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439,000 Added to PA Medicaid Rolls

150,000 Pennsylvanians have enrolled in Medicaid since the Wolf administration officially launched its HealthChoices expansion on April 27.
Added to the 289,000 who enrolled during the Corbett administration’s Healthy Pennsylvania program, that means about 439,000 Pennsylvanians have obtained Medicaid coverage since the state expanded its Medicaid program as authorized by the 2010 federal health care reform law.
To learn more about the latest Medicaid enrollments, their financial impact on the state, and how the HealthChoices expansion works, see this Wolf administration news release.

2015-07-27T06:00:19+00:00July 27th, 2015|Affordable Care Act, HealthChoices PA, Healthy PA|Comments Off on 439,000 Added to PA Medicaid Rolls

Variations on Medicaid Expansion

While most states that have taken advantage of the Affordable Care Act’s Medicaid expansion have simply expanded their existing Medicaid programs to incorporate the newly eligible, six states have taken a different path, pursuing what are known as section 1115 waivers – waivers of formal Medicaid requirements – to expand their Medicaid programs in different ways.
Typically, those different ways involve coverage modeled on private sector insurance practices, including requiring the newly eligible to choose from among approved managed care plans on the private market; the elimination of some traditional Medicaid benefits; the imposition of work requirements and higher premiums; and more.
In the new report Medicaid Expansion, The Private Option and Personal Responsibility Requirements:  The Use of Section 1115 Waivers to Implement Medicaid Expansion Under the ACA, the Urban Institute takes a close look at the six states that have taken this alternative path; among the states reviewed is Pennsylvania and its now-discarded “Healthy Pennsylvania” Medicaid expansion plan.  In addition, the Commonwealth Fund has published “The Promise and Pitfalls of Alternative State Approaches to Medicaid Reform,” a commentary on the efforts of the states that have followed this alternative path.

2015-06-17T06:00:02+00:00June 17th, 2015|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Variations on Medicaid Expansion

PA Completes First Phase of Medicaid Transition

Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program.
Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014.  In the next few days they will receive written notification of the shift.  All will receive the same Medicaid benefits:  a basic adult benefit package.
Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by September 1.
For more information about the continued transition from Healthy Pennsylvania to HealthChoices, see this news release from the governor’s office.

2015-04-28T06:00:43+00:00April 28th, 2015|HealthChoices PA, Healthy PA, Pennsylvania Medicaid policy|Comments Off on PA Completes First Phase of Medicaid Transition

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February newsletter.
This edition features articles on Medicaid expansion in Pennsylvania; problems posed by Healthy Pennsylvania for individuals who receive drug and alcohol or mental health services and how the state is addressing those problems; and the new, special enrollment period for those who are uninsured to sign up through the federal marketplace and avoid the fine for failing to secure health insurance.
The newsletter also lists upcoming state legislative budget hearings that will address health care issues and raises the possibility of the state establishing an Affordable Care Act-authorized “Community First Choice” program, which gives a state access to additional federal matching funds to pay for attendant services for Medicaid beneficiaries with severe intellectual or physical disabilities.
Find the latest edition of Health Law PA News here.
 

2015-03-13T06:00:18+00:00March 13th, 2015|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on New Pennsylvania Health Law Project Newsletter

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its January 2015 newsletter.
Among the articles in it are pieces on the launch of the Healthy Pennsylvania Medicaid expansion; an update on the temporary extension of the state’s Select Plan for Women; information on how Medicaid recipients who believe they need the state’s new Medicaid “Healthy Plus” benefits package can seek that enhanced coverage; and news on who should consider shifting from a health insurance plan purchased on the federal marketplace to Medicaid.
Find the newsletter here.

2015-02-04T06:00:34+00:00February 4th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off on New Pennsylvania Health Law Project Newsletter

Medicaid Expansion Glitch Hits Drug and Alcohol Patients, Providers

A flaw in the implementation of Pennsylvania’s Medicaid expansion has left many of the state’s Medicaid beneficiaries with no coverage for the treatment of their drug and alcohol problems – and some providers without payment for some care they have delivered.
Health Benefits Claim FormUnder the Healthy Pennsylvania Medicaid expansion program, beneficiaries with extensive health problems, like drug and alcohol issues, were supposed to be directed into the state’s “Healthy Plus” Medicaid benefits package, which covers services that address such problems.  Instead, many were places in private, state-approved insurance plans for Medicaid beneficiaries, which do not cover those services.
State officials are aware of the problem and say they will soon have a plan to fix it.
Learn more about this glitch in Pennsylvania’s Medicaid expansion and how state officials hope to address it in this Philadelphia Inquirer article.
 

2015-01-30T06:00:14+00:00January 30th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off on Medicaid Expansion Glitch Hits Drug and Alcohol Patients, Providers

SNAP Principles for Changing Course on Medicaid Expansion in Pennsylvania

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The third of those four papers presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Those eight principles are:

  • communicate changes effectively to the provider community
  • ensure beneficiaries’ continuity of coverage and continuity of care
  • ensure the adequacy of provider networks
  • simplify beneficiary and provider enrollment
  • preserve vital supplemental payments to safety-net hospitals
  • continue pursuing Medical Assistance payment reforms
  • ensure the long-term financing of Medical Assistance in response to current and future threats to that financing
  • invest in innovative, population-based infrastructure and programmatic improvements

Safety-Net Association of Pennsylvania logoThe first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania:  what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
Find all three SNAP papers here.

2015-01-28T06:00:12+00:00January 28th, 2015|Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off on SNAP Principles for Changing Course on Medicaid Expansion in Pennsylvania

Healthy Pennsylvania Medicaid Benefits Posted

Bookshelf with law booksThe Pennsylvania Department of Human Services has published materials describing Medicaid benefits under the state’s Healthy Pennsylvania Medicaid expansion.
A Medical Assistance Bulletin (#99-15-02) describing the “Interim Healthy Benefit Plan” can be found here and tables comparing the benefits packages under the “Healthy” (low risk), “Healthy Plus” (high risk), and Private Coverage Option plans (PCO) can be found here.

2015-01-22T06:00:53+00:00January 22nd, 2015|Healthy PA, Meetings and notices, Pennsylvania Medicaid laws and regulations|Comments Off on Healthy Pennsylvania Medicaid Benefits Posted

Problems Reported in Healthy PA Medicaid Enrollment

It appears some people may be having trouble taking advantage of Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion.
The Pittsburgh Post-Gazette reports that there is a backlog in processing applications, some people who are eligible to participate are getting rejected for coverage, and some who need drug and alcohol treatment services have been placed in plans that do not provide such coverage.
The state has acknowledged the problem with drug and alcohol coverage but notes that processing applications can take up to 45 days.  So far, the state estimates that 150,000 Pennsylvania households have applied for Medicaid coverage since the enrollment period started on December 1.
To learn more about the challenges Pennsylvania’s Medicaid expansion is encountering, see this Pittsburgh Post-Gazette article.

2015-01-16T06:00:04+00:00January 16th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off on Problems Reported in Healthy PA Medicaid Enrollment

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
The December edition includes articles about Medicaid benefits under Healthy Pennsylvania; the eligibility criteria for Medicaid; the continuation of the state’s General Assistance program for selected immigrants; and the process for some Pennsylvanians currently insured through the federal insurance marketplace to shift to Medicaid coverage instead.
Find the newsletter here.

2015-01-12T06:00:58+00:00January 12th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off on New Pennsylvania Health Law Project Newsletter
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