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PA Health Policy Update for January 16

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

General Assembly

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

  • Rep. Joe Webster introduced House Bill 2115 which creates antitrust review processes in healthcare transactions.
  • Rep. Greg Scott introduced HB 2134 to modernize the State Fire Commission Fire Company & EMS Grant Program
  • House Bill 2135, introduced by Rep. Morgan Cephas, would provide workplace protections and accommodations for menopause and perimenopause.
  • Sen. Nick Pisciottano introduced SB 1113, which would regulate the use of AI in healthcare.
  • Senate Bill 1133, sponsored by Sen. Frank Farry, would add two additional members to the State Board of Pharmacy – a pharmacy tech and an additional acute care institutional pharmacist.
  • Reps. Borowski, Friel, and Kutz have released a cosponsor memo to allow for companies to apply for a state pharmaceutical licensure concurrently with FDA approvals.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

DHS issued an MA Bulletin on Orthopedic footwear.

The Department released its proposed renewal of the Adult Autism Waiver for a 30 day public comment period. Proposed updates would change the lifetime limit on assistive technology to an annual limit, continue supports for competitive, integrated employment, and update Specialized Skill Development services. 

Stakeholder Meetings

DOH’s Statewide HIV Planning Group will hold public meetings on Jan. 21-Jan. 22 from 9am-3pm on both days.

DHS has a scheduled Medical Assistance Advisory Committee meeting for Thurs. Jan. 22nd at 10am.

DOH’s WIC State Advisory Board meeting will be held on Tues. Jan. 27th from 1-2pm.

The Department of Health’s Special Pharmaceutical Benefit Program Advisory Council will meet on Thurs. Jan. 29 from 10a.m. to 12p.m. The Council will offer guidance and recommendations to the Department on the program’s drug formulary, covered lab services, drug utilization review, clinical programs, eligibility and program management.

DOH’s Brain Injury Advisory Board will hold a public meeting on Fri. February 6th from 10am to 3pm.

The Patient Safety Authority will hold a public board meeting on Tues. Feb. 10th at 1pm. 

Federal Update

Click here for a review of this week’s federal activities.

2026-01-16T22:13:12+00:00January 16th, 2026|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for January 16

PA Health Policy Update for December 31

The following is an update of selected state health policy developments in Pennsylvania from December 22 – December 31 (Some of the language used below is taken directly from state documents).

Rural Health Transformation Program

The Shapiro Administration announced Pennsylvania’s $193 million portion of federal Rural Health Transformation Program funds. As previously shared in other updates, the Administration’s plan focuses on several initiative areas to drive federal investment:

  • Technology & Infrastructure
  • Workforce
  • Maternal Health
  • Behavioral Health
  • Aging & Access
  • EMS & Transportation

Investments will be coordinated through Partnerships for Regional Economic Performance (PREP) organizations, already existing regional economic collaboratives, and coordination with locally created Rural Care Collaboratives steered by regional stakeholders and healthcare leaders. Updates on these investments will be shared as more information becomes available. 

Reorganizations

The Shapiro Administration released departmental reorganizations for both the Office of Administration and the Department of General Services. 

General Assembly

The House and Senate will briefly convene Session on Tuesday, Jan. 6, 2026. House Session will be non-voting. The House shared scheduled Session days through 2026 and Senate Session days are released through June. 

Department of Human Services

DHS launched Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued proposed notice for Disproportionate Share and Supplemental Payments to Qualifying Hospitals for 2025-2026.

DHS issued updated Emergency Medical Services Rates for Publicly Owned Providers which will be effective 1/1/2026.

The Department released a Bulletin notice regarding the Medical Assistance Program Compensable Service Change: GLP-1 Drugs to Treat Overweight and Obesity and issued an MA Bulletin notice revising Prior Authorization Requirements for GLP-1 medications.

DHS issued an MA Bulletin updating the EPSDT Periodicity Schedule to reflect vaccine schedule changes.

The Department released an MA Bulletin with guidelines for Hospital-Grade Breast Pumps.

DHS shared an MA Bulletin with updates to Limited English Proficiency Requirements. 

Department of Health

The Department published final-form Sexual Assault Victim Emergency Services Regulations listing hospitals that do not provide emergency contraception due to a stated moral or religious belief.  

Stakeholder Meetings

The Department of Health’s Renal Disease Advisory Committee will meet for its quarterly public meeting on Friday, January 16, 2026, from 10 a.m. to 12 p.m.

The Department of Health’s Special Pharmaceutical Benefit Program Advisory Council will meet on Thursday Jan. 29, 2026, from 10a.m. to 12p.m. The Council will offer guidance and recommendations to the Department on the program’s drug formulary, covered lab services, drug utilization review, clinical programs, eligibility and program management. 

Federal Update

Click here for a review of this week’s federal activities.

Wishing you all a happy, healthy, and prosperous 2026.

2026-01-02T17:06:07+00:00December 31st, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Rural Health|Comments Off on PA Health Policy Update for December 31

PA Health Policy Update for December 19

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

SNAP Eligibility Screening Tool

DHS issued a new screening tool designed to help Pennsylvanians determine their eligibility for SNAP benefits. This tool follows new federal rules implemented by the One Big Beautiful Bill Act which changed eligibility requirements for public assistance programs such as SNAP. 

General Assembly

The House concluded its voting days for the remainder of the year. As the year concludes, so does the tenure of service for some in the legislature. State Representatives Dan Miller in Allegheny County and Josh Siegel in Lehigh County both have tendered resignations to the Speaker to assume local offices won in November’s elections. The Speaker has set dates for special elections on Feb. 24th to replace these members. Two additional resignations will also be forthcoming between now and early 2026 for Reps. Torren Ecker of Adams County and Lou Schmitt of Blair County, also to assume local elected positions.

During House Session this week, the House Communications & Technology Committee held a public hearing on HB 1925, Rep. Arvind Venkat’s AI in Healthcare legislation. The hearing can be viewed here.

The House Health Committee unanimously voted out both HB 1202 & HB 1851 this week. Rep. David Zimmerman’s HB 1202 would create a Commonwealth Medical Stockpile which could be accessed by healthcare facilities. HB 1851, sponsored by Rep. Gina Curry, would allow nurse-midwives to sign fetal death certificates.

Additionally, the House acted on the following healthcare-related bills this week:

  • Receiving Second Consideration
    • HB 348, by Rep. Tim Bonner, which requires nursing facilities to make residents and their families aware of their rights and options to apply for Medicaid benefits at the time of entering a nursing home;
    • HB 1129, sponsored by Rep. Paul Friel, which provides for the sale of Net Operating Losses and unused Research & Development Tax Credits.
  • Final Passage from the House
    • HB 1530, by Rep. Danilo Burgos, which establishes privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services). This bill was passed unanimously.
    • HB 1957, by Rep. Melissa Shusterman, which would establish the reproductive right in the Pennsylvania Constitution. This legislation passed 102-101.
    • HB 1881, by Rep. Arvind Venkat, passed 106-97. This bill would mirror an executive order by Governor Shapiro, allowing pharmacists’ practice authority to provide vaccines recommended by Pennsylvania’s health authorities that may be informed by our professional medical societies. 

Department of Human Services

DHS launched Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued an MA Bulletin regarding prior authorization for Lynkuet.

DHS updates to the Pennsylvania Medicaid Managed Care Directory and issued its MCO Enrollment Report for November 2025.

The Shapiro Administration announced the launching of a suite of new technology and tools to support the Commonwealth’s administration and management of public assistance programs and improve customer experience.  

State Board of Pharmacy

The State Board of Pharmacy proposed rulemaking that sets forth the board’s criteria for eligibility for licensure by endorsement, including the specific methods required for an applicant to demonstrate competency. It also sets forth the requirements for granting a provisional endorsement license. 

Independent Fiscal Office

The IFO published a new budget brief that uses the latest SNAP benefits data for November 2025. The data show that the number of enrollees declined by 158,000 (-8%) from the prior year as new work requirements take effect. 

Stakeholder Meetings

The Department of Health’s Renal Disease Advisory Committee will meet for its quarterly public meeting on Friday, January 16, 2026, from 10 a.m. to 12 p.m. 

Federal Update

Click here for a review of this week’s federal activities.

2025-12-19T21:18:56+00:00December 19th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for December 19

PA Health Policy Update for December 5

The following is an update of selected state health policy developments in Pennsylvania from November 24 – December 5 (Some of the language used below is taken directly from state documents).

Shapiro Administration Staffing Changes

The Shapiro Administration announced a change in senior leadership with Budget Secretary Uri Monson leaving his post to serve as Executive Director at the PA Public School Employees Retirement System (PSERS). The Governor has appointed Zach Reber, current Deputy Secretary for Fiscal Policy and Program Coordination in the Budget Office, to serve as the next Secretary of the Budget. 

General Assembly

The Senate returns next week for three voting session days from December 8th through the 10th. The House will return for non-voting session on December 15th and voting session on the 16th & 17th.

On Monday, Dec. 15th at 1pm, the House Communications & Technology Committee is holding a public hearing on HB 1925, Rep. Arvind Venkat’s AI in Healthcare legislation.

Rep. Bryan Cutler released a cosponsor memo for Certificates of Merit in Healthcare liability claims. 

Department of Health

DOH updated its respiratory virus outbreak toolkit with minor changes and issued a new FAQ about Fall 2025 respiratory viral illness guidance. 

Department of Human Services

DHS is launching Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued Medical Assistance Bulletins on the following areas:

DHS released its October 2025 Managed Care Enrollment Report.

The Department issued revisions to its list of drug companies participating in the Medicaid Drug Rebate Program.

DHS issued a notice of intent to update its Chapter 5100 Mental Health Procedures Regulations to align with Act 32 of 2022. 

Independent Fiscal Office

The IFO released a report detailing its assessment of factors contributing to anticipated structural deficits for Pennsylvania’s budget. 

Independent Regulatory Review Commission

IRRC approved the final form covered outpatient drug regulations, which updated the payment methodology for pharmaceutical services, recognized the prescriptive and dispensing authority of certified registered nurse practitioners and midwives as well as made technical amendments to recognize advances in information technology. 

Pennsylvania Health Care Cost Containment Council

The PA Health Care Cost Containment Council (PHC4) released its 2024 Hospital Performance Report, which examines trends on mortality and readmissions, among other data points.

Stakeholder Meetings

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here. 

Federal Update

Click here for a review of this week’s federal activities.

2025-12-05T20:44:06+00:00December 5th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for December 5

PA Health Policy Update for November 21

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

Rural Health Transformation Program

The Shapiro Administration released its application for the federal Rural Health Transformation Program dollars. The application highlights focuses on several initiative areas to drive federal investment, if awarded:

  • Technology & Infrastructure
  • Workforce
  • Maternal Health
  • Behavioral Health
  • Aging & Access
  • EMS & Transportation

Awarded investments will be coordinated through Partnerships for Regional Economic Performance (PREP) organizations, already existing regional economic collaboratives, and coordination with locally created Rural Care Collaboratives steered by regional stakeholders and healthcare leaders. CMS has indicated it will decide awards by December 31, 2025. 

General Assembly

In the wake of budget passage, the General Assembly will return for a few more session days before the end of the year. The Senate will return for three voting session days beginning on December 8th. The House will return for a non-voting session on December 15th and voting session on the 16th & 17th.

Earlier this week, the House Human Services Committee held an informational hearing on the federal SNAP changes in HR 1 and their impacts on Pennsylvania.

On Tuesday Nov. 18th, the House Health Committee voted unanimously to advance HB 1652 and HB 1715. Both bills amend the Newborn Child Testing Act to include Gaucher Disease (HB 1652) and Duchenne Muscular Dystrophy (HB 1715) in PA’s newborn screening requirements. Both bills move to the full House for consideration.

The House unanimously passed HB 1894, legislation which would require the Independent Enrollment Broker to enhance the counseling provided to individuals on the LIFE program during the MA long term care enrollment process. This legislation now moves to the Senate for its consideration.

The House passed SB 88 by a margin of 196-7. This legislation updates insurance coverage requirements for breast cancer screenings and is now awaiting signature by the Governor.

The Senate Health & Human Services met on Tuesday and voted in support of SB 1095, which changes references from global budgets to alternative payment models in laws relating to the Rural Health Redesign Center Authority.

Below is a list of health and human services related legislation introduced or cosponsor memos released:

  • HB 2041, sponsored by Rep. Shelby Labs, would update blood lead testing requirements for children.
  • Rep. Danilo Burgos introduced HB 2050, which would prohibit Pharmacy Benefit Managers from owning and operating pharmacies.
  • House Bill 2051, sponsored by Rep. Seth Grove, would impose a state False Claims Act in the MA program.
  • Rep. Burgos also introduced HB 2060, which would ensure prescribing parity between non-opioid and opioid pain medications in the MA program. 

Department of Human Services

DHS is launching Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc, – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued Medical Assistance Bulletins on the following areas:

The Department released updates to the School Based ACCESS Program Provider Handbook. 

State Board of Medicine

The State Board of Medicine released proposed regulations on continuing education and volunteer services.

Stakeholder Meetings

The DHS Medical Assistance Advisory Committee plans to meet December 4th at 10am. You can register for the meeting here.

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here. 

Federal Update

Click here for a review of this week’s federal activities.

2025-11-21T19:18:40+00:00November 21st, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Rural Health, Rural Health Transformation Program|Comments Off on PA Health Policy Update for November 21

PA Health Policy Update for November 14

The following is an update of selected state health policy developments in Pennsylvania from November 10 – November 14 (Some of the language used below is taken directly from state documents). 

Budget Update

After a stalemate lasting 135 days, the General Assembly has passed a comprehensive Fiscal Year (FY) 2025-2026 budget. The state House of Representatives passed Senate Bill 160 – the General Appropriations Act – by a vote of 156-47. Senate passed it by a vote of 40-9. 

In total, the FY 2025-2026 budget spends $50.1 billion, which represents a $2.3 billion or 4.7 percent increase over the prior fiscal year. It is nearly $1.4 billion less than the budget proposed by Governor Shapiro in February. The budget is balanced primarily by utilizing prior-year funding lapses and special fund balances in state agencies totaling $3 billion. Using these funds in the 2025-26 budget prevented draining the state’s emergency reserves in the Rainy Day Fund, while leaving more than $200 million in the fund’s balance.

The budget includes a new Working Families Tax credit program. However, it does not include many of the spending initiatives highlighted in the governor’s proposal, such as additional mass transit funding, taxation for skill games, minimum wage increases, or legalization and taxation of recreational adult use cannabis. Also part of the deal includes the Commonwealth ending its participation in the Regional Greenhouse Gas Initiative.

In addition to the General Appropriations Bill, the General Assembly also passed code bills related to the budget and its enactment. House Bill 416 is an amended Fiscal Code which includes various instructions to help effectuate passage of the budget bill. House Bill 749 is an update to the Human Services Code which includes several policy provisions below:

  • Regulatory alignment with federal rules on MA reimbursement for behavioral health in telehealth settings – the “Four Walls” Requirement,
  • Requires DHS to report to the General Assembly on SNAP recipient data and lottery winnings, resources, and vehicles owned by public assistance recipients
  • Crosschecking MA and SNAP beneficiaries with data from DOH’s Vital Records system and wage records from the Department of Labor & Industry
  • Requires DHS to study the feasibility of a brokerage model for nonemergency Medical Transportation Services
  • Allows indefinite suspension of MA benefits for incarcerated individuals while incarcerated, among other provisions.

General Assembly

On Monday, November 17th, the House Human Services Committee will hold an informational hearing on the federal SNAP changes in HR 1 and their impacts on Pennsylvania. The livestream link will be made available here.

The House Health Committee will meet on Tuesday Nov. 18th to consider HB 1652 and HB 1715. Both bills would amend the Newborn Child Testing Act to update newborn screening requirements to include Gaucher Disease (HB 1652) and Duchenne Muscular Dystrophy (HB 1715), respectively.

Department of Health

The Department issued a Health Alert Network notice urging providers’ awareness for Acute Flaccid Myelitis through late Fall.

DOH updated the residency criteria for the Chronic Renal Disease Program effective November 15, 2025. 

Department of Human Services

DHS is launching Human Services Helpers, a Substack that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department has announced it has restarted issuing full November Supplemental Nutrition Assistance Program (SNAP) benefit payments.

DHS shared a suicide prevention resource guide in recognition of National Suicide Prevention Month.

The Department released a Medical Assistance Bulletin with revisions to the MA Fee Schedule and prior authorization requirements.

The Department issued an updated Preferred Drug List which will be effective Jan. 1, 2026.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

The Department released an updated Managed Care Directory. 

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19th and Thursday November 20th both from 9am-3pm.

The DHS Medical Assistance Advisory Committee plans to meet December 4th at 10am. You can register for the meeting here.

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here. 

Federal Update

Click here for a review of this week’s federal activities.

PA Health Policy Update for November 7

The following is an update of selected state health policy developments in Pennsylvania from November 3 – November 7 (Some of the language used below is taken directly from state documents). 

General Assembly and Budget Update

After Pennsylvania’s judicial and local election this past Tuesday, four members of the PA House won local elected offices which will require special elections early next year following their respective swearing-in to those offices. As Rep. Lou Schmitt, winner of a county judicial race indicated, “People were focused on the election… Now that the election is out of the way, people can go back to policy.” The House and Senate will have the opportunity to do so when both chambers are set to return on November 17th.

On Monday, November 10th at 10am, the Senate Democratic Policy Committee will hold a public hearing on supporting home care workers and consumers. The hearing can be streamed live here.

Department of Health

The Department’s Special Pharmaceutical Benefits Program released their approved covered drug list in their October Advisory Council meeting which will take effect on December 1st. The Department also updated its list of Medicare Part C and D plans with premium payment agreements with SPBP for 2026. 

Department of Human Services

DHS has issued helpful guidance and information to assist individuals in understanding the federal SNAP work requirements instituted earlier this fall.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

State Board of Medicine

The State Board of Medicine shared Education and Volunteer Services proposed regulations to add new mandatory education requirements and clarify the process for a volunteer license. 

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19th and Thursday November 20th both from 9am-3pm.

DOH’s Infant Hearing Screening Advisory Committee will meet on Thursday Nov. 13th from 10am – Noon.

The DHS Medical Assistance Advisory Committee plans to meet December 4th at 10am. You can register for the meeting here. 

Federal Update

Click here for a review of this week’s federal activities.

PA Health Policy Update for September 12

The following is an update of selected state health policy developments in Pennsylvania from September 8- 12 (Some of the language used below is taken directly from state documents). 

Budget Update 

The state budget impasse continues, more than ten weeks past the constitutional deadline. Senate Majority Leader Pittman told reporters this week that he is “encouraged by the meaningful work at the negotiating table” but there is no agreement on a final budget at this time. Various potential budget-related bills continue to be positioned in order for a completed budget to be passed within a few days of a budget deal being reached.  The Senate stands in recess to the call of the President Pro Tempore and the House stands adjourned until Monday, September 22, 2025 unless sooner recalled by the Speaker.

General Assembly

The Senate met for voting session this week. The following is a summary of health care related legislative activity:

  • The Senate passed SB 381 that would prohibit the use of commonwealth funding for certain animal testing activities in research facilities. The bill will be sent to the House for consideration.
  • The Senate Consumer Protection and Professional Licensure committee favorably reported SB 507 with amendments. The bill provides for licensure of certified midwives, allows them to prescribe treatment for opioid use disorder, and seeks to modernize the collaborative agreement structure for midwives.

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) issued comments on the State Board of Nursing’s proposed regulations for the certified registered nurse anesthetists. See IRRC’s comments in this Pennsylvania Bulletin notice. The nursing board is required to address IRRC’s comments and questions when issuing its final form regulations.

Department of Human Services 

The Department of Human Services (DHS) updated its list of Remittance Advices with information on a new ADA claim form that should be used for dental claims with dates of service after November 1, 2025. See the alert here.

DHS issued its 2024 Annual Report from the Bureau of Human Services Licensing, which licenses personal care homes and assisted living residences. The report shows data on the number of facilities, patient census and demographics, and facility incidents and complaints. Click here for the full report.

The Office of Long-Term Living is accepting statements of interest from new and existing Living Independence for the Elderly (LIFE) program operators to serve 12 counties that do not yet have LIFE program services available for seniors age 55 and older. Click here to view the announcement in the Pennsylvania Bulletin with instructions on how to request information about the application and evaluation process.

DHS issued an Medical Assistance Bulletin with updates to the Dental Fee Schedule. These updates include revised frequency and unit limitations for several codes as well as a change in age limits for two codes. These changes are considered effective as of August 1, 2025. 

Around the State  

  • An article from the Penn Capital Star explores the ways in which health care providers in Pennsylvania are already responsibly using artificial intelligence (AI) amid discussions from lawmakers to introduce legislation to regulate AI use in health care.
  • ABC27 describes the geographic split that may be compounding the political split between legislative leaders as the budget impasse wears on. With caucus leaders from opposite sides of the commonwealth and regional transit funding issues at the core of negotiations, “There’s no question geography of the membership and leadership members has played a role,” said Senate Minority Leader Jay Costa (D-Allegheny).
  • Though it is not an unusual financing move for many school districts, the Philadelphia district this week voted to borrow up to $1.55 billion (WHYY) to support services during the state budget impasse. Because of the lack of state and federal funds, this year’s borrowed amount is $1 billion more compared to previous years, costing millions more in interest payments for the district.

Stakeholder Meetings

Medical Assistance Advisory Committee (MAAC) – Sept. 25

The DHS Medical Assistance Advisory Committee will meet virtually on September 25, 2025, at 10:00am. To register, click here.

Department of Drug and Alcohol Programs Emerging Drug Trends Symposium – Nov. 18 

DDAP will host its 2025 Emerging Drug Trends Symposium on November 18 from 7:00am to 4:00pm at the Penn Harris Hotel & Conference Center in Camp Hill, PA. Attendees will discuss the latest drug use and overdose trends in PA, shifting overdose patterns and drug supply, and evidence-based best practices. Click here to register for this free event.

2025-09-12T21:51:32+00:00September 12th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for September 12

PA Health Policy Update for September 5

The following is an update of selected state health policy developments in Pennsylvania from September 1 – 5 (Some of the language used below is taken directly from state and federal documents). 

Fiscal Year 2025-26 Budget Update 

There was no legislative activity surrounding the state budget this week. Governor Shapiro sent a compromise budget proposal to Senate Republican leadership last week, but they have yet to take any action. The Senate is scheduled to return to session next week on September 8, but that date could be pushed back if an agreement is not ready.

The House stands adjourned until September 22.

Department of Health

The Department of Health (DOH) issued interpretative guidance to clarify staffing regulations for hospitals, allowing for flexible physician coverage models while maintaining patient safety and regulatory compliance. It focuses on on-site, on-call, and telemedicine-based physician coverage requirements. Review the full document here. 

Department of State

The State Board of Pharmacy met this week and voted to approve four new entities as “competent authorities” to issue guidelines for licensed pharmacists under 49 PA Code § 27.403 on the use of injectable immunizations. This action was taken in anticipation of changes from the Centers for Disease Control’s upcoming vaccine committee meeting and will permit pharmacists to continue providing COVID-19 vaccinations, which had been paused by some providers. Find a news release about the voting meeting here.

Department of Human Services 

The Department of Human Services (DHS) updated its list of Remittance Advices with an updated participating drug company list for the Medicaid Drug Rebate Program. Find the updated list here.

The Offices of Long-Term Living and Medical Assistance Programs issued a Medical Assistance bulletin alerting providers that it will begin issuing electronic visit verification (EVV) alerts to providers whose EVV manual entry percentages exceed 15 percent for the previous quarter. These alerts will be sent directly by DHS for fee-for-service claims and the department will transmit a list of noncompliant providers to the appropriate managed care organizations for awareness and follow up.

The Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) Letter jointly developed by CMS and the Substance Abuse and Mental Health Services Administration (SAMHSA). This SHO provides guidance to states on the best practices for implementing the continuum of crisis services. It describes specific Medicaid and CHIP authorities and flexibilities to support the full continuum of crisis response services and suggests strategies for measuring and monitoring crisis response services. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 released a new interactive map displaying access to care in different counties, called MAPPED 2. This resource includes hospitals, ambulatory surgery centers, and nursing homes. It was designed to help patients, legislators, and health care providers learn more about the health care landscape of Pennsylvania. 

Around the State  

  • A Philadelphia judge has directed SEPTA to immediately reverse all service cuts imposed last month. WHYY reports on the decision in this article.
  • The Penn Capital Star reported on the state pharmacy board’s decision this week to permit additional professional organizations to issue guidance for immunizations.
  • An article from the Altoona Mirror details the financial strain and difficult decisions that are facing county providers and non-profits now that the state budget is two months late. 

Stakeholder Meetings

DHS Statewide Positive Approaches & Practices Conference – September 17

This quarterly meeting is jointly hosted by The Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs (ODP). It aims to provide the most recent research and resources for people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities to live an everyday life. The meeting is held virtually from 10am to 3pm. For details and registration, click here.

Dual Diagnosis Professional Conference Series – September 18

Jointly hosted by OMHSAS and ODP, this presentation will review the clinical clues for identifying the effects of fetal alcohol spectrum disorder, suggestions for screening, current research, and statistics. The meeting is held virtually from 9am to 12:30pm. Click here to register.

2025-09-05T19:11:23+00:00September 5th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for September 5

PA Health Policy Update for May 23

The following is an update of selected state health policy developments in Pennsylvania from May 19 – 13.  (Some of the language used below is taken directly from state documents). 

Primary Election Update 

Voters went to the polls on Tuesday, May 20 for Pennsylvania’s 2025 Primary Election. On the ballot there were judicial candidates seeking to fill vacancies on the Commonwealth and Superior Courts, along with municipal races. Find the Department of State’s unofficial election results here 

General Assembly

The state House of Representatives and Senate were recessed this week. Both chambers are scheduled to return to Harrisburg on Monday, June 2. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule and Coding Matrix. This bulletin applies to all providers enrolled in the Medical Assistance program who provide EPSDT screens for Medical Assistance (MA) beneficiaries. 

Board of Nursing 

The State Board of Nursing has announced that it has adopted temporary regulations, which can be found here, necessary to implement the Nurse Licensure Compact. The temporary regulations are effective upon their publication in the Pennsylvania Bulletin. Additional information about the Nurse Licensure Compact is available on the Department of State’s website here. 

Insurance Department 

The Pennsylvania Insurance Department (PID), along with the Department of Health, the Department of Human Services, and the Department of Drug and Alcohol Programs (DDAP), has announced the  launch of a women’s health survey to identify challenges and questions women have about their health insurance benefits, and to remind women about preventive health services that are available to them at no cost through their insurance. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) has released its initial revenue estimate for FY 2025-26. The IFO has estimated Pennsylvania’s General Fund revenues will total $47 billion in FY 2025-26. The IFO has also revised the current fiscal year’s deficit to $3.6 billion, an increase of $280 million. Find the full report here and the IFO’s presentation here. 

Around the State 

  • The Tribune-Review has published an article about the potential spike in the number of Pennsylvanians without health insurance that will occur if the reconciliation bill passed by the U.S. House this week moves forward. 
  • Spotlight PA has continued to report about state legislative efforts to implement additional oversight of health care facility mergers and acquisitions. 
  • The mayoral elections that featured prominently in Tuesday’s Primary Election were the focus of an article by City & State Pennsylvania. 
  • Spotlight PA has published an article about the Commonwealth and Superior Court candidates advancing to November’s General Election. 

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – June 4

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on June 4 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

2025-05-23T20:21:35+00:00May 23rd, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 23
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