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PA Health Policy Update for September 22

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

General AssemblyHarrisburg, PA capital building 

  • The state Senate convened for voting session this week. The following bills were passed on third and final consideration.
    • House Bill 1209 and House Bill 1407 make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. Both bills will now be sent to Governor Shapiro for his signature.
    • Senate Bill 712 allows clinical laboratories certified by the federal government to directly or indirectly advertise or solicit business for diagnostic laboratory testing under certain terms and conditions. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
    • Senate Bill 773 makes various changes to the Medical Marijuana Act. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
  • The House Health Committee held a public hearing on Wednesday, September 20 on House Bill 1657, which amends the Clean Indoor Air Act. A recording of the hearing may be viewed here.
  • Democrat Lindsay Powell won a special election Tuesday, September 19 to fill the vacancy created by the resignation of Representative Sara Innamorato (D – Allegheny), who’s running for Allegheny County Executive. Powell’s victory will preserve the Democrat’s one-seat majority in the House of Representatives.
  • The state House of Representatives will convene next Monday, September 26 and Tuesday, September 27 for voting session. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to electronic visit verification requirements for pediatric home health aide services in the fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate $258 million for FY 2023-2024 inpatient disproportionate share hospital (DSH) 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 October. Find the updated calendar here.

Department of Health 

The U.S. Centers for Disease Control and Prevention (CDC) reported this week that a team of epidemiologists from the Pennsylvania Department of Health (DOH) was the first to identify the transmission of Legionella from an organ directly to a transplant patient. This finding will help protect transplant recipients from serious lung infections. The published research can be viewed in the CDC’s Morbidity and Mortality Weekly Report.

DOH has released a Health Advisory (PAHAN – 719) with recommendations regarding the updated (2023-2024) Monovalent mRNA COVID-19 vaccines. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (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 

DHS – Consumer Subcommittee of the MAAC – September 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, September 27 at 1:00 p.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – September 28

The MAAC will hold a meeting on Thursday, September 28 at 10:00 a.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here. 

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

2023-09-22T18:52:13+00:00September 22nd, 2023|Medicaid Eligibility Redetermination , Medicaid supplemental payments, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for September 22
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PA Health Policy Update for February 17

The following is an update of selected state health policy developments in Pennsylvania from February 11-17.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House of Representatives will convene for session on Tuesday, February 21 at 12:00 p.m. The state Senate is scheduled to return on Monday, February 27.

Department of Human Services

  • The fee-for-service subcommittee of the Department of Human Services (DHS) Medical Assistance Advisory Committee met on Wednesday, February 8.  See the presentation made by Office of Medical Assistance officials during that meeting.
  • DHS’s Office of Long-Term Living offered a presentation during the February 14 meeting of the Medical Assistance Advisory Committee’s long-term services and supports subcommittee.  Find that presentation here.
  • DHS has published a notice of its funding allocation for FY 2023 inpatient disproportionate share hospital (DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals; outpatient supplemental payments to qualifying inpatient acute-care general hospitals; direct medical education payments to qualifying inpatient acute-care general hospitals; and certain DSH and supplemental payments to new hospitals.  It is not otherwise changing the qualifying criteria or payment methodology for these payments.  These payments will amount to $257.76 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a notice of its funding allocation for DSH payments to qualifying acute-care general hospital burn centers, to qualifying acute-care general hospitals providing obstetrical and neonatal services, to critical access and qualifying rural hospitals, and to qualifying acute-care general hospitals that treat a high percentage of Medical Assistance patients under 18 years of age.  Together, the payments amount to $107.655 million in total state and federal funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published procedure codes and payment rates for the administration of the Pfizer and Moderna bivalent booster dose of the COVID-19 vaccines.   Find the codes, the rates, and their effective dates in this Pennsylvania Bulletin notice.
  • DHS’s Office of Long-Term Living has informed stakeholders that the Centers for Medicare & Medicaid Services has approved renewal of the Community HealthChoices waiver, effective January 1, 2023, for five years.  See the DHS message here.
  • DHS has published a notice announcing that it will increase fees in the Medical Assistance Program for certain ambulance transportation services in both the fee-for-service and managed care delivery systems, effective with dates of service on and after January 1, 2023.  Those fees will be not less than $325 for basic life support ambulance transportation services, not less than $400 for advanced life support ambulance transportation services, and not less than $4 per loaded mile for each loaded mile beyond 20 loaded miles for ground ambulance transportation.  Learn more from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has issued a health alert to providers advising them about a possible nation-wide increase in invasive group A streptococcal (iGAS) infections in children.  This increase, however, reflects only a return to pre-pandemic levels.  The alert includes information about the condition and offers guidance for clinicians and laboratories.  Find the alert here.
  • DOH has published information about its Medical Care Availability and Reduction Error (MCARE) Act surcharge for FY 2023, a per unit assessment of approximately $156.56 payable by June 1.  Learn more about the surcharge and the providers to which it applies from this Pennsylvania Bulletin notice.
  • DOH has published information about its Nursing Home Patient Safety Trust Fund surcharge for FY 2023.  That surcharge will be $13.83 per nursing facility bed.  Learn more from this Pennsylvania Bulletin notice.
  • DOH has published a list, as required by regulation, of hospitals that have chosen to exercise their religious or moral beliefs regarding the provision of certain contraception-related emergency services and will instead refer patients to other hospitals to receive such services.  Learn more from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week remained at the same levels as last week.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs declined 25 percent.
  • The CDC reports a six percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
  • For the week ending February 15, five Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 16 counties experienced a substantial rate of community transmission; and the remaining 46 counties experienced a high rate of community transmission – all the same numbers as last week.

Department of Drug and Alcohol Programs

In response to the continuing challenge health care providers are having maintaining an adequate workforce, the Department of Drug and Alcohol Programs is conducting a workforce climate survey among drug and alcohol service providers to learn about which jobs and positions are in short supply or understaffed, the challenges these providers face, what they are doing to address them, and how they think the state can help them address those challenges.  Find that survey here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission has issued comments in response to regulations proposed by the State Board of Nursing that address licensure by endorsement and reactivation.  Find those comments in this Pennsylvania Bulletin notice.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – February 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on  Wednesday, February 22 at 1:00.  Learn more from the meeting’s agenda and go here to register to participate.

DHS – Medical Assistance Advisory Committee Meeting – February 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 23 at 10:00.  For the meeting agenda go here and to register to participate go here.

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

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00.  For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-02-17T21:42:53+00:00February 17th, 2023|COVID-19, DSH hospitals, long-term care, Medicaid supplemental payments, Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 17
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PA Health Policy Update for February 3

The following is an update of selected state health policy developments in Pennsylvania from January 28 to February 3.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro has signed an executive order seeking to improve the state’s licensing, permitting, and certification processes, launching a review of how long it takes agencies to process applications and how workers and businesses apply online.  This executive order seeks to establish definitive dates for when applicants for licenses, permits, and certificated will hear back from the state, and if applicants do not receive a response by that date, the agency responsible will refund their application fee.  Learn more from this news release from the governor’s office and from the executive order.

General Assembly

State Representative Lynda Schlegel Culver won a special election this week to replace former state Senator John Gordner, who resigned to become counsel to Senate President Kim Ward.  Senator-elect Culver will represent the 27th district, which includes all of Columbia, Montour, Northumberland, and Snyder counties and part of Luzerne County.  Once she resigns from her state House seat a special election will be scheduled to replace her.

Department of Human Services

  • The Department of Human Services (DHS) has notified hospitals with accredited Level I, II, III, or IV trauma centers of the required annual attestation for inclusion in the FY 2022-23 Trauma DSH Program.  The deadline to submit completed attestations is February 24.  Potentially eligible trauma centers that have not been notified should contact DHS at RA pwdshpymt@pa.gov.  Questions regarding the attestation form and the Trauma DSH Program also should be directed to this address.
  • DHS has posted information for providers on how to check the status of their electronic Medical Assistance provider enrollment application and what to do if their application was returned for additional information.  Find it here.
  • DHS has posted information for group providers on how to reactivate, revalidate, or make
    changes to group members.  Find it here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has announced a grant program through which qualified entities may apply for funding to invest in technology and training for behavioral health telehealth providers.  The state has allocated $4 million for one-time grants of up to $50,000 for providers that meet a number of criteria, including having fewer than 50 employees and at least 51 percent of their clients enrolled in Medicaid.  Learn more about the program, eligibility criteria, and how to apply from this OMHSAS notice.  Applications will be accepted until December 31 or until the $4 million is exhausted.
  • DHS has posted the presentations offered during the January 26 meeting of the Medical Assistance Advisory Committee.  See presentations from the:

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported daily in Pennsylvania declined over the past week and the number of new daily deaths returned to the usual range for COVID-19-related deaths in recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on a ventilator because of the virus, and in hospital ICUs with COVID-19 all declined slightly over the past week.
  • The CDC reports an 11 percent decrease in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • For the week ending February 2, one Pennsylvania county – Cameron – experienced a low rate of community transmission of COVID-19; seven counties experienced a moderate rate of community transmission; eight counties experienced a substantial rate of community transmission; and the remaining 49 counties experienced a high rate of community transmission.

Insurance Department

The Insurance Department is conducting a medical professional liability insurance study to determine whether sufficient capacity exists to increase the basic coverage limits of insurance required by the Medical Care Availability and Reduction of Error (MCARE) Act.  Learn more about the issues the study will address from this Pennsylvania Bulletin notice.  Stakeholder comments are due by March 4.

Stakeholder Events

Department of Health – Preventative Health and Health Services Block Grant Advisory Committee Meeting – February 13

The Department of Health’s Preventative Health Services Block Grant Advisory Committee will meet in Harrisburg on Monday, February 13 at 1:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

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

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00.  For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00.  For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-02-03T20:51:28+00:00February 3rd, 2023|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 3
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PA Health Policy Update for Friday, December 23

The following is an update of selected state health policy developments in Pennsylvania for the week of December 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers about new procedures for dispensing 340B-purchased drugs to Medical Assistance beneficiaries and about the implementation of the program’s 340B drug exclusion list.  Find the bulletin here.  Find the policies this new bulletin replaces here.
  • DHS has extended its schedule for sending Remittance Advice documents, Medicaid payment checks, and electronic transfers of payments into early February.  Find the updated schedule here.
  • DHS has announced that it will add several prescription drugs to the Medical Assistance program’s list of services and items requiring prior authorization:  corticotropin; targeted systemic immunomodulators for atopic dermatitis, designated as preferred on the program’s preferred drug list (PDL); PCSK9 inhibitor lipotropics, designated as preferred on the PDL; and obesity treatment agents designated as preferred on the PDL.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has posted revisions of the participating drug company list for the Medicaid drug rebate program.
  • DHS has announced its intent to allocate funds in FY 2023 for several classes of inpatient disproportionate share hospital (DSH) payments (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  See the announcement, including information about the different purposes for which Medicaid DSH payments will be made, in this Pennsylvania Bulletin notice.
  • DHS has circulated the following materials from the December 7 meeting of the Medical Assistance Advisory Committee meeting.

Department of Health

  • The Department of Health (DOH) has announced that Pennsylvania will receive $98 million in federal funding to enhance public health infrastructure, including staffing, health planning, and equity and data modernization efforts.  A portion of the funding, from the CDC’s Public Health Infrastructure grant program will be allocated to 10 county and municipal health departments.   Learn more from this Department of Health news release.
  • DOH has issued a health advisory informing providers to be aware of possible increases in group A streptococcal infections.  The alert also informs providers about symptoms, testing, and treatment; provides instructions for laboratories that identify cases; and reminds providers and laboratories that they are required to report such cases to DOH.  Find the alert here.
  • DOH has issued a health advisory with interim guidance for clinicians on how to prioritize antiviral flu treatment at a time when there is limited availability of the drug oseltamivir (Tamiflu).  Find the advisory here.
  • DOH has revised long-term-care nursing facility regulations recently approved by the Independent Regulatory Review Commission to correct typographic errors.  Find the revised, final regulations in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs remained steady over the past week but the number on ventilators rose 17 percent.
  • The CDC reports no change over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 21, 46 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 15 were experiencing substantial rates of community transmission; and six counties were experiencing a moderate rate of community transmission.
  • As 2022 draws to a close, Pennsylvania has now experienced 3.4 million confirmed, reported cases of COVID-19 and suffered nearly 49,000 deaths from the virus.
2022-12-23T21:11:29+00:00December 23rd, 2022|COVID-19, long-term care, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 23
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PA Health Policy Update for Friday, December 9

The following is an update of selected state health policy developments in Pennsylvania for the week of December 5-9, 2022.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Shapiro announced that he will appoint Uri Monson, the chief financial officer of the School District of Philadelphia, as Budget Secretary.  He also announced Jennifer Selber will be appointed General Counsel and Larry Hailsham, Jr. will be Executive Deputy Chief of Staff.  Selber currently serves as the Executive Deputy Attorney General of Pennsylvania in charge of the criminal division and Hailsham most recently served as the Shapiro campaign’s political director.

General Assembly

  • Democrats and Republicans continue to struggle over control of the state House. On Wednesday Representative Joanna McClinton (D-Philadelphia) was sworn in during an unannounced ceremony as majority leader.  Republicans swiftly denounced the swearing-in as an “illegitimate power grab.”  In addition, Representative Summer Lee (D-Allegheny County) and Representative Austin Davis (D-Allegheny County) formally submitted their resignations on Wednesday.  At the same time they won re-election to those seats Ms. Summer was elected to Congress and Mr. Davis was elected Lieutenant Governor.  Their resignations, along with the passing of Representative Tony DeLuca (D-Allegheny County), make the current breakdown in the state House 101 Republicans and 99 Democrats.
  • The state Senate released its 2023 session calendar through June.  The calendar can be viewed here.

Department of Human Services

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose nearly 30 percent in the past week, an increase possibly attributable to social gatherings over the Thanksgiving holiday.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively unchanged.
  • The CDC reports a 22 percent increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 7, 39 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 25 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.  This is almost identical to the previous week.

Department of Drug and Alcohol Programs

  • The Department of Drug and Alcohol Programs has issued an information bulletin explaining that as a result of a new Pennsylvania law passed last month, private and public treatment and rehabilitation facilities may not deny addiction treatment to individuals based solely on a negative result on a drug test.  This policy takes effect on January 1.  Learn more from this information bulletin.
  • The Department of Drug and Alcohol Programs has announced that it has awarded nearly $19 million in grant funding through its substance use disorder loan repayment program to help substance use disorder treatment professionals repay their outstanding qualifying educational loans.  More than 280 practitioners, including case managers, counselors, licensed social workers, physician assistants, and registered nurses, shared in the funding.  Learn more from this department news release.

State Board of Nursing

The State Board of Nursing proposes amending its process for reactivating nursing licenses.  Learn more from this Pennsylvania Bulletin notice.  Public comments on the proposed changes are due within 30 days.

2022-12-09T21:00:26+00:00December 9th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 9
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PA Health Policy Update for Friday, December 2

The following is an update of selected state health policy developments in Pennsylvania for the week of November 28 to December 2, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced ​the availability of more than $9 million in state grant funding for Single County Authorities to establish or expand crisis stabilization services for individuals with co-occurring mental health and substance use disorders.  Grants of up to $3 million will be awarded to eligible Single County Authorities and can be applied toward a range of activities, including construction and building infrastructure, staffing, and programming.  Learn more about how the state envisions counties using this money from this announcement from the governor’s office.

Governor-Elect Shapiro

The Shapiro-Davis transition team announced that Dana Fritz will serve as chief of staff in a new Shapiro administration.  Immediately prior to joining the incoming administration, Ms. Fritz, a long-time aide to Shapiro, served as his campaign manager.  Find additional information about the transition here.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for November.  General Fund revenue collections were $201.9 million, or 6.8 percent, below estimate for the month.  The shortfall is due, in part, to personal income tax revenue being deposited in December rather than November. Fiscal year-to-date General Fund collections total $15.7 billion, which is $183.2 million, or 1.2 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to update the qualifying criteria and payment methodology for Medicaid disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying emergency departments in acute-care general hospitals by adding references to the report used in determining the eligibility for and the payment amounts beginning FY 2022-2023.  This announcement appears to be a codification of current state policy.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that it plans to expand the Living Independence for the Elderly (LIFE) Program to serve Carbon County and Monroe County as one area and is soliciting expressions of interest in serving this area.  Learn more about the LIFE program, DHS’s intentions for Carbon and Monroe counties, and the process for pursuing an opportunity to establish a LIFE program in those counties from this Pennsylvania Bulletin notice.
  • CMS has written to states to remind them that with the passage of the Inflation Reduction Act, Medicaid and Children’s Health Insurance Program (CHIP) programs will be required to provide coverage for approved adult vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) without cost-sharing for certain enrollees beginning October 1, 2023.  Learn more from this CMS notice.
  • DHS has circulated the minutes of the October 26 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.  Find those minutes here.

Department of Health

  • The Department of Health (DOH) issued a press release announcing its plans to distribute approximately $11.7 million in federal CDC funding to help long-term-care facilities build resilience to sustain quality care.  The money will be invested for purposes such as workforce development, staff retention, and infrastructure developments that support infection prevention control and emergency preparedness.  Eligible applicants include skilled nursing facilities, personal care homes, assisted living facilities, and intermediate care facilities.  Learn more about the program and find links to additional information about it here.  The deadline for applying for funding is December 31.
  • DOH has issued a health alert informing health care providers of a recent increase in reports of mushroom poisoning received by poison control centers in the state.  The majority of these cases have involved individuals consuming wild mushrooms foraged from backyards, public parks, wooded areas, and other locations in the southeastern part of the state.  Learn more from this department health alert.
  • DOH has updated the guidelines and fees that health care providers and facilities may charge in response to requests for production of medical charts or records.  Learn more, including the new fees, from this Pennsylvania Bulletin notice.
  • In preparation for the holiday season, DOH has established ten temporary COVID-19 testing and home test distribution sites across the state.  Go here for information about the location and hours for these sites.

COVID-19:  By the Numbers                          

  • According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania and the number of new deaths has remained steady in recent weeks, with the state averaging about 1400 new daily cases and 16-20 new daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively steady as well.
  • The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of November 30, 38 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 26 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has issued “COVID-19 Disaster Emergency Report,” to provide data on the effect of the COVID-19 emergency on the financial performance of Pennsylvania hospitals and health care facilities.  According to the report, Pennsylvania hospitals and health systems reported $206 million in COVID-19 costs, between related expenses and revenue losses, for the period April-June of 2022.  Total COVID-19-related expenses and lost revenue reported by Pennsylvania hospitals and health systems through December 2021 are $7.8 billion but these figures do not reflect emergency funding provided under federal or state laws.  Learn more from this PHC4 news release and the report itself.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually.  For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

Department of Aging – Pennsylvania Long-Term Care Council – December 8

The Department of Aging’s Pennsylvania Long-Term Care Council will meet publicly on Thursday, December 8 at 10:00.  For information about how to attend in person or virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – December 8

The board of directors of the state’s Patient Safety Authority will meet virtually on Thursday, December 8 at 1:00.  Learn about how to register for and participate in this meeting from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-12-05T13:53:45+00:00December 2nd, 2022|COVID-19, Federal Medicaid issues, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 2
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PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21
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PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

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

  • The House of Representatives unanimously passed House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.  The bill was received in the Senate and referred to the Aging & Youth Committee.
  • The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
  • The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania.  A recording of the hearing and witness testimony may be viewed here.
  • The Senate Banking & Insurance Committee favorably reported Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
  • The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

  • The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
  • The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
  • The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
  • DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered.  This policy took effect on September 20.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix.  The update took effect on September 19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax.  The update is effective as of July 13.  Find that bulletin here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2.  Find that notice here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1.  Find that notice here.
  • 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 state’s nursing facility assessment program beginning in FY 2023.  Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers.  Learn more from this Pennsylvania Bulletin notice.
  • DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

  • DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding.  The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead.  Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of about 10 percent.
  • To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 195 admissions a day over the past week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26.  Find that notice here.
  • The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures:  coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement.  The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay.  It also documents case volumes, hospital charges, and statewide trends and offers other statistics.  To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00.  The meeting will be held virtually. An agenda will be available here 24 hours in advance.  Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 23
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PA Health Policy Update for Friday, May 27

The following is an update of selected state health policy developments in Pennsylvania for the week of May 23-27, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The Senate unanimously passed House Bill 889, which authorizes the State Board of Nursing to approve graduates of international nursing education programs to sit for the RN licensure examination provided that such international programs are determined to be equivalent to that which is required in Pennsylvania.  The bill will now be sent to the governor.
  • The Senate passed Senate Bill 848 by a vote of 35-12.  This legislation creates a Chief Nursing Officer position in the Department of Health.  The bill will now be sent to the House for consideration.
  • The House unanimously passed House Bill 1644, which directs the Department of Human Services to develop an escalation process to place Medicaid patients with behavioral health or long-term-care needs in an appropriate care setting.  The bill now will be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2530, which ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs.  The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee favorably reported House Bill 2585, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting a bid.
  • The Senate Banking & Insurance Committee favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
  • The Legislative Budget and Finance Committee released a report on the Pennsylvania CARE Act (Act 20 of 2016) and its impact on patient outcomes.  Find the report’s highlights here and the full report here.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has revised its revenue estimate for the current fiscal year, increasing it to $47.7 billion, a $5.8 billion increase over its initial estimate.  According to the IFO, revenue in most categories, including corporate net income tax, sales tax, and personal income tax, exceeded projections.  The IFO also cautioned that the state will likely see reduced revenue collections in future years.  Find the IFO’s full report here and a PowerPoint presentation of its initial FY 2023 revenue estimate here.

Office of the Attorney General

The Office of the Attorney General released a report on the significant increase in fentanyl importation and use across the commonwealth.  The report highlights the Bureau of Narcotics Investigations’ seizure of more fentanyl in the first three months of 2022 than it seized in all of 2021.  The report recommends weighing the costs and benefits of legalizing fentanyl test strips to combat the increase in overdoses and continuing to make access to substance use disorder treatment a priority. Find the full report viewed here.

Department of Human Services

Department of Health

  • The Department of Health (DOH) has issued an alert updating previously released information about monkeypox in the U.S. and elsewhere and offering information for clinicians and the public, including links to additional resources.  Find the alert here.
  • DOH has notified skilled nursing facilities that they will no longer be permitted to hire temporary nurse aides after June 6, 2022 due to the expiration of a CMS waiver related to the COVID-19 pandemic.  That waiver enabled nursing facilities to hire nursing assistants who had not yet passed the skills and written portions of the state nurse aide examination.  In addition, nurse aides hired under the waiver must pass the skills and written portions of the state nurse aide examination by October 6 or they cannot continue to work in that capacity.  Go here to read the letter explaining this change.
  • DOH has published its final set of proposed amendments to the state’s long-term-care facility regulations.  Learn more about the changes that have been proposed and the process DHS intends to use to move from proposed to final regulations from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the ninth consecutive week, rising seven percent, from a seven-day average of 3971 new daily cases on May 18 to 4238 new daily cases on May 25.
  • The seven-day average of COVID-19-related deaths tripled, from 12 to 36.
  • The growing number of COVID-19 cases in the state led to an 11 percent increase in COVID-19-related hospitalizations in the past week.
  • The number of these patients on ventilators, on the other hand, declined 19 percent over the past week while the number in hospital intensive care units rose 12 percent.
  • Sixty-four of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, leaving three counties experiencing “only” a substantial rate of community transmission.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published a new report on the number of cancer-related surgeries performed in Pennsylvania during the state’s 2021 fiscal year.  Go here to learn about the report and find a link to the report itself.

Stakeholder Events

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for 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 upcoming changes.  Go here to register to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

2022-05-27T20:41:50+00:00May 27th, 2022|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for Friday, May 27
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PA Health Policy Update for the Week of May 9-13

The following is an update of selected state health policy developments in Pennsylvania for the week of May 9-13, 2022.  (Some of the language used below is taken directly from state documents.)

Primary Election

Pennsylvania’s 2022 primary election will be held on Tuesday, May 17.  Registered Republicans and Democrats will have an opportunity to select which candidates will represent their parties in the general election for local and statewide races, including governor, lieutenant governor, U.S. senator, U.S. representative, state senator, and state House representative.

General Assembly

The Joint State Government Commission issued a report this week regarding nurse licensure in the commonwealth.  House Resolution 142 directed the Joint State Government Commission to conduct a review of the State Board of Nursing, specifically the “authorization to test” process and how it might be improved.  Among other recommendations, the report highlights the need for additional staff at the state Board of Nursing, improved processing of licensure applications, and revision of the criminal background check process.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers of the addition of CPT codes M0222 and M0223 to the program’s fee schedule for the administration of the monoclonal antibody bebtelovimab for treatment of COVID-19 effective February 11, 2022.  Find that bulletin here.
  • DHS has published a Medical Assistance Bulletin to issue its 2022 immunization schedule for Medical Assistance beneficiaries ages 18 years or younger.  Find the bulletin here.
  • DHS has published a final notice of its funding allocation for FY 2022 for several classes of inpatient disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying inpatient acute-care general hospitals.  The funding allocation is for DSH and supplemental payments for inpatient care, critical access hospitals, burn centers, obstetric and neonatal services, academic medical centers, physician practice plans, autism intervention, and trauma centers.  DHS is not changing the qualifying criteria or payment methodology for these payments and the notice does not list allocations to individual recipients.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a flyer explaining how individuals and organizations can obtain doses of Naloxone, the life-saving medication used in the event of a suspected opioid overdose.
  • DHS has posted the minutes of the April 28 meeting of its Medical Assistance Advisory Committee.
  • The federal Centers for Medicare & Medicaid Services (CMS) has released a “State Health Official Letter” to provide guidance to states on coverage and payment for stand-alone vaccine counseling in Medicaid and CHIP.  In the letter, CMS explains that it is interpreting the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit to require the provision of stand-alone vaccine counseling to eligible beneficiaries.  This guidance links the mandatory COVID-19 vaccine and vaccine administration coverage and reimbursement under the American Rescue Plan with the health education requirement under Medicaid’s EPSDT benefit.  Learn more from the CMS letter to state health officials.
  • CMS has published its reassignment of Medicaid provider claims final rule.  This rule reinterprets the scope of the general requirement that state payments for Medicaid services must generally be made directly to the individual practitioner or institution providing services or to the beneficiary in the case of a class of practitioners for which the Medicaid program is the primary source of revenue.  Specifically, this final rule explicitly authorizes states to make payments to third parties on behalf of individual practitioners for practitioners’ health insurance and welfare benefits, skills training, and other benefits customary for employees if the individual practitioner consents to such payments on their behalf.  This rule is generally viewed as an effort to aid home health care workers.  See the final rule here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the seventh consecutive week – this week, significantly.  The state’s seven-day average of new cases rose 65 percent, from 1874 on May 5 to 3101 on May 12.
  • The seven-day average of COVID-19-related deaths rose from ten on May 6 to 12 on May 12.
  • The growing number of COVID-19 cases in the state has led to a large but not proportional increase in COVID-19-related hospitalizations:  after consecutive weeks of 22 percent increases in hospitalizations, COVID-19-related hospitalizations rose 24 percent in the past week.
  • The number of these patients on ventilators remained unchanged over the past week while the number in hospital intensive care units rose 14 percent.
  • The significant increase in the number of new COVID-19 cases in Pennsylvania has resulted in significant changes in the status of community transmission of the virus in the state’s 67 counties.  Currently, no counties are experiencing a low rate of community transmission and only four counties (Mifflin, Perry, Snyder, and Somerset) are experiencing a moderate rate; nine counties (Blair, Fayette, Franklin, Fulton, Greene, Huntingdon, Jefferson, Juniata, and Philadelphia) experienced a substantial rate of community transmission; and the remaining 54 counties are currently experiencing a high rate of community transmission of COVID-19.

Stakeholder Events

Department of Health – Health Research Advisory Committee – May 18

The Department of Health’s Health Research Advisory Committee will meet virtually on Wednesday, May 18 to hold a formal vote on upcoming priorities.  For information about how to participate in the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS, Department of Health, Department of Veterans Affairs – PA Cares Training Summit – May 24

Pennsylvania’s departments of Human Services, Health, and Veterans Affairs, in cooperation with the five branches of the U.S. armed forces, will hold a “PA Cares Training Summit 2022” on Tuesday, May 24 at 8:00 a.m.  The event will focus on considerations that are needed to promote wellness in the lives of service members, veterans, and their families.  The target audience is professionals in the field and includes but is not limited to community mental health and substance abuse agencies, social workers, professional counselors, nurses, psychiatrists, psychologists, clergy/pastoral or spiritual practitioners, and the staff of Pennsylvania veterans centers.  Learn more about the event, its agenda, the presenters, and how to participate from this program announcement.  Participation is limited to the first 300 people who register.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – May 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, May 25 at 1:00.  Go here to register to participate.

Department of Health – Statewide HIV Planning Group – May 25 and 26

The Department of Health’s Statewide HIV Planning Group will hold a public meeting in Harrisburg, on Wednesday, May 25 and Thursday, May 26 from 9:00 to 4:30 on both days.  The purpose of these meetings is to conduct an integrated prevention and care HIV planning process in which the Department of Health works in partnership with the community and stakeholders to enhance access to HIV prevention, care and treatment services.  Interested parties also may participate virtually.  For additional information, including the location of the meeting and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – May 26

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, May 26 at 10:00.  Go here to register to participate.

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for 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 upcoming changes.  Go here to register to participate.

2022-05-13T20:36:26+00:00May 13th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for the Week of May 9-13
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  • 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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