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PA Health Policy Update for April 18

The following is an update of selected state health policy developments in Pennsylvania from April 14 – 18.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

An arsonist attacked the Governor’s Residence in Harrisburg on Sunday, April 13, which forced the Governor and his family, who were present at the time of the attack, to be evacuated. The suspect has been arrested and formally charged with attempted murder, terrorism, and other charges. Find additional details, and the Governor’s statement on political violence, in this press release. 

General Assembly

  • The state House of Representatives and Senate were recessed this week. The House of Representatives will return to Harrisburg on Tuesday, April 22. The Senate will remain recessed until Monday, May 5.
  • The House Majority Policy Committee held an informational meeting on Monday, April 14 examining the impact of the life science sector on advanced manufacturing and health care workforce development. Find additional details and a recording of the meeting here.
  • The House Majority Policy Committee also held an informational meeting on Tuesday, April 15 examining midwifery modernization and maternal health deserts in Pennsylvania. Find additional details and a recording of the meeting here.
  • The House Insurance Committee has scheduled an informational meeting on Wednesday, April 23 at 9:15 a.m. to examine infertility care in Pennsylvania. The meeting will be held in Room 523 of the Irvis Building and livestreamed here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers enrolled on the Medical Assistance (MA) program of updates to the MA program fee schedule, including the addition of new procedure codes and the end-dating of certain codes based on provider request and clinical review. These changes will take effect May 1.
  • DHS has issued a Medical Assistance Bulletin to advise federally qualified health centers (FQHCs) and rural health clinics (RHCs) of the procedure codes, modifiers, and places of service to utilize when billing for covered services provided to Medicaid beneficiaries.
  • DHS Secretary Val Arkoosh along with other health-related cabinet officials participated in the Western Pennsylvania Regional Rural Healthcare Summit to discuss opportunities and challenges communities face accessing health care services. Find more information in this press release.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of May. Find the updated calendar here. 

Department of Health 

  • The Department of Health has announced that an individual from another state tested positive for measles while visiting Lancaster County after a trip to Texas, creating a potential for exposure to others. Find additional details and information about measles from DOH here.
  • The Newborn Screening and Follow-up Technical Advisory Board had voted to recommend the addition of Metachromatic leukodystrophy (MLD), a lysosomal storage disorder, to the commonwealth newborn screening panel effective January 1, 2026. Find additional information in this Pennsylvania Bulletin notice.
  • DOH has announced it will hold four public comment sessions to provide stakeholders an opportunity to comment on the development of the 2026 State Plan for the Pennsylvania Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program). Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Around the State  

Crozer Health’s ongoing challenges, as well as efforts to transition certain service lines were the subject of an article published by The Philadelphia Inquirer.  

PA has published an article about measles, the increasing cases nationally, and growing vaccine hesitancy. 

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – May 2

The Brain Injury Advisory Board will hold a public meeting on Friday, May 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 Cumberland conference room. Find additional details in this Pennsylvania Bulletin notice.

2025-04-18T17:47:31+00:00April 18th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 18
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PA Health Policy Update for April 11

The following is an update of selected state health policy developments in Pennsylvania from April 7 – 11.  (Some of the language used below is taken directly from state documents). 

General Assembly

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

  • The House of Representatives passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Monday, April 7 to examine potential updates to the Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.
  • The House Human Services Committee met on Tuesday, April 8 and favorably reported House Bill 561, which expands Act 80 to include all FDA-approved medication assisted treatment, and House Bill 1117, which updates language defining DDAP’s duties and responsibilities. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, April 8 and favorably reported House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, April 9 and favorably reported, among other legislation, the following pertinent bills. A recording of the meeting is viewable here.
    • House Bill 69, which expands the existing Cancer Drug Repository program to other prescription drugs.
    • House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements.
    • House Bill 1104, which caps the costs of obtaining electronic medical records.

The House of Representatives and the Senate have now recessed. The House will reconvene Tuesday, April 22 and the Senate will reconvene Monday, May 5. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to remind physicians, physician assistants (PAs), and certified registered nurse practitioners (CRNPs) enrolled in Medicaid that they are able render topical fluoride varnish (TFV) services to Medicaid beneficiaries.
  • DHS has issued a reminder to all participating Medicaid providers of the need to complete a “MA 112 Form” after the birth of a child to a mother enrolled in Medicaid in order to notify the mother’s respective county assistance office (CAO).  The “MA 112 Form” should be completed and submitted within three working days of the child’s birth.
  • DHS has published final notice of its funding allocation for FY 2024-25 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to Medicaid-enrolled, qualifying inpatient acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice. 

Around the State  

  • CBS News has published an article about the continued challenges facing Crozer Health in Delaware County. An attorney for Prospect Medical Holdings, the parent company of Crozer, indicated Crozer would start transitioning certain service lines to other providers.
  • Pennsylvania’s home care industry and its need for additional funding was the focus of an article by Politics PA this week.
  • The Pennsylvania Capital-Star has published an article about increasing measles cases in the state and some counties’ lagging vaccination rates. 

Stakeholder Meetings

DOH – WIC State Advisory Board – April 22

The WIC State Advisory Board will hold a public meeting on April 22 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice. 

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information. 

DOH – Renal Disease Advisory Committee – April 25

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 25 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-11T22:36:44+00:00April 11th, 2025|Governments, Medical Assistance Bulletin, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 11
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PA Health Policy Update for April 4

The following is an update of selected state health policy developments in Pennsylvania from March 31 – April 4.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

The Shapiro administration has announced it joined a multi-state lawsuit against the Trump administration’s decision to cancel more than $500 million in public health grant funding that supported programs in the Department of Health, Department of Human Services, and the Department of Drug & Alcohol Programs. Find a copy of the lawsuit here and additional information in this press release. 

General Assembly

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

  • The Senate passed Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, by a vote of 38-11. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Institutional Sustainability & Innovation Committee held an informational hearing on Tuesday, April 1 examining the commonwealth’s life science sector and Pennsylvania’s innovation economy. A recording of the hearing is and testimony offered to the committee is viewable here.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, April 1 and favorably reported, among other bills, Senate Bill 115, which provides skills competency examination opportunities to individuals seeking employment as a direct caregiver in lieu of successfully obtaining a high school diploma or GED equivalency, and Senate Bill 411, which implements a statewide stroke registry.

The Senate has now recessed until Monday, May 5. The state House of Representatives will reconvene Monday, April 7 through Wednesday, April 9. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS is implementing an alternative payment methodology for federally qualified health centers (FQHCs) and rural health clinics (RHCs) for a supplemental payment at the Medicaid fee schedule rate for a long-acting reversible contraceptive (LARC) device and its insertion, or the removal of a LARC device.

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. 

Revenue Collection Update  

The Department of Revenue has announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $70.0 million, or 1.1 percent, more than anticipated. Fiscal year-to-date General Fund collections total $33.2 billion, which is $34.3 million, or 0.1 percent, below estimate. 

Board of Pharmacy ission, 

The State Board of Pharmacy has published a notice in the Pennsylvania Bulletin of the current income levels necessary for participation in the Cancer Drug Repository program. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin that it has received the following final form rulemaking which will be considered at its May 15 meeting.

IRRC has also published a notice in the Pennsylvania Bulletin announcing it has issued comments to the State Board of Nursing regarding its proposed rule on nursing education programs issued January 25, 2025. Find IRRC’s comments here. 

Around the State

  • The Philadelphia Inquirer has published an article about Independence Blue Cross’, the largest health insurer in southeastern Pennsylvania, reported financial loss in 2024 due, in part, to Medicare and Medicaid rates. 
  • Governor Shapiro’s decision to join a multi-state lawsuit against the Trump administration’s decision to cancel public health grant funding was reported by the Pennsylvania Capital-Star. 
  • The Pennsylvania Capital-Star also published an article about the potential impact Medicaid cuts at the federal level may have on rural health care access. 
  • Spotlight PA has published an article about the Department of Aging’s decision to revise a policy that previously required the tracking of the cause of death for every adult who died during an active abuse or neglect investigation. 

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

PHC4 – Meeting Schedule

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Payment Data Advisory Group meeting for April 10 at 1:00 p.m., a Data Systems Committee meeting for April 15 at 10:00 a.m., an Education Committee meeting for April 23 at 10:00 a.m., and a Council meeting for May 1, 2025, at 10:00 a.m. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-04T20:41:43+00:00April 4th, 2025|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 4
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PA Health Policy Update for February 21

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

 General Assembly

The state House of Representatives and Senate began hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.

  • The Department of Health appeared before the Senate Appropriations Committee on Wednesday, February 19. A recording of that hearing is viewable here.
  • The Department of Health and the Department of Drug & Alcohol Programs appeared before the House Appropriations Committee on Friday, February 21. A recording of that hearing is viewable here.  

The House of Representatives and Senate will continue budget hearings next week. The only health-related agency scheduled to appear is the Department of Aging, which will be before the Senate Appropriations Committee on Tuesday, February 25 at 1:00 p.m. and the House Appropriations Committee on Thursday, February 27 at 1:00 p.m. The House Appropriations Committee’s full hearing schedule is viewable here and the Senate Appropriations Committee’s full hearing schedule is viewable here. 

Department of Human Services

The Department of Human Services (DHS) has released a rate and wage study for its long-term services and supports (LTSS) and home and community-based services (HCBS) programs. The study assessed rates paid to LTSS and HCBS providers in order to inform the commonwealth’s budget and rate setting process. The study is viewable here.

DHS has issued a Medical Assistance Bulletin to advise providers that effective February 18, the Medical Assistance (MA) program will cover Early and Periodic Screening, Diagnostic and Treatment (EPSDT) screening and diagnostic services to eligible juveniles in the 30 days prior to release, and targeted case management services, both physical and behavioral health, in the 30 days prior to and for at least 30 days following release from a carceral setting.  

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will hold a webinar on March 3 at 10:00 a.m. to discuss the changes to 42 CFR Part 8 (Medications for the Treatment of Opioid Use Disorders) and their practical implications in treatment settings. Find additional information and details on how to participate here. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of a special report on the finances of rural hospitals in Pennsylvania. Find the full report and data visualizations from the report here. 

Around the State  

The Philadelphia Inquirer’s Harold Brubaker has written an article about Sharon Regional Medical Center and Crozer Health and the financial support provided by the state to help keep them open and serving patients.

Governor Shapiro’s appointment by President Trump to serve a two-year term on the Council of Governors was covered by The Philadelphia Inquirer. Among other things, the council is tasked with improving state-federal partnerships and coordinating national security and disaster response efforts. 

Stakeholder Meetings

DHS – Consumer Sub-MAAC – February 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – February 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

Pennsylvania Health Care Cost Containment Council – Committee Meetings

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the schedule of various committee meetings for the first quarter of 2025. Find a detailed schedule and details on how to participate in this Pennsylvania Bulletin notice.

2025-02-21T21:58:30+00:00February 21st, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for February 21
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PA Health Policy Update for January 10

The following is an update of selected state health policy developments in Pennsylvania January 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The General Assembly convened on Tuesday, January 7 to officially commence the 2025-2026 legislation session. Members of the state House of Representatives and Senate who were newly elected or re-elected were sworn in. In addition, the two chambers elected their respective presiding officers, adopted rules, and established standing committees.

At the conclusion of Tuesday’s legislative business, the House and Senate recessed until Monday, January 27. Following are their respective 2025 session calendars.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has approved the remainder of the commonwealth’s request for a five-year section 1115 demonstration – Bridges to Success: Keystones of Health for Pennsylvania. You will recall Pennsylvania received approval from CMS back in November to implement multi-year continuous eligibility for Medicaid-eligible children through age six and one year of continuous coverage for Medicaid-eligible citizens returning from a state correctional facility. The Department of Human Services (DHS) has stated it, “will work through the state budget process to determine next steps for potential implementation.” Find CMS’ approval letter to DHS here. 

Department of Human Services 

  • DHS has issued updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Anticonvulsants submitted for prior authorization. Find additional information in this Medical Assistance Bulletin.
  • DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the Admissions Notice Packet (MA 401) form due to an increase in the personal needs allowance (PNA) deduction amount. This bulletin applies to nursing facilities, intermediate care facilities, and long-term care facilities enrolled in the Medical Assistance program. 

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that 259 Pennsylvanians successfully appealed denied health service claims through PID’s new Independent External Review process. Of the total health service denials submitted for review in 2024, 50.1 percent were overturned.

PID has also shared information related to its efforts to increase health insurance transparency through several reports available to the public, including its annual Transparency in Coverage Report for ACA Health Plans, which outlines data on claims, denials, and appeal information, and its inaugural ACA and Qualified Health Plans (QHP) Summary. Find additional information in this press release.

Around the State

  • WHYY has written about the Pennsylvania Insurance Department’s external review program which received 517 health service denial appeals in 2024. 259 of those denials were overturned. 
  • City & State Pennsylvania has published an article about the General Assembly’s first session day of 2025. 
  • The Pittsburgh Post-Gazette has written an article about a study released by Pennsylvania Partnerships for Children that kids largely stayed insured despite uncertainties during the Medicaid eligibly redetermination process following the conclusion of the COVID-19 public health emergency. 

Stakeholder Meetings

DOH – WIC Advisory Board – January 14

The WIC State Advisory Board will hold a meeting on January 14 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Special Pharmaceutical Benefits Advisory Council – January 30

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, January 30 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-01-10T20:27:58+00:00January 10th, 2025|Federal Medicaid issues, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 10
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PA Health Policy Update for January 3

The following is an update of selected state health policy developments in Pennsylvania December 23 – January 3.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The state House of Representatives and Senate will convene on Tuesday, January 7 at 12:00 p.m. to swear in newly elected and re-elected members for the 2025-2026 legislative session. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that the department is adding doula services to the Medical Assistance (MA) program fee schedule and will pay enrolled certified perinatal doulas beginning January 1, 2025.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has issued a bulletin announcing the Peer Support Services (PSS) and PSS Provider Handbook has been updated to reflect the requirements for PSS. The revisions better clarify which requirements apply to OMHSAS licensure and which apply to MA payments. Additional updates include staff qualifications and requirements for certified peer specialists and their supervisors and telehealth requirements.
  • DHS has provided final notice of its intent to adjust the managed care assessment fixed fee. Effective January 1, 2025, the fee will be $30.47 per member per month. The aggregate fiscal impact for this change in FY 2024-2025 will be $208.6 million dollars in additional assessment revenue. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has issued comments to the Department of Human Services (DHS) regarding the transition to the Patient-Driven Payment Model (PDMP) for non-public and county nursing facilities. Find additional information in this Pennsylvania Bulletin notice.   

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.8 billion in General Fund revenue in December, which was $87.2 million, or 2.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $20.2 billion, which is $97.1 million, or 0.5 percent, below estimate.

Around the State  

  • Spotlight PA has written an article about the scrutiny, and at times, lack of transparency over how counties across Pennsylvania are spending billions of dollars in opioid settlement money.
  • Writing for The Philadelphia Inquirer, Harold Brubaker has published an article about Pennsylvania’s new law limiting noncompete agreements for health care practitioners. Brubaker also wrote an article about the success and challenges of Pennsylvania-based biopharmaceutical companies in 2024. 
  • The Pittsburgh Post-Gazette has reported that Sharon Regional Medical Center announced an agreement has been made with Tenor Health Partners to take over operations at the hospital, avoiding the anticipated January 6th closure. 

Stakeholder Meetings

DOH – HIV Planning Group – January 15

The Statewide HIV Planning Group will hold a public meeting on Wednesday, January 15 and Thursday, January 16 from 9:00 a.m. to 4:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – January 17

The Renal Disease Advisory Committee will meet on Friday, January 17 at 10:00 a.m. to discuss new and ongoing issues relating to the treatment of chronic renal disease and the department’s programs related to care and treatment. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Preventive Health Services Block Grant Advisory Committee – January 27

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Monday, January 27 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – February 7

The Brain Injury Advisory Board will hold a public meeting on Friday, February 7 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2025-01-03T18:57:52+00:00January 3rd, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for January 3
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PA Health Policy Update for November 15

The following is an update of selected state health policy developments in Pennsylvania November 4 – 15.  (Some of the language used below is taken directly from state documents). 

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it approved an amendment to Pennsylvania’s section 1115 Medicaid demonstration waiver to provide continuous Medicaid eligibility for children until the age of six, and 12 months of continuous eligibility for individuals aged 19 through 64 leaving incarceration, who meet certain high-risk criteria. Find additional information about Pennsylvania’s section 1115 demonstration amendment approval here. 

General Assembly

The state House of Representatives and Senate briefly convened for voting session this week to conclude legislative business for the 2023-2024 session and elect caucus leadership for the upcoming 2025-2026 legislative session. Following is the comprehensive list of each caucus’ leadership team.

* Denotes majority party.  

Department of Human Services

  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it released an updated Psychiatric Outpatient Clinic Regulatory Compliance Guide (RCG). The changes made were primarily to language and updates based on comments received from stakeholders on the original document issued in 2021. OMHSAS has been working on developing RCGs for each licensed level of care. The RCG is designed to be a tool for providers, OMHSAS staff, and the public to better understand pertinent regulations. The guide is a companion piece to 55 Pa. Code Chapter 5200.
  • DHS has issued several Medical Assistance bulletins with updated handbook pages that include the requirements for prior authorization for various pharmacy services. Following is a comprehensive list of prior authorization bulletins recently issued by DHS.

Department of Health 

The Department of Health (DOH) has published notice of the Secretary of Health’s decision not to effectuate the recommendation of the Medical Marijuana Advisory Board that certified registered nurse practitioners (CRNPs) and podiatrists be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana. Find the notice regarding CRNPs here and podiatrists here. 

Insurance Department

The Pennsylvania Insurance Department (PID) has released a comprehensive study of the accuracy of health insurer provider directories. The report highlights persistent inaccuracies in health insurer provider directories that can delay care, hinder scheduling, or result in surprise out-of-network charges. PID is planning to initiate stakeholder outreach to gather input and develop solutions that reduce inaccuracies in provider directories. Find additional information in this press release. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) has released its Economic and Budget Outlooks for FYs 2024-2025 to 2029-2030. This annual fiscal outlook report, which includes projections of state revenues and expenditures, also considers economic and demographic trends that will impact tax revenues and expenditures over the next five fiscal years. Find the IFO’s presentation here and its full report here. 

Office of Administration 

The Office of Administration has recently announced the launch of a new resource page on PA.gov that makes it easier for residents, businesses, non-profits, and local government entities to find and apply to various grant programs from state agencies. Find additional information in this press release. 

Around the State  

  • The Hill has published an article about Governor Shapiro’s national political prospects following the 2024 election. 
  • WHYY has written an article about this year’s open enrollment for health insurance coverage in 2025.  The Pittsburgh Post-Gazette has also written about open enrollment and the potential for premiums to increase. 
  • An article published by the Patriot-News highlights the continued partisan split in Harrisburg for the upcoming 2025-2026 legislative session.  The Pennsylvania Capital-Star also wrote about this dynamic but noted House Democrats’ hope for greater cooperation with the Republican Senate. 

Stakeholder Events 

DOH – Newborn Screening Advisory Committee – November 21

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 21 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual conference. Find additional information in this Pennsylvania Bulletin notice.

2024-11-15T20:57:21+00:00November 15th, 2024|Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for November 15
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PA Health Policy Update for November 1

The following is an update of selected state health policy developments in Pennsylvania October 28 – November 1.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed the following bills into law this week.

  • House Bill 1608, now known as Act 115 of 2024, which extends Medicaid coverage to doula services and creates a doula advisory board.
  • House Bill 2185, now known as Act 117 of 2024, which requires the Department of Health to develop type 1 diabetes informational materials for parents and guardians.
  • House Bill 2381, now known as Act 119 of 2024, which enables the licensing boards or commissions under Department of State to promulgate one-time, temporary regulations necessary for the implementation of each licensure compact enacted by the General Assembly.
  • Senate Bill 365, now known as Act 121 of 2024, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage.
  • Senate Bill 920, now known as Act 122 of 2024, which establishes a statewide sexual assault evidence tracking system.
  • Senate Bill 267, now known as Act 134 of 2024, which adds urgent care centers to the list of safe haven locations for newborn children.
  • Senate Bill 1080, now known as Act 137 of 2024, which allows licensed practical nurses to make death pronouncements in the hospice setting. 

General Assembly

The state House of Representatives and Senate are currently recessed until after the November 5 General Election. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2024-2025 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance enrolled, qualifying inpatient general acute care hospitals. DHS does not intend to change the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published its proposed Psychiatric Residential Treatment regulations in the Pennsylvania Bulletin. These proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.
  • DHS has published a Medical Assistance Bulletin with updates to the PROMISe™ Provider Handbook 837 for Medical Assistance enrolled federally qualified health centers (FQHCs) and rural health clinics (RHCs).
  • The Office of Medical Assistance Programs (OMAP) has announced it will be hosting several upcoming community health worker (CHW) listening sessions throughout November and December in order to gather information that will help DHS’ strategic plan for CHWs. Find a schedule of the listening sessions as well as details on how to participate here.
  • 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 beneficiaries.

Insurance Department

The Pennsylvania Insurance Department has published a notice in the Pennsylvania Bulletin that the Medical Care Availability and Reduction of Error (MCARE) assessment for all basic insurance coverage and self-insured participating health care providers for calendar year 2025 will be 29 percent applied to the prevailing primary premium for each participating health care provider.  

Board of Medicine 

The State Board of Medicine has published its final-form rulemaking related to licensure by endorsement. The regulations are effective upon publication in the Pennsylvania Bulletin. Find the final-form regulations here. 

Office of the Attorney General

The Office of the Attorney General (OAG) has filed a civil suit against Prospect Medical Holdings, which owns Crozer Health System, over breach of contract. OAG has alleged Prospect has broken its 2016 court-approved “asset purchase agreement” by closing facilities and diverting funding from the sale of real estate to shareholders and investors. The lawsuit seeks a preliminary injunction to preserve Crozer’s existing services, and the appointment of a receiver to manage the Crozer Health System until another buyer can be identified. Find additional details in this press release. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate. 

Around the State  

  • Spotlight PA has published an article written by Stephen Caruso about a slate of bills to improve maternal health care in Pennsylvania.
  • WHYY has written an article about Attorney General Michelle Henry’s decision to sue Prospect Medical Holdings over Crozer Health System. 
  • City & State Pennsylvania has published an article about Pennsylvania’s health insurance marketplace, Pennie, as the open enrollment period nears. 

Stakeholder Events 

Pennsylvania Health Care Cost Containment Council – November 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, November 7. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Organ Donation Advisory Committee – November 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Planning Committee – November 20

The Statewide HIV Planning Committee will hold public meetings at the Hilton Harrisburg (One North 2nd Street, Harrisburg, PA 17101) on Wednesday, November 20 from 9:00 a.m. to 5:00 p.m. and on Thursday, November 21 from 9:00 a.m. to 4:30 p.m. The meeting will also be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Spinal Cord Research Advisory Committee – November 18

The Spinal Cord Research Advisory Committee will hold a public meeting on Monday, November 18 from 10:30 a.m. to 11:30 a.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.   

2024-11-01T20:14:07+00:00November 1st, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for November 1
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PA Health Policy Update for October 18

The following is an update of selected state health policy developments in Pennsylvania October 14 – 18.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

Governor Shapiro has signed the following bills into law this week.

  • House Bill 155, now known as Act 96 of 2024, removes the requirement that direct care workers be interviewed in-person for a position.
  • House Bill 2084, now known as Act 101 of 2024, establishes a license for prescription drug virtual manufacturers.
  • House Bill 2127, now known as Act 102 of 2024, allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources.
  • Senate Bill 668, now known as Act 109 of 2024, permits certified nurse aides to become certified medication aides in long-term care facilities, assisted living residences, and personal care homes.
  • Senate Bill 840, now known as Act 111 of 2024, creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. 

General Assembly

  • The state House of Representatives and Senate are scheduled to return to Harrisburg on Monday, October 21 for session. This is the last scheduled session week prior to the November 5 General Election. 
  • The House Children & Youth Committee will meet on Tuesday, October 22 at 10:00 a.m. in Room 515 of the Irvis Office Building to consider House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system.
  • The House Children & Youth Committee will also meet on Wednesday, October 23 at 10:00 a.m. in Room 515 of the Irvis Office Building for an informational meeting the CCAP Complex Case Task Force report and the DHS Blueprint report. 
  • The Senate Aging & Youth and Banking & Insurance Committees will hold a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. The meeting will be held in Hearing Room 1 of the North Office Building. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that DHS will continue the alternative payment methodology and pay the Medical Assistance (MA) program fee schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit.
  • DHS has shared the agenda for the next Medical Assistance Advisory Committee (MAAC) meeting on Thursday, October 24. Find additional details on how to participate in Stakeholder Events below.

Department of Health 

The Department of Health (DOH) has reminded long-term care providers that its annual questionnaire of long-term care facilities must be completed and submitted to the department electronically by Friday, October 25, 2024. Any questions regarding the questionnaire may be directed to RA-dohbhssurveys@pa.gov.

Around the State  

Spotlight PA published an article about the increasing number of long-term care facility closures in the commonwealth. 

Pennsylvania pharmacists are receiving less money for drugs dispensed to Medicaid patients, the Pennsylvania Capital-Star reports. 

Stakeholder Events 

DHS – Consumer Sub-MAAC – October 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 23 at 1:00 p.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DHS – Medical Assistance Advisory Committee – October 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 24 at 10:00 a.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-21T20:36:11+00:00October 18th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for October 18
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PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. 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 published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

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.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20
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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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