Medical Assistance Bulletin Archives - Page 10 of 11 - Safety-Net Association of Pennsylvania

PA Health Policy Update for the Week of September 6

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The House of Representatives announced it will return to session a week early to address the Wolf administration’s implementation of a mask mandate for K-12 schools and child care facilities. The House, which was originally scheduled to return on September 27, has added September 20, 21, and 22 as voting session days.

Department of Health

The Department of Health has issued a health alert updating guidance about tuberculin skin testing for tuberculosis for individuals who have been vaccinated against COVID-19. The department no longer recommends waiting four weeks from the final COVID-19 vaccination for immune-based TB testing.
The Department of Health has published notices in the Pennsylvania Bulletin authorizing expanded scope of practice for various professionals functioning as part of an emergency medical services agency that has been licensed as a critical care transport ambulance service.
The Department of Health will offer free potassium iodide, or KI, tablets on Thursday, September 16 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants. Learn more from this department news release.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin announcing the addition of CPT codes 0003A and 0013A to the Medical Assistance Program Fee Schedule for the administration of a third dose of the Pfizer and Moderna COVID-19 vaccines. See the notice here.
The Department of Human Services has posted a notice announcing FY 2022 rates for selected services provided by the state’s Office of Mental Health and Substance Abuse Services (OMHSAS).
The Department of Human Services has announced that it will allocate $255.556 million in total funds in FY 2022 for inpatient disproportionate share hospital (Medicaid DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals, outpatient supplemental payments to qualifying inpatient acute-care general hospitals, and direct medical education payments to qualifying inpatient acute-care general hospitals. The department is not changing the state plan provisions addressing the qualifying criteria or payment methodology for these payments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has announced its intention to make COVID-19-related Medicaid DSH payments to qualified hospitals and how much it will pay hospitals based on their Medical Assistance days and their degree of Medicaid dependence. See the Pennsylvania Bulletin notice here.
The Department of Human Services is adding and end-dating procedure codes as a result of implementing the 2021 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The department also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance Program Fee Schedule, including fee adjustments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has published its latest monthly physical health managed care enrollment report. Find it here.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first report on the performance of its Pennsylvania Rural Health Model. Find that report here and go here for further information about the program.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained high this week, including the first day (today) with more than 5000 new cases since mid-April.
The number of new COVID-19-related deaths increased over the past week.
For the week ending September 9 in Pennsylvania, every county in the state is experiencing a high level of COVID-19 transmission. The CDC classifies transmission as follows:
- Low: 0-10 new cases per 100,000 residents over the past week or 0-5% positivity rate
- Moderate: 15-50 new cases per 100,000 residents over the past week or 5-8% positivity rate
- Substantial: 50-100 new cases per 100,000 residents over the past week or 8-10% positivity rate
- High: 100+ new cases per 100,000 residents over the past week or 10%+ positivity rate

The number of Pennsylvanians hospitalized because of COVID-19 has risen 17 percent since the beginning of the month, the number on ventilators has risen 14 percent, and the number in hospital intensive care units has risen 11 percent.
According to the state’s revised figures, 66.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.0 million people – up from 66.0 percent last week. Only 11,000 Philadelphians and 65,000 other Pennsylvanians (fewer than last week) completed a vaccine regimen in the past week.

Around the State

The Delaware County Board of Health is now hiring people to staff the county’s new health department, which is scheduled to begin operations in January, the Delaware County Times reports.
The city of Reading has been awarded $3.3 million by the federal government to remove lead paint from homes, according to the Reading Eagle.
The mayor of Scranton will propose legislation to the city’s council to decriminalize possession of fentanyl test strips, which are currently considered drug paraphernalia under state law. The Scranton Times-Tribune explains why.
Children ages 12 and under constituted 12 percent of Allegheny County’s COVID-19 cases in August, the county’s health director told the Pittsburgh Tribune-Review.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has rejected regulations proposed by the state’s Department of Drug and Alcohol Programs for the licensure or certification of drug and alcohol recovery houses that receive funds or referrals from the department or a federal, state, or other county agency to ensure that a drug and alcohol recovery house provides a safe environment for residents. See the commission’s explanation of its decision in this Pennsylvania Bulletin notice.

Stakeholder Events

The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm. Go here to register to participate remotely.
The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am. Go here to register to participate remotely.
The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

jsteinbock2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of August 16-20

The following is an update of selected state health policy developments in Pennsylvania for the week of August 16-20, 2021. (Some of the language used below is taken directly from state documents.)

The Wolf Administration

The Wolf administration has directed vaccine providers to support COVID-19 vaccination clinics and has introduced a free COVID-19 testing program for schools across the state. Learn more from this news release and from a Department of Health order in support of the governor’s directive.

General Assembly

The Senate Aging & Youth Committee held a hearing this week to examine proposed revisions of the state’s Child Protective Services Law. Testimony presented to the committee and a video transcript may be found here.

Next week the Senate Health & Human Services and Aging & Youth committees will hold a joint hearing with the House Aging & Older Adult Services and Human Services committees to “discuss the Department of Human Services’ intent to contract with Maximus as its independent enrollment broker (IEB) and the impact this will have on seniors and adults with disabilities.” The hearing will take place on Monday, August 23 at 12:30 p.m. Livestream the hearing here.

Department of Health

Effective August 18, the Department of Health’s order regarding daily hospital data reporting through the Corvena system is amended to add new data fields related to the vaccination status of hospital patients. View details in the amended order here.
The Department of Health has issued an advisory to health care facilities and providers caring for people whose immune systems are moderately to severely compromised about the CDC’s recommendation that such individuals may benefit from an additional dose of mRNA COVID-19 vaccine to ensure they have enough protection against COVID-19. Find the advisory here.
The Department of Health has informed health care facilities and providers of the CDC’s recommendation that pregnant people should be vaccinated against COVID-19. Learn more from a department health advisory.
In July the Department of Health’s nursing home surveyors conducted 466 inspections, including 289 complaint investigations, of 329 separate nursing homes. Of these inspections, 30 were COVID-19-specific investigations. There were five new sanctions finalized against nursing care facilities in the past month resulting in a total of $40,150 in fines. Learn more from this department news release.

Department of Human Services

DHS has added September dates to its calendar of MA remittance advice delivery dates. Find the updated list here.
DHS has published a Medical Assistance Bulletin announcing changes in the Medical Assistance program fee schedule, including changes resulting from the implementation of the 2021 Healthcare Common Procedure Coding System procedure codes updates. In addition, DHS also is adding other procedure codes and making changes to procedure codes currently in the MA program fee schedule, including fee adjustments, as well as setting limitations and prior authorization requirements. These changes are effective for dates of service on and after August 23, 2021. Find this Medical Assistance Bulletin here.
Officials from DHS and the Department of Health have introduced the PA Health Equity Analysis Tool (HEAT), an interactive map that synthesizes Medical Assistance and population health data to show opportunities for intervention to promote better health and promote health equity. PA HEAT provides state, county, zip code, and census track-level data on a number of population health measures and social determinants of health and how they affect local communities and Pennsylvania as a whole. Results can also be displayed according to environmental justice areas, which are calculated based on concentrations of people living at or below the federal poverty line, based on resident demographics. Learn more about PA HEAT from this DHS announcement and from the PA HEAT web site.
DHS has released quarterly licensing and enforcement activity data for its five licensing offices that oversee providers of long-term care, child care, behavioral health care, day activity programs, and residential care for individuals with intellectual disabilities and autism. Find a summary of the report in this DHS announcement.
A notice in the Pennsylvania Bulletin announces that documents are now available on DHS’s web site about proposed annual case-mix per diem rates for state fiscal year 2021-2022 for non-public and county nursing facilities and the budget adjustment factor that will be applied to non-public and county nursing facilities. Find the Pennsylvania Bulletin notice here and the DHS web site with the nursing facility rates here.

COVID-19: By the Number

The daily number of new COVID-19 cases continued to rise during the past week. The 3451 new cases reported on Thursday was the highest single-day total since April 30.
The number of deaths, while slightly higher during the past week, remains far lower than when comparable numbers of new cases were being reported in the spring.
For the week of August 6-12 the state’s overall COVID-19 test positivity rate was 6.0 percent, up from 5.4 percent last week and the fifth consecutive week with an increase.
In Pennsylvania, only Sullivan County is classified as having a low rate of COVID-19 transmission this week; three counties – Forest, Tioga, and Warren – have a moderate rate of transmission; 25 counties are currently experiencing a substantial rate of transmission; and 38 currently show a high rate of transmission, including nine of the ten most populous counties in the state: Philadelphia, Allegheny, Delaware, Bucks, Montgomery, York, Lehigh, Berks, and Lancaster.
The number of Pennsylvanians hospitalized because of COVID-19 has more than doubled since the beginning of the month; the number on ventilators because of the virus is two-and-half times greater than it was at the beginning of the month; and the number in hospital intensive care units has more than tripled since the beginning of the month.
According to the state’s COVID-19 Dashboard, only 57 pediatric ICU beds in the state are not currently occupied. That figure represents 14.7 percent of the total of such beds in Pennsylvania.
According to the state’s revised figures, 64.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 5.86 million people – up from 62.8 percent last week. Only 54,000 Pennsylvanians completed a vaccine regimen in the past week and only 134,000 have done so since the beginning of August.

Around the State

Governor Wolf is “…reinstating a mask mandate for all state employees and contracted staff working under his jurisdiction regardless of their vaccination status, starting on Monday,” PennLive reports.
A shortage of nurses in the Philadelphia area has led hospitals to offer signing and retention bonuses of as much as $20,000 to experienced nurses. The Philadelphia Inquirer offers the details.
“Overburdened health care systems from Texas to Florida are pleading with Western Pennsylvania hospitals to take on transfer patients at record-high rates as beds and ventilators reach capacity in covid-19 hot spots across the country,” the Pittsburgh Tribune-Review reports.
“While nearly a third of deer tested in Pennsylvania carried antibodies indicating they were exposed to COVID-19, the Pennsylvania Game Commission noted there is no evidence that deer can transmit the virus to humans and advised hunters to ‘take usual precautions when handling their harvests.’” The Bradford Era explains what this means.
WTAE TV in Pittsburgh has published on its web site an interactive map showing the COVID-19 transmission rate for every county in the state. Find the map here (scroll down to see it).
The Wolf administration plans to engage at least 100 people to perform COVID-19 contact tracing, Spotlight PA reports.

Stakeholder Event

The Department of Health’s Health Research Advisory Committee will hold a public meeting on Monday, August 23, from 10:00 a.m. to 11:30 a.m. The meeting will be held virtually via Microsoft Teams at +1 267-332-8737 with Conference ID: 545 844 262#. The purpose of the meeting is to review the work of the committee and plan future health research priorities. Find the meeting agenda here.

jsteinbock2021-08-20T21:33:37+00:00August 20th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, social determinants of health|Comments Off

PA Health Policy Update for the Week of August 2-6

The following is an update of selected state health policy developments in Pennsylvania for the week of August 2-6, 2021. (Some of the language used below is taken directly from state documents.)

The Wolf Administration

The Wolf administration has announced plans to extend postpartum Medicaid coverage for mothers. Federal law requires Medicaid to extend eligibility for pregnant women with incomes up to 138 percent of the federal poverty level for 60 days following the birth of a baby but the American Rescue Plan Act authorizes states to expand the Medicaid postpartum coverage period for mothers to one year following the birth of a baby beginning on April 1, 2022. Learn more from this Wolf administration news release.

Department of Health

The Department of Health announced that it will begin sending text messages to people who received their first dose of a COVID-19 vaccine but have not received their second dose. See the department’s announcement about this effort.
The Department of Health has updated its guidance for who should quarantine if they have been exposed to someone who is diagnosed with COVID-19 or has been in contact with someone who has COVID-19 and for how long they should quarantine. See the updated guidance here.
The Department of Health has published a Health Alert Network notice that provides an update on the outbreak of C. auris in Pennsylvania, first reported in March of 2020 and affecting 52 cases in 13 health care facilities since then. The notice describes the current epidemiology of C. auris and discusses risk factors, transmission, diagnosis, and prevention. See the notice here.
The Department of Health will be publishing facility-level COVID-19 vaccination rates (as reported to the CDC) on its website next week. It compiled materials from multiple sources to help educate skilled nursing facility staff about the safety and benefits of COVID-19 vaccines. Those sources include:

- CDC Long-Term Care Facility Toolkit
- PA Department of Health COVID-19 Resource Library
- Resource guides to address concerns linked to race, ethnicity, and reproduction
- A presentation on the safety and science of vaccines that can be customized to your organization

Department of State

The Department of State notified providers about its plans to phase out many of the current waivers and flexibilities in place for the pandemic as a result of legislation calling for an end to such waivers by September 30, 2021 or earlier at the discretion of each department. These flexibilities will expire on either August 17, August 31, or September 15, 2021, as indicated in this announcement. Licensees and other affected stakeholders are urged to return to compliance with all requirements without delay but in any event no later than the relevant expiration dates.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin explaining that the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has removed from its terms and conditions for grant funding a statement that prohibited any entity from receiving funds if the entity provides or permits marijuana use for the purposes of treating substance use or mental disorders. Updated manuals can be found on the Department of Drug and Alcohol Programs website.

Department of Aging

The Department of Aging announced changes to the maximum amount available to a qualified primary caregiver for out-of-pocket expenses incurred for services and the lifetime amount for home modifications or assistive devices. The new maximum amounts will be effective August 10, 2021 and are the result of legislative changes enacted earlier this summer. Find the new amounts in this Pennsylvania Bulletin announcement.

COVID-19: By the Numbers

The daily number of new COVID-19 cases rose considerably again over the past week. Thursday’s new case count was the highest single day total since May 21.
The number of deaths, however, remains very low.
For the week from July 23 through July 29 the state’s overall COVID-19 test positivity rate was 3.9 percent, up from 2.6 percent last week and the fourth consecutive week with an increase after more than two months of declining rates.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital intensive care units because of COVID-19, and on ventilators because of COVID-19 rose sharply in the past week.
According to the state’s revised figures, 63.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated, a small increase over last week’s number. In Philadelphia, only 17,000 people reached full vaccination status in the past week and 46,000 have done so since July 1.

Around the State

The high numbers of COVID-19 deaths in nursing homes was expected to lead to an avalanche of lawsuits but so far it has not. The Philadelphia Inquirer looks into why.
Governor Wolf has asked the state legislature to return early to Harrisburg to extend his declaration of an opioid disaster emergency. The Pennsylvania Capital-Star explains what this means. Republican legislative leaders replied that they are not interested in extending the state of emergency, the Allentown Morning Call reports.
Delaware County continues to work on launching its new public health department. The Delaware County Daily Times tells the story.
When the Boyertown school board voted to make masks optional when school resumes in September, a virologist serving on the board’s pandemic advisory board resigned his position, according to the Pottstown Mercury.

Stakeholder Events

Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

August 11-12 at 9:00 a.m.

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, August 11, 2021, and Thursday, August 12, 2021 from 9 a.m. to 4:30 p.m. To see the agenda and find information about where the meeting will be held and how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Pennsylvania Rural Health Redesign Center Authority Board

August 17 at 10:00 a.m.

The Board is charged with administering the Pennsylvania Rural Health Model and the virtual meeting will provide updates on a variety of topics including model status updates, Federal grant deliverables, global budget methodology, and more. For information on how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Maternal Mortality Review Committee Virtual Public Meeting

August 18 at 9:00 a.m.

The purpose of the virtual public meeting is to discuss new and ongoing issues relating to treatment of maternal mortality and the Department of Health’s programs related to care and treatment. For information on how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Stakeholder Event Materials

jsteinbock2021-08-16T15:17:35+00:00August 16th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of July 26-30

The following is an update of selected state health policy developments in Pennsylvania for the week of July 26-30, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

House majority leader Kerry Benninghoff announced this week that he sent letters to state agencies notifying them that they should be prepared to have the nearly 500 waived and suspended regulations that were in place under the COVID-19 emergency disaster declaration reinstated on September 30, 2021. He also encouraged agencies to work closely with the relevant standing committees in the House to review which regulations should be permanently repealed or reformed. The letter noted the need to work expeditiously given the limited number of legislative session days scheduled between now and September 30. Benninghoff also highlighted in a letter to the Department of Health that “…nothing in current law prohibits tele-health services from being provided at pre-pandemic levels.” See Benninghoff’s letter to the Office of Administration here and his letter to the Department of Health here.

Department of Health

The Department of Health has invited applications for the approval of up to two additional academic clinical research centers as part of its medical marijuana program. Applications will be available beginning on August 3 on the Department of Health’s web site and applications are due September 2. Learn more from the department’s notice published in the Pennsylvania Bulletin.

The Department of Health plans to pursue a series of changes in the manner in which long-term-care facilities are regulated. It intends to do so in five separate parts and has published one of those parts, with explanations, in the Pennsylvania Bulletin.

Department of Human Services

DHS has issued a Medical Assistance Bulletin to inform providers that it is expanding the scope of Medicaid-enrolled providers that may bill the program for administration of COVID-19 vaccines and monoclonal antibody therapy. The new policy applies to physicians, certified registered nurse practitioners, certified nurse midwives, outpatient hospital clinics, independent medical/surgical clinics, home health agencies, renal dialysis centers, psychiatric outpatient clinics, drug and alcohol outpatient clinics, partial psychiatric hospitals, ambulance providers and licensed pharmacies. The policy is retroactive to April 1. Find the bulletin here.
DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will make an enhanced payment for the administration of COVID-19 vaccines to Medicaid beneficiaries who are homebound and has added a CPT code for the billing of this service. The policy is retroactive to April 1. Learn more in the bulletin notice.
DHS and the Department of Aging are seeking presenters for their 2021-2022 protective services virtual conference, to be held on October 6 and October 7. This year’s conference is about getting back to basics and mastering the core competencies of protective services: opening and conducting investigations. Learn more about the conference and opportunities to make presentations during it from this conference notice. The deadline for applying to make a presentation is August 6.
DHS has updated its Pennsylvania Medicaid Managed Care Directory with key contacts for both the physical health and behavioral health HealthChoices programs.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has published a policy bulletin to announce changes in its prevention, fiscal, operations and case management, and clinical services manuals. Go here to find the revised manuals.

The state’s Independent Regulatory Review Commission has disapproved a proposed regulation submitted by the Department of Drug and Alcohol Programs seeking to “…establish regulations for recovery houses that receive public funds or referrals. Recovery houses provide support to individuals receiving outpatient treatment for substance use disorder who may benefit from supportive housing, a substance-free environment and peer camaraderie.” The commission has not yet issued an explanation for the rejection. The department now has three options: it may withdraw the regulation, resubmit the regulation with revisions within 40 days of receipt of the commission’s disapproval order, or submit the regulation without revision to the General Assembly.

COVID-19: By the Numbers

The daily number of new COVID-19 cases rose considerably again over the past week. Thursday marked the first time since May 28 that the state registered more than 1000 new cases in a single day. Even these numbers, however, are less than half of what they were in mid-May.
The number of deaths, however, remains very low.
For the week from July 16 through July 22 the state’s overall COVID-19 test positivity rate was 2.6 percent, up from 1.7 percent last week and the third consecutive week with an increase after more than two months of declining rates. As a frame of reference, however, that rate was 9.5 percent just three months ago.
Since the beginning of July the number of Pennsylvanians hospitalized with COVID-19 has risen 53 percent; the number in hospital ICUs has risen 71 percent; and the number on ventilators has risen 37 percent.
According to the state’s revised figures, 62.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated, up from 62.2 percent last week. Only 56,000 Pennsylvanians completed a vaccine regimen in the past week and only 300,000 have done so since July 1. In Philadelphia, only 17,000 people reached full vaccination status in the past week and 46,000 have done so since July 1.

Around the State

Spotlight PA has identified all of the emergency procurement spending the state has done since the start of the COVID-19 pandemic and highlighted those that were pandemic-related. Find its report here.
A Department of Drug and Alcohol Programs web site that enabled visitors to obtain information about drug abuse treatment facilities’ violations of state guidelines identified during state inspections had inaccurate information and has been taken down. Learn more from two Allentown Morning Call reports: the article about the inaccurate information and a separate story about the state’s decision to take down the site while it reviews the inaccurate data.
Shortly after the federal Centers for Disease Control and Prevention recommended that school teachers, staff, and students wear face masks in areas with high rates of COVID-19 transmission, a spokesperson for Governor Wolf said that the governor did not intend to mandate such a policy although he would urge local school districts to follow the new federal guidance. PennLive tells the story.
Shortly after the CDC recommended that even vaccinated people wear face masks indoors and under certain circumstances in areas of high transmission of COVID-19, Pittsburgh’s WTAE television published an interactive map showing community transmission rates throughout Pennsylvania.
PennLive was even more specific: it listed the seven Pennsylvania counties where the COVID-19 transmission rates meet the criteria for vaccinated people to wear masks indoors. They are Cameron and Crawford counties (high rates of community transmission) and Adams, Lawrence, Monroe, Northampton, and Wyoming counties (substantial rate of community transmission).
Scranton’s city council has voted to accept a three-year, $360,000 grant from the Moses Taylor Foundation to fund a health coordinator position for the city, according to the Scranton Times-Tribune.
“Drexel University College of Medicine at Tower Health is ready to welcome its inaugural class of first-year medical students next week,” the Reading Eagle reports.

Stakeholder Events

Traumatic Brain Injury Advisory Board

August 6 at 9:00 a.m.

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, August 6, 2021. For information about the board’s mission, meeting materials, and how to participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

August 11-12 at 9:00 a.m.

jsteinbock2021-08-16T15:10:18+00:00July 30th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for the Week of July 5-9

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-9, 2021. (Some of the language used below is taken directly from state documents.)

State Revenue Collections

According to the Independent Fiscal Office’s Monthly Revenue Update, the state collected $3.77 billion in June, the last month of the fiscal year; that was $350.7 million, or 10.3 percent, more than projected. This strong monthly performance was led by growth in corporate net income tax collections, which were 42.2 percent higher than anticipated. Pennsylvania ended FY 2020-21 with the largest budget surplus in the state’s history: $3.4 billion more than anticipated.

Department of Human Services

DHS has published a Medical Assistance Bulletin announcing that it is increasing the fee it pays for dispensing disposable gloves to Medicaid beneficiaries from $8 to $14 for 100 pairs of gloves effective July 1.
DHS has published a notice in the Pennsylvania Bulletin about disproportionate share payments and supplemental hospital payments to qualifying hospitals. The notice consists of the state’s final notice of its funding allocation for FY 2020-2021 for several classes of inpatient DSH and supplemental payments to Medical Assistance-enrolled and qualifying inpatient acute-care general hospitals. Find the notice here.
DHS has published a notice about opioid treatment programs (OTP) stating that Medical Assistance will pay secondary to Medicare for OTP services provided on or after August 16, 2021 to dually eligible individuals because Medicare now covers OTP services and Medicaid is the payer of last resort.
DHS is promoting its Emergency Rental Assistance Program, which provides direct assistance for unpaid and upcoming rent and utility bills and other costs related to housing at a time when the federal eviction moratorium is approaching its end, at the end of July. The state is encouraging DHS stakeholders to share information about this program with their constituents. Go here to learn more about the program, here to find resources to facilitate communicating about the program, and here to download a multi-lingual media kit.
DHS’s Office of Developmental Programs has published updated guidance to providers of its home and community-based services addressing infection control procedures and mitigation of the spread of COVID-19.

COVID-19: By the Numbers

The daily number of new COVID-19 cases and deaths remained down and steady over the past week.
The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital ICUs because of it remained down and steady.
To date, nearly 1.2 million Pennsylvanians have contracted COVID-19, among them 29,000 health care workers and 88,000 residents and staff of nursing facilities and personal care homes. 27,700 Pennsylvanians have died from the virus.
For the week from June 25 through July 1 the state’s overall COVID-19 test positivity rate was 1.1 percent, down from 1.2 percent last week and 1.4 percent the week before.
5.5 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard, but only 82,000 have completed the full vaccination regimen in the past week; another 9000 Philadelphians have done so as well. According to the state, 60.5 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 63.0 percent of the entire population has now received at least the first dose of a vaccine.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has sent a reminder to stakeholders that under the federal Health Resources and Services Administration’s (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment Program, HRSA will provide up to $250,000 in loan repayment to substance abuse disorder health professionals in exchange for a six-year, full-time service commitment in rural and underserved areas. Facilities interested in hiring or supporting current substance use disorder health professionals who receive loan repayment must apply to become an approved facility. Learn more about the HRSA program here and apply to become an approved facility to employ current substance use disorder professionals here. Applications are due July 22.

Around the State

The Department of Health is hiring a new contractor to run its COVID-19 contact tracing program after firing its old contractor after a major data breach. Spotlight PA explains who, why, and how much.
Western Pennsylvania hospitals, nursing homes, assisted living facilities, personal care homes, and home care agencies are experiencing a major shortage of nurses. The Pittsburgh Tribune-Review details the extent of the problem.
A new law passed late last month gives Pennsylvania parents the right to have their children repeat the grade they just finished because of the learning loss they believe their children experienced during remote schooling while the COVID-19 pandemic raged. Parents must make a decision and file appropriate paperwork by July 15. The Pittsburgh Post-Gazette offers the details.
The Butler County commissioners have unanimously voted to end their emergency declaration, KDKA Pittsburgh reports, “… because the vaccination site at the county mall is closed and they no longer require the state’s emergency funding.”
A new law in Pennsylvania “…will require treatment facilities to notify a patient’s emergency contacts if they leave a rehab center against medical advice,” the Pittsburgh Post-Gazette reports, adding that “Heather’s Law, as it’s called, will take effect in 60 days and is named after a woman who overdosed and died 12 hours after leaving a treatment facility in Pennsylvania. Her family wasn’t aware she had left.” Learn more here.
“After more than five months of discussions and one meeting with Tower Health’s board of directors, Lehigh Valley Health Network and StoneBridge Healthcare have decided not to make an offer to acquire the financially ailing Reading-based health system,” according to the Philadelphia Business Journal. Tower Health’s hospitals include Reading Hospital, Brandywine Hospital, Chestnut Hill Hospital, Jennersville Hospital, Phoenixville Hospital, Pottstown Hospital, and St. Christopher’s Hospital for Children, a partnership of Tower Health and Drexel University.
“Geisinger Health Plan has expanded its Children’s Health Insurance Program (CHIP) coverage to eight more Pennsylvania counties including all five in the Philadelphia region. GHP Kids coverage is now available for uninsured children and teens, up to age 19, in 48 of Pennsylvania’s 67 counties,” the Philadelphia Business Journal writes

Stakeholder Events

Health Research Advisory Committee Meeting

July 12 at 10:00 a.m.

The public meeting will be held virtually by means of Microsoft Teams at (267) 332-8737 with Conference ID: 689 378 043#.

Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting. The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728# United States, Pittsburgh

(866) 588-4789,,785376728# United States (Toll-free)

Phone Conference ID: 785 376 728#

jsteinbock2021-07-09T20:01:40+00:00July 9th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for the Week of June 28-July 2

The following is an update of selected state health policy developments in Pennsylvania for the week of June 28-July 2, 2021. (Some of the language used below is taken directly from state documents.)

FY 2021-2022 Budget

On Wednesday Governor Wolf signed into law Pennsylvania’s FY 2021-2022 General Fund appropriations bill and related code bills. The governor partially vetoed Senate Bill 255, the General Appropriations Act, to remove the funds appropriated by the General Assembly for the establishment and operation of a new Bureau of Election Audits. The full package of budget-related bills passed by the legislature and signed by the governor includes the FY 2022 General Appropriations Act – Senate Bill 255; the Fiscal Code – House Bill 1348; the Administrative Code – House Bill 336, and the Tax Code – House Bill 952.

Legislative Update

The legislature has passed, and Governor Wolf has signed, the following health care-related bills:

House Bill 649 (Act 67) – requires the Department of Health, in consultation with the Department of Human Services, to establish protocols to permit an essential caregiver to provide in-person physical and emotional support to a congregate care facility resident during a declaration of disaster emergency.
House Bill 1024 (Act 44) – revises to the state’s Medical Marijuana Act, including caregiver, dispensing, and criminal background check provisions.
House Bill 1429 (Act 48) – adds a new section to the state Crimes Code providing for the offense of financial exploitation of an older adult or care-dependent person. It also clarifies that district attorneys have the right to investigate and institute criminal proceedings for any violation of this new section.
House Bill 1431 (Act 49) – adds a new section to the Crimes Code that defines as abuse and establishes as a misdemeanor the use of social media by employees who post pictures of care-dependent individuals without permission.
Senate Bill 108 (Act 56) – provides for a $130 supplemental per diem payment for ventilator or tracheostomy care provided by qualified skilled nursing facilities that meet certain criteria based on the volume and proportion of Medicaid patients they serve.
Senate Bill 115 (Act 68) – establishes the Nurse Licensure Compact Act, which makes the state a party to the Nurse Licensure Compact with all other states that have joined the compact.
Senate Bill 416 (Act 60) – establishes the certified registered nurse anesthetist (CRNA) designation in the commonwealth. The legislation grants an individual licensed to practice professional nursing and who meets the requirements of this act the right to use the CRNA designation.
Senate Bill 425 (Act 61) – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions or medications and devices.
Senate Bill 445 (Act 23) – permits a person renewing a driver’s license, identification card, or vehicle registration electronically through the Department of Transportation’s web site to contribute $5 to the Pennsylvania Breast Cancer Coalition for breast cancer research.
Senate Bill 484 (Act 63) – adds the chair of the State Veterans Commission or a designee to the Pennsylvania Long-term Care Council.

Governor Wolf vetoed Senate Bill 618, which would have prohibited the use of vaccine passports by government entities and prevented institutions of higher education from requiring proof of vaccination against COVID-19. The bill also sought to restrict the Secretary of Health’s ability to implement certain disease control measures. See the governor’s veto message here.

The General Assembly has now adjourned until September.

Department of Human Services

DHS has updated the Medical Assistance fee schedule to reflect 2020 HCPCS codes. The update is retroactive to December 21, 2020. Learn more in this Medical Assistance Bulletin.
DHS has issued a Medical Assistance Bulletin with the 2021 recommended child and adolescent immunization schedule. The bulletin applies to all providers enrolled in the Medicaid program who administer immunizations and provide services in the fee-for-service and managed care delivery systems.
DHS has updated its requirements for enrolling in Pennsylvania’s Medicaid program as a mental health substance abuse (Type 11) provider.
DHS has updated its requirements for enrolling in Pennsylvania’s Medicaid program as a case manager (Type 21).
DHS has updated its list of drug companies participating in the Medicaid drug rebate program.
DHS has published installment #254 in its “Provider Quick Tips” series. The subject: “Payment Error Rate Measurement (PERM) Initiative for RY 2022.” Find it here.
DHS has published a notice in the Pennsylvania Bulletin reminding hospitals that, as it informed them last fall, the assessment percentage of the state’s Quality Care Assessment for FY 2021-2022 and FY 2022-2023 will return to 3.32 percent of net inpatient revenue and 1.73 percent of net outpatient revenue for affected hospitals. See the notice here.

Department of Health

The departments of Health and Human Services have extended to September 30 the period during which the Regional Congregate Care Assistance Teams (RCAT) will remain available to help long-term-care facilities prevent and respond to COVID-19. See the announcement here and updated call center information here.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline and the number of COVID-19 deaths continues to decline significantly.

For the week from June 18 through June 24 the state’s overall COVID-19 test positivity rate was 1.2 percent, down from 1.4 percent last week and 1.9 percent the week before.
Sixty-five counties had a positivity rate lower than five percent, up from 64 last week, and no counties had a positivity rate greater than 20 percent for the ninth consecutive week.

Fifty-five counties are currently experiencing low levels of community transmission of COVID-19, up from 37 last week; the remaining 12 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
On July 1 the number of Pennsylvanians hospitalized with COVID-19 was less than one-third of what it was on June 1; the number on ventilators was 30 percent of what it was on June 1; and the number in hospital ICUs was 25 percent of what it was on June 1.
5.4 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past month, with fewer than 100,000 new, complete vaccinations reported in the past week. Another 760,000 people have been vaccinated in Philadelphia. According to the state, 60.3 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.9 percent of the entire population has now received at least the first dose of a vaccine.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued a memo establishing a procedure for drug and alcohol treatment providers to request additional time beyond July 1 to reach substantial alignment with service delivery conditions under The ASAM Criteria, 2013.

Around the State

While Pennsylvania is among the nation’s leaders in the percentage of its residents receiving their first dose of a COVID-19 vaccine it is the fifth-worst state when it comes to getting those first shot recipients their second dose. The Philadelphia Inquirer lays out the situation and explores why.
Following a 2018 fire at the U.S. Steel Clairton Coke Works site the number of asthma-related visits to doctors’ offices and hospital emergency departments nearly doubled, according to a new study. WESA Pittsburgh tells the story.
According to the Philadelphia Business Journal, “A partnership involving an Allentown-based health system and a recently formed hospital turnaround company has emerged as a bidder for the financially struggling Tower Health.” Learn more here.
After today Lancaster County closes its COVID-19 mass vaccination site. Lancaster Online recounts some of the site’s accomplishments and experiences.
With people spending more time at home, HIV testing at non-health care sites in Philadelphia fell 75 percent in 2020, according to the Pennsylvania Capital-Star.

Stakeholder Events

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar. Public comments will be taken after each presentation and questions can be entered in the chat box. Interested parties can participate in the following ways:

- Webinar registration – go here
- Dial in: 1-914-614-3221, access code 716-025-613
- Remote captioning and streaming link – go here

Health Research Advisory Committee Meeting

July 12 at 10:00 a.m.

The public meeting will be held virtually by means of Microsoft Teams at (267) 332-8737 with Conference ID: 689 378 043#.

Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting. The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728# United States, Pittsburgh

(866) 588-4789,,785376728# United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Financial Management Services Meeting – June 28

At the most recent Financial Management Services stakeholder meeting on June 28, 2021the Community HealthChoices managed care organizations announced that Tempus Unlimited, Inc. will be the new statewide Vendor Fiscal/Employer Agent, with HHA eXchange as the software solution, supporting FMS in the Community HealthChoices program.

Stakeholder Events Materials

DHS has shared materials presented at the June 28 meeting of its Financial Management Services stakeholder meeting. This public meeting discussed the upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations participated in the meeting. Those presentations are:

jsteinbock2021-07-06T03:16:48+00:00July 6th, 2021|Coronavirus, COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania proposed FY 2022 budget|Comments Off

PA Health Policy Update for the Week of June 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of June 21-25, 2021. (Some of the language used below is taken directly from state documents.)

State-Wide Mask Mandate

The Department of Health announced that it is lifting its order requiring universal face coverings at 12:01 a.m. on Monday, June 28.   See the announcement here. The department continues to urge Pennsylvanians to follow CDC guidance for wearing a mask where required by law, rule, and regulations, including health care, local business, and workplace guidance.  For the protection of themselves and others, individuals who have not yet been vaccinated or are partially vaccinated are still encouraged to wear a mask when in public.

Legislative Update

The following are health care bills that have received third and final consideration in the state House and/or Senate as of Thursday, June 24. Both chambers will hold voting session on Friday and Saturday and we anticipate there will be additional health care-related measures passed. We will provide an update following the end of session on any pertinent bills.

Senate Bill 115 – establishes the Nurse Licensure Compact Act, which upon enactment makes the Commonwealth a party to the Nurse Licensure Compact with all other states that have joined the compact. The bill was passed by the House 146-55 and sent to the Governor’s desk.
Senate Bill 425 – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions, or medications and devices. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 484 – adds the chair of the State Veterans’ Commission or a designee to the Pennsylvania Long-term Care Council. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 618 – prohibits the use of vaccine passports by government entities. It also prohibits institutions of higher education from requiring proof of vaccination against COVID-19 to use a service, enter a building, or undertake an activity, including attending class in person. In addition, the bill further restricts the Secretary of Health’s ability to implement certain disease control measures for individuals who have not been exposed, potentially or otherwise, to a contagious disease. The bill was signed in the state House and Senate on June 24^th and sent to the governor. The governor has indicated he will veto

Department of Human Services

DHS and its Office of Medical Assistance Programs have posted a Medical Assistance Bulletin on the state’s Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program periodicity schedule reminding all providers they must revalidate the Medical Assistance enrollment of each service location every five years. Find the notice here.
DHS has added two COVID-19 antigen laboratory test codes to the Medical Assistance Program Fee Schedule, effective with dates of service on and after November 2, 2020.
DHS has proposed rescinding a regulation that prohibits a provider from leasing space within its office to another provider; see the proposed change in this Pennsylvania Bulletin notice. The agency will accept public comment on this proposal and it will become effective when final formal regulations are published in the Pennsylvania Bulletin.
DHS and its Office of Medical Assistance Programs have updated their guidance on providing direct services via telemedicine in the School-Based ACCESS Program during the COVID-19 emergency.
DHS has posted updates of six of its “provider quick tips.”
DHS has updated its list of providers participating in its Healthy Beginnings Plus program. See the list here.
DHS announced its proposed rates for non-public and county nursing facilities for FY 2022 in this Pennsylvania Bulletin notice. These figures will be posted on the DHS web site here.
DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.
DHS and its Office of Child Development and Early Learning have posted an FAQ on guidance for tuberculin skin testing and COVID-19 vaccinations.

Department of Health

Effective at midnight on June 23, 2021, the Department of Health terminated its order requiring skilled nursing facilities to complete a vaccine needs assessment survey since those facilities are now reporting to the federal government.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline significantly. The 174 new COVID-19 cases reported on Wednesday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths continues to decline significantly as well.
For the week from June 11 through June 17 the state’s overall COVID-19 test positivity rate was 1.4 percent, down from 1.9 percent last week and 2.9 percent the week before.
Sixty-four counties had a positivity rate lower than five percent, up from 62 last week, and no counties had a positivity rate greater than 20 percent for the eighth consecutive week.
Thirty-seven counties are currently experiencing low levels of community transmission of COVID-19, up from 22 last week; the remaining 30 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
Since June 1 the number of Pennsylvanians hospitalized with COVID-19 has fallen 62 percent; the number on a ventilator has fallen 54 percent; and the number in hospital intensive care units has fallen 70 percent.
5.3 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past month and only about 150,000 new vaccinations were reported in the past week. Another 760,000 people have been vaccinated in Philadelphia. According to the state, 59.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.2 percent of the entire population has now received at least the first dose of a vaccine.

Around the State

Two Pennsylvania children’s hospitals ranked among the best ten such hospitals in the U.S. in the latest rankings published by U.S. News & World Report: Children’s Hospital of Philadelphia ranked second and UPMC Children’s Hospital of Pittsburgh ranked ninth.

Two Pennsylvania-based health insurers, Highmark and Independence Blue Cross, are among five Blues plans joining forces in a new venture called Evio, a for-profit venture that will seek to make prescription drugs more affordable and improve health care outcomes. Learn more here.

Stakeholder Events

Maternal Mortality Review Committee

June 28 at 8:00

This meeting will be held via conference call. The purpose of the meeting is to discuss new and ongoing procedural issues relating to the review process for the committee. To join the call, dial +1 (267) 332-8737 and when prompted, enter the following conference code: 522 321 931#.

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

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar. Public comments will be taken after each presentation and questions can be entered in the chat box. Interested parties can participate in the following ways:

Webinar registration – go here

Dial in: 1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting. The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728# United States, Pittsburgh

(866) 588-4789,,785376728# United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Medical Assistance Advisory Committee Meeting – June 24

Deputy DHS Secretary Sally Kozak announced that DHS will perform readiness reviews of the managed care organizations selected to participate in the latest HealthChoices program procurement. The procurement remains the subject of litigation so DHS will stop short of negotiating with the managed care organizations until there is a final decision in that case.

Stakeholder Events Materials

DHS has posted four presentations offered at the June 24 meeting of the Medical Assistance Advisory Committee. Those presentations were delivered by its:

Office of Mental Health and Substance Abuse Services (crisis services)
Office of Mental Health and Substance Abuse Services (medication-assisted treatment during the public health emergency)
Office of Medical Assistance Programs
Office of Long-Term Living

jsteinbock2021-06-26T13:46:01+00:00June 26th, 2021|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2022 budget, Pennsylvania state budget issues|Comments Off

MA Bulletin Presents New PDL

Pennsylvania’s new Medicaid preferred drug list is presented in an October 10, 2019 state Medical Assistance Bulletin.

Bookshelf with law books The Department of Human Services bulletin outlines the purpose of the new PDL, provides background information, and describes how the PDL was developed and will work. In addition, it lists the past Medical Assistance Bulletins rendered obsolete by the new bulletin and describes the prior authorization procedures that will be employed when the new program takes effect on January 1, 2020.

Finally, the bulletin includes a comprehensive list of the prescription drugs on the new PDL.

See the October 10 PDL Medical Assistance Bulletin here.

PA Safety Net Admin2019-10-15T09:59:07+00:00October 15th, 2019|Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Issues Bulletin on Medicaid Expansion

The Pennsylvania Department of Human Services (DHS) has issued a new Medical Assistance Bulletin on the state’s expansion of its Medicaid program via the HealthChoices managed care program.
The bulletin notifies providers of the introduction of a new adult benefit package that applies to all adult Medicaid recipients in the state, highlighting some of the major changes in benefits from past packages. It also provides information about the state’s plan for a phased transition from the current private care option (PCO) insurance plans to HealthChoices plans over the coming months.
See DHS Medical Assistance Bulletin 99-15-05 here.

PA Safety Net Admin2015-04-30T06:00:10+00:00April 30th, 2015|HealthChoices PA, Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Revises Guidelines for Medicaid Presumptive Eligibility

The Pennsylvania Department of Human Services has revised its guidelines for hospitals qualified to make presumptive eligibility determinations for potentially Medicaid-eligible patients who seek services but are uninsured.
The revisions are described in Medical Assistance Bulletin 01-15-08, “Revised Presumptive eligibility as Determined by Hospitals,” which was issued on February 24 but is retroactive to January 1.
In support of that new guidance the state also has issued an addendum for providers outlining their responsibilities and a worksheet for hospitals to use in determining eligibility.

PA Safety Net Admin2015-03-05T06:00:02+00:00March 5th, 2015|Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

Previous 1 2 3 4 5 6 7 8 91011 Next

SNAPShots

SNAPShots

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

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