters such as initial licensure and renewal, change in ownership, location, emergency preparedness, reportable diseases, and others.  Find the proposed changes in this Pennsylvania Bulletin notice.  Written comments are due within 30 days of the proposed regulations’ March 19 publication; see the bulletin notice for information about how to submit comments.
  • DOH has shared with the state’s health care providers two documents recently updated by the federal Centers for Medicare & Medicaid Services:  updated guidance on nursing facility visiting, testing, and quarantine policies and an update to CMS guidance for nursing facilities on compliance with the federal rule requiring vaccination of staff and residents.
  • DOH continues to sponsor COVID-19 testing sites in six counties across the state.  Go here for updated information about the sites and their hours.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar for delivering Remittance Advices and corresponding checks to extend into early May.
  • DHS has updated the Medical Assistance fee-for-service fee schedule with new procedure codes for the administration of the MenQuadfi® and Vaxelis® vaccines effective for dates of service on and after June 1, 2021.  For details, see this Pennsylvania Bulletin notice.
  • DHS has updated the Medical Assistance fee-for-service fee schedule to reflect increased fees for the administration of ten COVID-19 monoclonal antibody products effective May 6 and has end-dated procedure code M0239 effective April 16, 2021.  Find the details in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall.  A week ago the state’s seven-day average of new cases was 1108 cases a day; yesterday (March 17) it was 751 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 40 deaths a day a week ago but was 32 deaths a day yesterday (March 17).
  • The decline in the number of Pennsylvania counties experiencing higher rates of community transmission of COVID-19 continues.  Last week, seven counties were in the highest rate of community transmission of COVID-19 cases; this week, none are.  Last week, 37 counties were experiencing a substantial rate of community transmission; this week, 21 are.  Last week, 23 counties were experiencing only a moderate rate of community transmission; this week, 46 are.
  • This week marked the first time since August 5 that the number of Pennsylvanians being treated on a ventilator for COVID-19 fell into double digits.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded $1.3 million in funding to expand drop-in center services for individuals with substance use disorder in areas of the state experiencing high numbers of overdose deaths.  Learn about the challenges the funding seeks to address, how the money will be used, and what organizations received the grant funding in this news release.

Office of the State Fire Commissioner

The Office of the State Fire Commissioner issued guidance this week for the EMS COVID-19 Recovery Grant Program.  Established by Senate Bill 739 (Act 10), this program will provide $25 million to support Pennsylvania’s EMS companies.  The guidance details eligible EMS companies and the certification process necessary to receive the funds.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – March 23

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, March 23 at 1:00 p.m.  Go here to register to attend.

Department of Human Services – Medical Assistance Advisory Committee – March 24

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, March 24 at 10:00 a.m.  Go here to register to attend.

Department of Health – Advisory Health Board – March 31

The Department of Health’s Advisory Health Board will meet virtually on Thursday, March 31 at 10.00 a.m. to discuss programmatic and departmental activities.  This meeting was a previously scheduled for March 16.  For information about how to participate, see this Pennsylvania Bulletin notice, which has the original, superseded meeting date but still has the latest information on how to participate in the meeting.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy, and Critical Congenital Heart Defects subcommittees.  Learn how to join the meeting in this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues.  To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m.  Public comments will be taken after each presentation.  Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation.  There will be an additional period at the end of the meeting for additional public comments.  Go here to register to participate.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

 

2022-03-18T21:10:08+00:00March 18th, 2022|Coronavirus, COVID-19, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of March 14-18
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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2022 newsletter Health Law News.

Included in this month’s issue are articles about:

  • Changes in the Community HealthChoices program.
  • Pennsylvania’s plan for using American Rescue Plan money to address the shortage of health care workers.
  • A new enrollment period on Pennie, the state’s new health insurance exchange.
  • Medicaid coverage of home COVID-19 tests.

Read about these subjects and more in the Pennsylvania Health Law Project’s February 2022 newsletter.

2022-02-28T16:32:18+00:00March 1st, 2022|HealthChoices, Pennsylvania Medicaid|Comments Off on PA Health Law Project Newsletter
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PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023.  Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds.  Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds.  Proposed spending increases include:

  • rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
  • increased Supplemental Nutrition Assistance Program benefits
  • increased supplemental payments to personal care homes
  • increased county mental health funding
  • reducing the waiting list for intellectual disability services
  • expanding court-appointed child special advocates
  • expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced.  The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate.  Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease.  It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate.  Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies.  A press release issued by the governor’s office can be viewed here.

General Assembly

  • The state House and Senate convened for voting session this week.  The following is a selection of health-related bills that received consideration.
    • House Bill 1440 passed on third and final consideration by a vote of 132 to 67.  This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals.  It will now be sent to the Senate.
    • House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66.  The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.
  • The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
  • The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
  • The House Appropriations Committee will begin budget hearings next Tuesday, February 15.  The Senate Appropriations Committee will begin budget hearings the following week, on February 22.  The hearing schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program.  The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system.  Find the bulletin here.
  • DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19.  Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action.  Such comments are due within 30 days.
  • DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting.  Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic.  The update reflects a recent revision in the CDC’s guidance.  Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state.  Learn more in this DOH news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
  • To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
  • The number of new COVID-19-related deaths also remains very high but declined slightly over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
  • To date, more than 42,000 Pennsylvanians have died from COVID-19.
  • The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
  • The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

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

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

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

 

2022-02-11T21:54:18+00:00February 11th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 7-11
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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2022 newsletter Health Law News.

Included in this month’s issue are articles about:

  • The implications of the federal extension of the COVID-19 public health emergency for the state’s Medicaid program.
  • Changes the state is planning for its HealthChoices program later this year.
  • The planned extension of Pennsylvania’s Medical Assistance for Workers with Disabilities Program.
  • An increase in the income limit for participation in the state’s PACENET program that provides financial assistance for prescription drug purchases for low-income seniors.

Read about these subjects and more in the Pennsylvania Health Law Project’s January 2022 newsletter.

 

2022-01-31T18:58:51+00:00February 1st, 2022|Coronavirus, COVID-19, HealthChoices, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter
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PA Health Policy Update for the Week of January 10-14

The following is an update of selected state health policy developments in Pennsylvania for the week of January 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has announced the creation of the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment program, or LTC RISE, which seeks to give long-term-care facilities “…the support they need to battle COVID-19, recover, and rebuild.”  Under the program, long-term-care facilities can pursue improvement projects in the areas of infection prevention and control and emergency preparedness; building a sustainable outbreak response operation; and promoting professional development and a resilient long-term-care facility workforce.  The program is funded by a federal grant and replaces the state’s Regional Congregate Care Assistance Teams program, which expired at the end of 2021.  Learn more about LTC RISE from this Wolf administration news release and from the LTC RISE web page.

General Assembly

  • The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act.  This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.  The bill was received in the Senate and referred to the Health and Human Services Committee.
  • The House Health Committee convened on Tuesday, January 11 and favorably reported House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.  The committee also reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
  • The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m.  The hearing will take place at the University of Pittsburgh at Bradford.
  • The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
  • The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
  •  The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

  • Various Department of Human Services (DHS) regulations were suspended to facilitate the state’s response to the COVID-19 pandemic.  Some of those suspensions have been lifted, so some of the temporarily suspended regulations are being enforced again.  For an updated list of regulations and their current status, organized by offices within DHS and with the most recent changes highlighted, go here.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of booster doses of COVID-19 vaccines.  To find those new codes and the rates to be paid, see this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of the Pfizer pediatric COVID-19 vaccine.  Find the procedure codes, rates, and more in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin informing providers of changes in billing procedures for certified registered nurse practitioners and physician assistants serving fee-for-service patients.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that the fee-for-service program will require prior authorization for prescribing Aduhelm (aducanumab), the new drug to treat Alzheimer’s disease.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that it has issued updated handbook pages presenting the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Xyrem (sodium oxybate)/Xywav (calcium, magnesium, potassium, and sodium oxybates) for fee-for-service patients.  Find the notice here.
  • DHS announced that it intends to continue making Medical Assistance Day One Incentive payments to qualified non-public nursing facilities in FY 2022.   These payments seek to give incentives to non-public nursing facilities to serve individuals who are Medical Assistance-eligible on the day of admission.  Learn more about how and when the payments will be made and how they will be calculated in this Pennsylvania Bulletin notice.
  • DHS is making available for public review and comment its proposed renewal application for extension of the Section 1115 Medicaid demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration.”  The effective dates of the current approved demonstration are October 1, 2017 through September 30, 2022.  The extension requested will be for an additional five years, through September 30, 2027.  Learn more about the program and the state’s planned request from this Pennsylvania Bulletin notice.
  • DHS’s Office of Child Development and Early Learning has updated its FAQ on its guidance for tuberculin skin testing and COVID-19 vaccinations for providers participating in its licensed programs.  Find that FAQ here.

Department of Health

In the past week the Department of Health announced the opening of a new COVID-19 testing site in Cambria County to go along with other recently opened testing sites in Berks, Blair, Centre, Clinton, Delaware, Luzerne and Mifflin counties.  In addition, the state has announced that a new high-volume and high-throughput COVID-19 testing site will be opening soon in Delaware County at Mercy Fitzgerald Hospital.  This site will be staffed by U.S. Department of Health and Human Services contractors with additional support from the host location, the costs for which will be eligible for reimbursement by FEMA.  The Department of Health continues to talk to federal officials about the possibility of opening an additional high-volume testing site in the south-central part of the state.

The Department of Health has announced that Credentia will serve as its new contractor to operate the Pennsylvania nurse aide registry previously operated by Pearson Vue.  Go here for the nurse aide registry search.  The Pearson Vue link no longer works as of January 3.

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

The Pennsylvania Rural Health Redesign Center Authority Board will hold its next virtual meeting on Tuesday, January 18 at 10:00 a.m.  The meeting will provide updates on a variety of topics, including model status updates, federal grant deliverables, global budget methodology, and more.  It also will address current and upcoming activities.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Infant Hearing Screening Advisory Committee – January 20

The Infant Hearing Screening Advisory Committee will hold a public meeting both in person and virtually on Thursday, January 20 at 1:00 p.m.  Agenda items will include reports by the cytomegalovirus and audiology subcommittees, an assessment of audiology training currently in development, and a review of upcoming program activities.  For information about how to join the meeting, either virtually or in person, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m.  Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m.  This meeting will be broadcast live through Commonwealth Media Services.  Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27 at 10 a.m.  To participate, call 412-648-8888 or 866-588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

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

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

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

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

 

2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 10-14
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PA Health Policy Update for the Week of October 25-29

The following is an update of selected state health policy developments in Pennsylvania for the week of October 25-29, 2021.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • The Senate passed Senator Vogel’s telemedicine bill (Senate Bill 705) this week by a vote of 46-4.  The bill has been received in the House and referred to the Insurance Committee.
  • The House of Representatives unanimously passed House Bill 1260, which, among other things, increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples.  The bill has been received in the Senate and referred to the Aging & Youth Committee.
  • The House Human Services Committee met on Tuesday, October 26 and favorably reported the following bills:
    • House Bill 1561 and House Bill 1563 amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to more easily share patient mental health and substance use disorder treatment information.
    • House Bill 1995 clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.
    • House Bill 1308 enables local communities and agencies to establish overdose fatality review teams.
  • The House and Senate will be in recess the week of November 1.

Department of Human Services

The Department of Human Services’ (DHS) Office of Mental Health & Substance Abuse Services (OMHSAS) has posted a Behavioral Health Telehealth Frequently Asked Questions (FAQs) memorandum in response to inquiries regarding recent OMHSAS behavioral health telehealth policy changes in OMHSAS-21-09 Guidelines for the Delivery of Behavioral Health Services Through Telehealth.

DHS has published Medical Assistance physical health managed care enrollment data for September.

Department of Health

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained steady over the past week.
  • The number of new COVID-19-related deaths remains high but did not rise during the past week.  The state surpassed 31,000 deaths from COVID-19 this week.
  • The number of Pennsylvanians hospitalized, in hospital ICUs, and on ventilators because of COVID-19 has remained steady throughout October.
  • 71.6 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people.  43,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Insurance Department

The Insurance Department has notified all basic insurance coverage insurers and self-insured participating health care providers that the annual assessment to be levied for calendar year 2022 shall be 12 percent applied to the prevailing primary premium for each participating health care provider.  Learn more from this Pennsylvania Bulletin notice.

Stakeholder Events

Health Care Cost Containment Council – November 4

The Health Care Cost Containment Council will meet via teleconference on Thursday, November 4 at 10:00 a.m.  The public is invited to participate.  See this Pennsylvania Bulletin notice about how to join the meeting.

Organ Donation Advisory Committee Meeting – November 4

The Organ Donation Advisory Committee will hold a virtual meeting on Thursday, November 4 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Traumatic Brain Injury Advisory Board – November 5

The Traumatic Brain Injury Advisory Board will hold a virtual meeting on Friday, November 5 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m.  To participate virtually or by phone, go here for further information.

Health Research Advisory Committee – November 15

The Department of Health’s Health Research Advisory Committee will hold a virtual public meeting on Monday, November 15 at 1:00 p.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Pennsylvania Rural Health Redesign Center Authority Board – November 16

The Department of Health’s Pennsylvania Rural Health Redesign Center Authority Board, which is charged with administering the Pennsylvania Rural Health Model, will hold a virtual public meeting on Tuesday, November 16 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Newborn Screening and Follow-Up Technical Advisory Board – November 18

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Thursday, November 18 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Stakeholder Events Materials

Medical Assistance Advisory Committee

Pennsylvania’s Medical Assistance Advisory Committee met on Thursday, October 28.  The Office of Medical Assistance Programs, Office of Long-Term Living, Office of Mental Health & Substance Abuse Services, and Office of Developmental Programs all made presentations.  Go here for links to those presentations.

 

2021-10-29T21:31:31+00:00October 29th, 2021|Coronavirus, COVID-19, HealthChoices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for the Week of October 25-29
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PA Health Policy Update for the Week of July 19-23

The following is an update of selected state health policy developments in Pennsylvania for the week of July 19-23, 2021.  (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate Health & Human Services Committee and Communications & Technology Committee held a joint hearing on Wednesday to examine contracts awarded by the Department of Health  through emergency procurements.  The hearing largely focused on the department’s recent announcement that it intends to enter into a year-long $34 million contract with Public Consulting Group (PCG) to conduct COVID-19 contact tracing.  PCG is being hired to replace the state’s former contact-tracing vendor, Insight Global, which received a multi-million contract last year through an emergency procurement but was fired in May for mishandling sensitive personal information.  Read Acting Health Secretary Alison Beam’s testimony here and watch a replay of the hearing here.

Office of the Attorney General

Attorney General Josh Shapiro announced this week a $26 billion settlement with Cardinal, McKesson, AmerisourceBergen, and Johnson & Johnson for their role in the opioid epidemic.  This agreement would resolve the claims of nearly 4,000 state and local governments across the country that have filed lawsuits against these companies.  States have 30 days to agree to the settlement and local governments have 150 days.  Shapiro has estimated that Pennsylvania will receive as much as $1 billion from the settlement.

Department of Health

Wolf administration officials announced proposed changes in state nursing home regulations that seek to improve the quality of care received by residents by increasing the minimum direct care hours by 1.4 hours each day.  The current skilled nursing facility regulations have not been updated since 1999.   The Department of Health has indicated that it intends for this to be the first of five proposals to update the regulations governing long-term-care facilities.  With this announcement the Department of Health submitted the first installment of the proposed nursing home regulations to the General Assembly, the state’s Independent Regulatory Review Commission, and the Legislative Reference Bureau.  The next step is for these proposed regulations to be published in the Pennsylvania Bulletin by the end of July, which will start a 30-day public comment period.  Learn more from this Wolf administration news release about the newly proposed regulations and go here, to the web site of the Independent Regulatory Review Commission, to find the proposed regulations themselves.

Department of Human Services

DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” with new data on the number of Pennsylvanians who participated in Medical Assistance managed care in April, May, and June.  The report breaks down Medicaid managed care enrollment by county, by racial and ethnic group, and by health plan.  Find the report here.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases rose considerably over the past week, with Tuesday’s total the highest one-day figure in more than one month.  Even these higher numbers are only between one-third and one-half of what they were at this time two months ago.
  • The number of Pennsylvanians hospitalized with COVID-19 has risen 12 percent since the beginning of July and the number in hospital ICUs has risen a good deal in recent days.  The number of COVID-19 patients on ventilators continues to decline.
  • 5.6 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard, but only 56,000 completed the full vaccination regimen in the past week – barely more than half the number of last week; another 823,000 Philadelphians are now fully vaccinated but only 10,000 reached that status in the past week.

Around the State

  • The Philadelphia Department of Public Health now “…strongly recommends that everyone, including fully vaccinated people, wear masks in all public indoor places,” Philadelphia health officials announced in their latest update on the state of COVID-19 in the city.
  • A long-sought psychiatric residential treatment facility in Philadelphia for kids with complex needs may close just a few months after it opened because the state has revoked its license.  The Philadelphia Inquirer explains why.
  • Opioid problems, addictions, and deaths are rising in western Pennsylvania, the Pittsburgh Tribune-Review reports.
  • Will Pennsylvania public school students be required to wear masks when they return to the classroom in September?  In Pittsburgh it looks like they will; elsewhere in Allegheny County, some will and some will not; in Philadelphia they definitely will; in the Scranton School District they are still deciding; and in the Central Bucks School District masks will be optional.
  • “Pennsylvania officials in Harrisburg are mulling pay increases, signing bonuses and student loan forgiveness for the state’s care workers who provide home and community based services – part of a plan to spend an additional $1.2 billion in federal funding for those services that allow seniors and people with disabilities to live independently,” according to the Pittsburgh Post-Gazette, which also reports on the proposed strategy the state has submitted to the federal Centers for Medicare & Medicaid Services.
  • City and State Pennsylvania, which describes itself as a “…multi-media news firm that dedicates its coverage to Pennsylvania’s state and local government, political and advocacy news,” has come out with a list of “The Pennsylvania Healthcare Power 100.”  See who made the cut here.
  • About 1500 employees of more than a dozen Pennsylvania nursing homes will go on a one-day strike on July 27.  GoErie explains why.
  • Worried about the recent increase in the number of new COVID-19 cases?  Experts in western Pennsylvania are not – at least not yet.  The Pittsburgh Tribune-Review shares their thoughts.
  • The Justice Department has informed the Wolf administration that it will not investigate whether the state ordered nursing homes to accept residents after they had been treated in a hospital for COVID-19, which would have been a violation of federal law, according to the Associated Press.

Stakeholder Events

Special Pharmaceutical Benefits Program

July 29 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728#   United States, Pittsburgh

(866) 588-4789,,785376728#   United States (Toll-free)

Phone Conference ID: 785 376 728#

Traumatic Brain Injury Advisory Board

August 6 at 9:00 a.m.

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, August 6, 2021.  For information about the board’s mission, meeting materials, and how to participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

August 11-12 at 9:00 a.m.

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, August 11, 2021, and Thursday, August 12, 2021 from 9 a.m. to 4:30 p.m.  To see the agenda and find information about where the meeting will be held and how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

2021-07-23T21:07:14+00:00July 23rd, 2021|Coronavirus, COVID-19, HealthChoices, long-term care, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of July 19-23
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HealthChoices Procurement Again Mired in Litigation

For the past six years Pennsylvania has been trying to rebid its HealthChoices Medicaid managed care contracts but every time it does, the losing bidders sue the state and the procurement process grinds to a halt.

Three times since 2015 the state has issued requests for proposals from managed care companies and all three times at least one of the losing parties has responded to its defeat by filing a lawsuit.

This is happening, many believe, because the state’s Medicaid managed care contracts are so lucrative – a stark contrast with state Medicaid payments to providers, which are generally considered poor.

The matter is now in the state’s Commonwealth Court, and the stakes are great:  the contracts are for five years, with a possible option for another three.

The Philadelphia Inquirer has taken a look at the challenges that have prevented Pennsylvania from awarding new HealthChoices Medicaid managed care contracts in the article “Insurers want Pa.’s Medicaid business so badly they keep suing the state.”

 

2021-07-07T19:42:10+00:00July 7th, 2021|HealthChoices, Pennsylvania Medicaid|Comments Off on HealthChoices Procurement Again Mired in Litigation
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PA Health Policy Update for the Week of June 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of June 21-25, 2021.  (Some of the language used below is taken directly from state documents.)

State-Wide Mask Mandate

The Department of Health announced that it is lifting its order requiring universal face coverings at 12:01 a.m. on Monday, June 28.   See the announcement here.  The department continues to urge Pennsylvanians to follow CDC guidance for wearing a mask where required by law, rule, and regulations, including health care, local business, and workplace guidance.  For the protection of themselves and others, individuals who have not yet been vaccinated or are partially vaccinated are still encouraged to wear a mask when in public.

Legislative Update

The following are health care bills that have received third and final consideration in the state House and/or Senate as of Thursday, June 24. Both chambers will hold voting session on Friday and Saturday and we anticipate there will be additional health care-related measures passed. We will provide an update following the end of session on any pertinent bills.

  • Senate Bill 115 – establishes the Nurse Licensure Compact Act, which upon enactment makes the Commonwealth a party to the Nurse Licensure Compact with all other states that have joined the compact. The bill was passed by the House 146-55 and sent to the Governor’s desk.
  • Senate Bill 425 – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions, or medications and devices. The bill was unanimously passed by the House on June 24th and sent to the Governor’s desk.
  • Senate Bill 484 – adds the chair of the State Veterans’ Commission or a designee to the Pennsylvania Long-term Care Council. The bill was unanimously passed by the House on June 24th and sent to the Governor’s desk.
  • Senate Bill 618 – prohibits the use of vaccine passports by government entities. It also prohibits institutions of higher education from requiring proof of vaccination against COVID-19 to use a service, enter a building, or undertake an activity, including attending class in person. In addition, the bill further restricts the Secretary of Health’s ability to implement certain disease control measures for individuals who have not been exposed, potentially or otherwise, to a contagious disease. The bill was signed in the state House and Senate on June 24th and sent to the governor. The governor has indicated he will veto

Department of Human Services

Department of Health

Effective at midnight on June 23, 2021, the Department of Health terminated its order requiring skilled nursing facilities to complete a vaccine needs assessment survey since those facilities are now reporting to the federal government.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline significantly.  The 174 new COVID-19 cases reported on Wednesday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
  • The number of COVID-19 deaths continues to decline significantly as well.
  • For the week from June 11 through June 17 the state’s overall COVID-19 test positivity rate was 1.4 percent, down from 1.9 percent last week and 2.9 percent the week before.
  • Sixty-four counties had a positivity rate lower than five percent, up from 62 last week, and no counties had a positivity rate greater than 20 percent for the eighth consecutive week.
  • Thirty-seven counties are currently experiencing low levels of community transmission of COVID-19, up from 22 last week; the remaining 30 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
  • Since June 1 the number of Pennsylvanians hospitalized with COVID-19 has fallen 62 percent; the number on a ventilator has fallen 54 percent; and the number in hospital intensive care units has fallen 70 percent.
  • 5.3 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard.  Growth in this number has slowed significantly over the past month and only about 150,000 new vaccinations were reported in the past week. Another 760,000 people have been vaccinated in Philadelphia.  According to the state, 59.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.2 percent of the entire population has now received at least the first dose of a vaccine.

Around the State

Two Pennsylvania children’s hospitals ranked among the best ten such hospitals in the U.S. in the latest rankings published by U.S. News & World Report:  Children’s Hospital of Philadelphia ranked second and UPMC Children’s Hospital of Pittsburgh ranked ninth.

Two Pennsylvania-based health insurers, Highmark and Independence Blue Cross, are among five Blues plans joining forces in a new venture called Evio, a for-profit venture that will seek to make prescription drugs more affordable and improve health care outcomes.  Learn more here.

Stakeholder Events

  • Maternal Mortality Review Committee

June 28 at 8:00

This meeting will be held via conference call.  The purpose of the meeting is to discuss new and ongoing procedural issues relating to the review process for the committee.  To join the call, dial +1 (267) 332-8737 and when prompted, enter the following conference code: 522 321 931#.

  • DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

  • Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar.  Public comments will be taken after each presentation and questions can be entered in the chat box.  Interested parties can participate in the following ways:

Webinar registration – go here

Dial in:  1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

  • Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting.  The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

  • Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728#   United States, Pittsburgh

(866) 588-4789,,785376728#   United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Medical Assistance Advisory Committee Meeting – June 24

Deputy DHS Secretary Sally Kozak announced that DHS will perform readiness reviews of the managed care organizations selected to participate in the latest HealthChoices program procurement.  The procurement remains the subject of litigation so DHS will stop short of negotiating with the managed care organizations until there is a final decision in that case.

Stakeholder Events Materials

DHS has posted four presentations offered at the June 24 meeting of the Medical Assistance Advisory Committee.  Those presentations were delivered by its:

 

2021-06-26T13:46:01+00:00June 26th, 2021|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2022 budget, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for the Week of June 21-25
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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May 2021 newsletter.

Included in this month’s edition are articles about:

  • Medicaid eligibility changes permitted for people with Medicare during the COVID-19 emergency.
  • Changes in the Medical Assistance work supports program.
  • The introduction of changes in the process for enrolling in the state’s Living Independence for the Elderly Program (LIFE).
  • The simplification of the dental benefit limits exceptions process.
  • A listening session during which Community HealthChoices participants expressed dissatisfaction with receiving their benefits through managed care.
  • Actions to terminate some participants from state home and community-based Medicaid programs because their health status has not been reassessed.

Read about these subjects and more in the Pennsylvania Health Law Project’s May 2021 newsletter.

2021-06-07T18:26:31+00:00June 9th, 2021|HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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