Medical Assistance Advisory Committee Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for December 13

The following is an update of selected state health policy developments in Pennsylvania December 9 – 13. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate have released their respective 2025 session calendars. Find the House’s calendar here and the Senate’s calendar here.

Department of Human Services

The Department of Human Services (DHS) has announced the addition of doula services to the Medical Assistance (MA) program fee schedule and the submission of a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS). DHS will issue an MA Bulletin to inform providers enrolled in the MA program of the addition of doula services and how to bill for the provision of doula services. Find additional information in this Pennsylvania Bulletin notice.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the Partial Hospitalization Regulatory Compliance Guide. The guidance is intended to help agencies providing partial hospitalization services with the goal of ensuring safe environments and effective services to individuals.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on December 5.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

Department of Health

The Department of Health (DOH) and the Pennsylvania Insurance Department (PID) have reminded Pennsylvanians of the importance of HIV pre-exposure prophylaxis (PrEP) medication for HIV prevention. The Affordable Care Act (ACA) requires that HIV PrEP be covered at zero cost-sharing for insured consumers. Find additional resources and information in this press release.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has released a “Family Members Training Needs Survey.” DDAP has requested feedback from family members and/or significant others of individuals who may be suffering from drug or alcohol use, receiving substance use disorder (SUD) treatment, or in recovery to better understand what would help them navigate SUD services. The survey will remain open until January 6, 2025.

Around the State

The Pittsburgh Post-Gazette has written an article about the expected increase in the number of Pennsylvanians diagnosed with Alzheimer’s Disease in the next 15 years and the challenges the current treatment system will face according to a recent analysis conducted by the Center for Rural Pennsylvania.

The Pennsylvania Capitol-Star published an article about the potential increase in insurance premiums for Pennsylvanians on Pennie, the state’s health insurance marketplace, if federal subsidies expire.

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Board – December 16

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 16 from 2:00 to 3:30 p.m. For connection information or any questions, please contact Megan McDaniel (memcdaniel@pa.gov).

DOH – Health Policy Board – December 19

The Health Policy Board will hold a meeting on Thursday, December 19 at 12:30 p.m. The purpose of the meeting is to consult with the board of the department’s draft proposed hospital regulations. The meeting will be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-12-13T21:47:50+00:00December 13th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for November 22

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

Governor Shapiro

Governor Shapiro has signed Executive Order 2024-04 creating the Pennsylvania Permit Fast Track Program to streamline the state’s permitting process for key economic development and critical infrastructure projects. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate have recessed until the call of their respective chair.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Medical Assistance (MA) Program Vaccine Desk Reference. This bulletin applies to all providers enrolled in the MA program that may administer vaccines to MA beneficiaries in the fee-for-service or managed care delivery system.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through December. Find the updated calendar here.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced the publication of the first Pennsylvania Affordable Care Act and Qualified Health Plans (QHP) Summary Report. This report examines how PID reviews health insurance products and enforces laws to ensure a fair insurance market and equitable treatment of consumers. Find more information in this press release.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has announced it received the following final form regulations, which will be considered at its public meeting on December 5, 2024.

State Board of Medicine Opioid Treatment Programs: this final-omitted rulemaking amends the Board of Medicine’s regulations to allow the initial physical examination required for prescribing, administering, and dispensing controlled substances to be done via telehealth under certain conditions.
State Board of Osteopathic Medicine Licensure Requirements: this final rulemaking includes amendments to licensure requirements that are, in part, necessary to reflect the merger of the post-graduate training bodies for osteopathic (DO) and allopathic (MD) medical school graduates into a single accreditation system.

Around the State

The New York Times has written about President Donald Trump’s plan to nominate Pennsylvania resident Dr. Mehmet Oz to serve as the administrator of the Centers for Medicare and Medicaid Services.

WKBN 27 has written an article about the Commonwealth’s continued efforts related to the potential sale of Sharon Regional Medical Center, part of Steward Health Care which filed for bankruptcy in May.

City & State Pennsylvania has published an article about the five bills signed into law by Governor Shapiro this week and his signing of an executive order on permitting.

Stakeholder Events

DHS – Long-Term Services and Supports Subcommittee – December 4

The Long-Term Services and Supports Subcommittee (LTSS) will hold a public meeting on December 4 from 10:00 a.m. to 1:00 p.m. The meeting will be held in person and virtually. Click here for more information.

DHS – Consumer Sub-MAAC – December 4

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 4 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – December 5

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 5 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2024-11-22T22:10:10+00:00November 22nd, 2024|Affordable Care Act, long-term care, Medical Assistance Advisory Committee, Meetings and notices|Comments Off

PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.

Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release.

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA). These changes are effective for dates of service on or after September 9, 2024.

DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.

DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

DHS has released an updated Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here.

Department of Drug & Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here.

Stakeholder Events

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Safety Net Admin2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for July 26

The following is an update of selected state health policy developments in Pennsylvania from July 15 – 26. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro has signed several bills into law, including the following health care bills.
- House Bill 1664 (Act 58 of 2024), which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card.
- House Bill 1633 (Act 74 of 2024), which establishes restrictions on non-compete covenants for certain health care practitioners.
- House Bill 1853 (Act 75 of 2024), which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys.
- House Bill 1993 (Act 77 of 2024), which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients.
- House Bill 2200 (Act 79 of 2024), which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts.

Governor Shapiro joined Insurance Commissioner Michael Humphreys, members of the General Assembly, and local pharmacists in Lawrence County this week to tout the recent enactment of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs). Read more in this press release.

The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through August 2024. Find the updated calendar here.

DHS has issued Provider Quick Tip #85 with eligibility and enrollment information for the Breast & Cervical Cancer Prevention & Treatment (BCCPT) program, which provides eligible individuals treatment for confirmed cases of breast and cervical cancer or precancerous conditions of the breast or cervix.

The Office of Long-Term Living (OLTL) has shared an important announcement from the U.S. Food and Drug Administration (FDA) about a recall of Clonazepam orally disintegrating tablets due to mislabeling.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on July 25.

Department of Health

The Department of Health (DOH) has reminded providers who operate mobile clinics to complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has issued a Licensing Alert to notify licensed treatment facilities and recovery houses of the new process for submitting licensing regulation exceptions and facility requests to DDAP.

Around the State

The Citizen’s Voice has published an article about Pennsylvania’s Cancer Drug Repository Program and barriers to its utilization.

The Patriot-News has written an article about President Joe Biden’s decision to withdraw from the U.S. presidential race and what it means for Governor Shapiro.

Governor Shapiro’s signing of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs), and its potential impact on local pharmacies and patients was featured in an article published by the Times Leader.

The Pittsburgh Business Times has published an article about the challenges confronting rural health care and efforts to find solutions.

PA Safety Net Admin2024-07-26T20:18:58+00:00July 26th, 2024|Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for June 21

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

General Assembly

The state House of Representatives and Senate will reconvene for voting session next Monday, June 24. Both chambers are currently scheduled to remain in session until Monday, June 30, which is Pennsylvania’s constitutional deadline to enact a budget.

The House Children & Youth Committee is scheduled to meet on Tuesday, June 25 at 9:00 a.m. to consider House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The meeting will be held in Room B-31 of the Main Capitol. It will be livestreamed here.

The House Health Committee is scheduled to meet on Wednesday, June 26 at 9:30 a.m. to consider House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. The meeting will be held in Room G-50 of the Irvis Building. It will be livestreamed here.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July 2024. Find the updated calendar here.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death. Find the notice here.

Department of Drug & Alcohol Programs

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

Around the State

The Pennsylvania Capital-Star has reported about the state’s looming budget deadline and Senator Majority Leader Joe Pittman’s assertion that “[negotiations] could perhaps use… a kick in the pants to get moving.”

The New York Times has published an article about the role of pharmacy benefit managers (PBMs) and how they contribute to the cost of prescription drugs.

Spotlight PA has published an article about efforts to legalize recreational marijuana and the likelihood of legalization being a part of this year’s budget package.

Stakeholder Events

DHS – Consumer Sub-MAAC – June 26

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

DHS – Medical Assistance Advisory Committee – June 27

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

PA Safety Net Admin2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off

PA Health Policy Update for May 17

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

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.

The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024.

Department of Health

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3^rd Edition resources are available on DDAP’s ASAM Transition page.

State Board of Medicine

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice.

State Board of Osteopathic Medicine

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice.

Around the State

Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.

City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.

The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

PA Safety Net Admin2024-05-18T00:20:37+00:00May 17th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for April 19

The following is an update of selected state health policy developments in Pennsylvania from April 15 – 19. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House passed House Bill 1633, which prohibits non-compete agreements for health care practitioners and establishes certain notification requirements, by a vote of 150-50. The bill will now be sent to the Senate for consideration.

The House Professional Licensure Committee met on Monday, April 15 and favorably reported House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. A recording of the meeting is viewable here.

The House Children and Youth Committee met on Tuesday, April 16 and favorably reported House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 321, which establishes an implementation deadline for the Department of Human Services’ enterprise case management system. A recording of the hearing is viewable here.

The House Health Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. A recording of the meeting is viewable here.

The House Judiciary Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. A recording of the meeting is viewable here.

The House Democratic Policy Committee held a roundtable discussion on Tuesday, April 16 examining maternal health deserts. Find the agenda and testimony presented to the committee here.

The Senate Democratic Policy Committee held an informational meeting on Monday, April 15 examining pharmacy deserts. Find a recording of meeting and testimony presented to the committee here.

The state House of Representatives and the Senate are in recess until Monday, April 29.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 745) with information regarding recent increases in reported congenital syphilis. The department is recommending that pregnant individuals be offered a test for Syphilis at the first prenatal visit, at the third trimester of pregnancy, and at delivery.

Department of Human Services

The Department of Human Services (DHS) has published a Medical Assistance Bulletin with the 2024 recommended child and adolescent immunization schedule.

DHS has published a Medical Assistance Bulletin to advise providers that the department will begin paying for ground ambulance mileage for each loaded mile in addition to increasing the fees for certain ambulance services on the Medical Assistance (MA) program fee schedule, effective with dates of service on or after January 1, 2024.

DHS has published the minutes of the March 28, 2024 Medical Assistance Advisory Committee (MAAC) meeting.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through May 2024. Find the updated calendar here.

Stakeholder Events

DHS – Consumer Sub-MAAC – April 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 1:00 p.m. Find the agenda here and register to participate here.

DHS – Medical Assistance Advisory Committee – April 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 25 at 10:00 a.m. Find the agenda here and register to participate here.

DOH – HIV Community Prevention Planning Committee – May 1

The Human Immunodeficiency Virus (HIV) Prevention Planning Committee will hold a public meeting on Wednesday and Thursday, May 1-2, 2024. The meeting will be held in person and virtually. Find additional details in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – May 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, May 2 from 10:15 a.m. to 1:15 p.m. The meeting will be held virtually and in person. Find additional details in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – May 3

The Brain Injury Advisory Board will hold a public meeting on Friday, May 3, 2024 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional details in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-04-19T20:14:21+00:00April 19th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for February 16

The following is an update of selected state health policy developments in Pennsylvania from February 12 – 16. (Some of the language used below is taken directly from state documents).

General Assembly

The Senate Republican Policy Committee held an informational meeting on Wednesday, February 14 examining challenges in rural health care. A recording of the meeting, as well as copies of the testimony offered to the committee, are viewable here.

The House Democratic Policy Committee held an informational meeting on Wednesday, February 14 to discuss the future of artificial intelligence, including how it may impact the field of medicine. A recording of the hearing in its entirety is viewable here, while testimony can be viewed here.

Next week the state House of Representatives and Senate Appropriations Committees will begin their hearings to examine Governor Shapiro’s proposed FY 2024-2025 spending plan. The Department of Aging is the only health-related agency that will have a budget hearing next week – it will be held on Thursday, February 22 at 10:00 a.m. Find the House Appropriations Committee’s complete schedule here and the Senate Appropriations Committee’s complete schedule here.

The House Republican Policy Committee will hold an informational meeting on Thursday, February 22 at 1:00 p.m. regarding, “A State Lost in Addiction: Pennsylvania’s Path to Recovery.” The meeting will take place at The Crane Room Grille (3009 Wilmington Rd.) in New Castle, PA.

Department of Human Services

The Department of Human Services (DHS) has published a report – Improving the Lives of Children, Youth, and Young Adults with Complex Needs and Their Families – prepared by its Blueprint Workgroup that seeks to improve care coordination and services for children and youth with complex, co-occurring physical and behavioral health care needs.

Last week DHS announced that pharmacists may enroll in the Medical Assistance (MA) program to provide services to MA beneficiaries effective March 1, 2024. The following guidance has subsequently been issued by DHS related to pharmacists’ enrollment in the MA program.

DHS has issued a Medical Assistance Bulletin providing information about the enrollment process for pharmacists.

DHS has issued a Medical Assistance Bulletin indicating the procedure codes that can be billed for pharmacists services. DHS also published notice of intent to add procedure codes for pharmacists to the MA program fee schedule in the Pennsylvania Bulletin, which is viewable here.

Additional information related to the enrollment requirements and application process, pharmacists should refer to the DHS website here.

DHS has issued a remittance advice alert notifying providers of a claims recovery that was done to recoup monies paid in error due to the department’s eligibility records indicating recipients being deceased prior to the dates of service being billed.

DHS has published the following notices which announce its intent to make payments to certain qualifying nursing facilities in Fiscal Year (FY) 2023-2024.

Department of Health

The Department of Health (DOH) has issued a revised template for nursing facilities to use in calculating their nursing staffing ratios. Click here to download the updated spreadsheet tool.

DOH has published a Pennsylvania Bulletin notice, as required, with a list of hospitals that have provided notice to the department that they may not provide emergency contraception or sexual assault emergency services due to various factors.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published comments in response to the proposed regulations submitted by DHS that would make changes to comply with CMS’ final rule – ”Medicaid Program; Covered Outpatient Drugs.” The proposed regulation also makes technical changes to add diabetic supplies, opioid overdose agents, and immunizations to the list of services excluded from copayments. In addition, it recognizes the prescriptive and dispensing authority of certified nurse practitioners (CRNP) and midwives. Find additional information in this Pennsylvania Bulletin notice.

Medicaid Continuous Coverage Unwinding

DHS has reported that it contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.

DHS 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.

- Options Available for Coverage through Pennie or CHIP
- Communications and Contacts Cheat Sheet

Stakeholder Events

DHS – Consumer Sub-MAAC – February 21

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

DHS – Medical Assistance Advisory Committee – February 22

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

DOH – Preventive Health & Health Services Block Grant Advisory Board – February 27

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, February 27 from 3:00 p.m. to 4:00 p.m. The purpose of the meeting is to discuss the status of the funding for the block grant. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 28

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, March 28 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual teleconference. Find additional information in this Pennsylvania Bulletin notice.

Long-Term Care Council – 2024 Meeting Dates

The Long-Term Care Council has published its 2024 bi-monthly meeting dates. Council meetings are open to the public and held virtually unless otherwise specified. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-02-16T20:34:54+00:00February 16th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for February 9

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

Governor Shapiro

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

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

Invests $100 million in mental health funding for K-12 schools, which builds upon one-time federal funds to ensure schools have the resources to provide mental health services to students and staff.

Increases funding for community-based mental health services by an additional $20 million this year and calls for additional funds in successive years (up to $60 million).

Invests $50 million of state funding into the state’s reinsurance program to create an additional subsidy wrap for low- and middle-income Pennsylvanians that are on the cusp of being able to afford health insurance.

Governor Shapiro highlighted the need to reform pharmacy benefit manager (PBM) operations and called on the General Assembly to enact legislation to that effect.

Although the budget proposal doesn’t include specific funding for rural health, Governor Shapiro noted the need to address rural hospital closures and indicated his administration would develop a plan soon.

Dedicates $4 million for medical debt relief for low-income Pennsylvanians and calls for health care providers to implement transparent practices to limit medical debt.

Includes $1.9 million toward the creation of the Alzheimer’s Disease and Related Disorders Division at the Department of Aging.

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

General Assembly

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

The Senate passed House Bill 1564, which provides for the creation of an associate license for marriage and family therapists and an associate license for professional counselors, on third and final consideration. The bill will now be sent back to the House for concurrence.

The House Health Subcommittee on Health Care held an informational meeting on Monday, February 5 on adult-use cannabis. Find a recording of the meeting here.

The Senate Veterans Affairs & Emergency Preparedness Committee favorably reported, among other bills, Senate Bill 1054, which adds EMS providers as required reporters to the Overdose Information Network (ODIN) system.

The House Health Committee met for a voting meeting on Tuesday, February 6 and favorably reported the following bills.

House Bill 1853, which requires the Department of Health to meet with licensed nursing facilities under their jurisdiction to discuss and share information on survey results, patterns, trends, best practices, etc.

House Bill 1931, which establishes a registry of medical directors in nursing facilities, personal care homes, and assisted living residences.

House Bill 1956, which makes certain amendments to the Patient Test Results Act.

The House Human Services Committee held an informational meeting on Wednesday, February 7 examining Centers of Excellence for Opioid Use Disorder. Find a recording of the meeting here.

Department of Human Services

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

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

Department of Health

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

Medicaid Continuous Coverage Unwinding

DHS reported that it has contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.

DHS 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.

- Options Available for Coverage through Pennie or CHIP
- Communications and Contacts Cheat Sheet

Stakeholder Events

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

DHS – Medical Assistance Advisory Committee – February 22

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

PA Safety Net Admin2024-02-09T20:45:39+00:00February 9th, 2024|Governments, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for January 19

The following is an update of selected state health policy developments in Pennsylvania from January 15 – 19. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration has issued a press release touting Act 32 of 2023, formerly Senate Bill 500 sponsored by Senator Michelle Brooks, which went into effect this week. Act 32 of 2023 increases access to pasteurized donor human milk by expanding the number of health conditions eligible for Medicaid-covered donor human milk.

General Assembly

The state House of Representatives and Senate are in recess until Tuesday, February 6 when they will convene for Governor Shapiro’s annual budget address.

The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise enrolled Medical Assistance program providers who prescribe and supply pasteurized donor human milk (PDHM) of changes in coverage conditions for PDHM and requirements for enrollment as a human milk bank.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 734) in follow-up to PAHAN 730 regarding high levels of chromium, in addition to lead, in cinnamon

samples and recalled applesauce pouch products, including WanaBana, Schnucks, and Weis

brands. DOH has advised patients and providers that a general clinical work-up

for anemia would be appropriate, since this is the health effect associated with the duration of exposure, if patients or clinicians are concerned or suspect chromium overexposure.

Medicaid Continuous Coverage Unwinding

DHS has announced the launch of a survey to collect feedback from Medicaid enrollees about their experience completing their annual renewal. The survey is being conducted in partnership with the University of Pittsburgh’s Medicaid Research Center, and feedback collected will be used to inform renewal outreach strategies moving forward. Participants will be contacted via text message.

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 – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here.

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – January 31

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, January 31 from 9:00 a.m. to 5:00 p.m. and on Thursday, February 1 from 9:00 a.m. to 4:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – February 1

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 1 from 10:00 a.m. to 1:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – February 2

The Brain Injury Advisory, formerly the Traumatic Brain Injury Advisory Board, will hold a public meeting on Friday, February 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network (6340 Flank Drive, Harrisburg, PA 17112) in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-01-19T21:15:32+00:00January 19th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

12 3 Next

SNAPShots

SNAPShots

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

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