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PA Health Policy Update for May 5

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

Medicaid Eligibility Redetermination 

The Department of Human Services (DHS) published the first section of an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code.

Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Governor Shapiro

Governor Shapiro signed the first bill of his administration on Monday. Act 1, formerly Senate Bill 8, requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. View this press release for additional information.

The Shapiro administration announced today that all commonwealth agencies completed a comprehensive review of their respective licensing, certification, and permitting processes as directed in the governor’s January 31 executive order. The administration will now work to establish “efficient processing times” for all permits and licenses. 

General Assembly

  • The state House and Senate returned to Harrisburg on May 1 for voting session. Below is coverage of selected health-related proceedings.
    • The House Health Committee held a public hearing Tuesday, May 2 on HB 106, the Patient Safety Act, which sets nursing staffing ratios. A recording of the hearing can be viewed here.
    • Representative Jennifer O’Mara (D-Delaware), Representative Eddie Day Pashinski (D-Luzerne) and Senator Carolyn Comitta (D-Chester) held a press conference Wednesday on hospital closure reform. More information can be found here.
    • The House Republican Policy Committee held a public hearing Thursday, May 4 on hospital pricing transparency. A recording of the hearing can be viewed here.
    • The Senate voted to confirm Governor Josh Shapiro’s nominee for the Secretary of Aging, Jason Kavulich, this week. A recording of the confirmation hearing in the Senate Aging and Youth Committee can be viewed here.
    • The Senate Health and Human Services Committee held a voting meeting on Tuesday, May 2 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act. The bill was unanimously reported as committed.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events. The bill was unanimously reported as committed.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE). The bill was unanimously reported as committed.
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk. The bill was unanimously reported as committed.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams. The bill was unanimously reported as amended.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here.

  • The state Senate will return to Harrisburg for voting session Monday, May 8. The state House is recessed and will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.
    • The House Aging and Older Adult Services Committee will hold an information meeting Wednesday, May 10 at 10:00am to receive updates from local Area Agencies on Aging and to discuss scams targeting older adults. The meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here. 

Office of the Attorney General 

Attorney General Michelle Henry issued the following Frequently Asked Questions (FAQ) document regarding medication abortion and mifepristone access in Pennsylvania. 

Department of Health 

The Department of Health’s (DOH) Division of Newborn Screening and Genetics, with support of the Newborn Screening and Follow-up Technical Advisory Board, is proposing that Guanidinoacetate Methyltransferase (GAMT) deficiency screening be added effective January 1, 2024 to the supplemental conditions mandated for screening. Additional information can be viewed in this Pennsylvania Bulletin notice. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to increase the funding and amend the payment methodology for the COVID-19 disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for FY 2022-23. Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its intent to allocate funding and amend the qualifying criteria and payment methodology allocation for DSH payments to acute-care general hospital trauma centers. These payments will amount to $18.034 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its funding allocation for FY 2022-23 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance (MA) Program, and to provide financial relief to hospitals during the COVID-19 pandemic. Learn more from this Pennsylvania Bulletin notice.
  • DHS published updates to the Medical Assistance (MA) Program Fee Schedule for administration of a booster dose of the SARS-CoV-2 vaccine manufactured by Novavax. Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced the temporary extension of the Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. The APM will be extended beyond the end of the federal PHE to September 30, 2024. Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued an updated Provider Quick Tip (#263) regarding the electronic submission process in the PROMISe Portal for Office of Medical Assistance Fee-for-Service (FFS) and Office of Long Term Living (OLTL) 180-day exception requests and other claims requiring documentation.

Revenue Collection Update

The Department of Revenue announced Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $51.1 million, or 0.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $37.9 billion, which is $1.2 billion, or 3.3 percent, above estimate. 

Stakeholder Events

DOH – WIC Advisory Board – May 10

The WIC Program Advisory will meet on May 10 from 1:00 p.m. – 2:00 p.m. Additional information and details on how to participate can be viewed in this Pennsylvania Bulletin notice. 

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DOH – HIV Community Prevention Planning Committee – May 18

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, May 17 and Thursday, May 18. For information on how to participate, review this Pennsylvania Bulletin notice.

DHS – Medical Assistance Consumer Subcommittee – May 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on Wednesday, May 24 at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – May 25

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, May 25 at 10:00 a.m.  Go here to register to participate.

 

2023-05-05T21:19:20+00:00May 5th, 2023|Federal Medicaid issues, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 5
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PA Health Policy Update for April 21

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

Governor Shapiro

Governor Shapiro announced this week his administration submitted a notice of intent to temporarily add xylazine, commonly known as “tranq,” to the list of schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. This step is an effort to limit access to xylazine, which is increasingly being found in Pennsylvania’s illicit drug trade. The administration also intends to schedule nitazenes, a class of synthetic opioids, as a schedule I drug. 

General Assembly

  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 20 on The State Master Plan on Aging. A recording of the hearing can be viewed here.
  • The House Children and Youth Committee held a public hearing Thursday, April 20 on overcrowding in Pennsylvania’s Juvenile Detention Facilities. A recording of the hearing can be viewed here.
  • The state House and Senate will return to Harrisburg on Monday, April 24 for voting session. Following are selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee will hold a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. The hearing will be held in Hearing Room 1 of the North Office Building and will be livestreamed here.
    • The House Insurance Committee will hold a voting meeting on Monday, April 24 at 11:00 a.m. to consider among other bills, SB 8 which requires insurers to cover all costs associated for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The meeting will be held in Room B31 of the Main Capitol and will be livestreamed here.
    • The House Health Committee will hold an informational meeting Wednesday, April 26 at 9:00 a.m. on unregulated intoxicants and psychoactive substances. The hearing will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.
    • The House Human Services Committee will hold a voting meeting Wednesday, April 26 at 9:15 a.m. to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits.

The meeting will be held in Room 523 of the Irvis Office Building and will be livestreamed here.

    • The House Professional Licensure Committee will hold an informational meeting April 26 at 10:00am on the Bureau of Professional and Occupational Affairs. The hearing will be held in Room 140 of the Main Capitol and will be livestreamed here.

Department of Health

  • DOH reminded long-term care facilities that the obligation to report COVID-19 cases and deaths through the ERS will continue beyond the end of the federal PHE on May 11. These records are reportable within 24 hours of diagnosis. Only new cases should be reported and positive cases that later result in death should be amended rather than entered as a new data record.  Find details on the reporting process here.
  • DOH encouraged nursing care facilities to make every effort to help temporary nurse aides to schedule and complete the required exams to become permanent certified nurse aides as soon as possible. When the federal PHE ends on May 11, candidates will have four months to complete the required testing as long as they are enrolled in an Approved Nurse Aide Training Program and candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here.   

Department of Human Services

  • The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) April 27 meeting. In advance of the meeting, DHS also issued a briefing document outlining proposed changes and clarifications to the 340B Drug Pricing Program.
  • DHS issued proposed regulations to strengthen and clarify the Adult Protective Services Act (Act 70). Implementation of Act 70 began in 2015 but has operated under agency guidance and contract amendments rather than formal regulation. Find additional information and the proposed regulations in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into late May.  Find the updated calendar here. 

Insurance Department

The Insurance Department issued a request for comments on a proposal to suspend the reinsurance program for the state-based insurance exchange, PENNIE®, and potentially replace it with a possible “state subsidy wrap.” Additional information on the proposal and details on how to comment may be found in this Pennsylvania Bulletin notice. 

Office of the Attorney General 

Attorney General Michelle Henry joined a coalition of seventeen other Attorneys General submitting a letter in support of the Federal Trade Commission’s proposal to prevent businesses from having employees sign non-compete agreements as a condition of employment. Find additional information in this press release. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) released the agenda for its May 18 meeting. Following are certain health-related regulations IRRC will consider.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DDAP – Xylazine: A New Drug Additive – June 12

The Department of Drug & Alcohol Programs (DDAP) will host two additional sessions of “Xylazine: A New Drug Additive,” presented by Savage Sisters Recovery, in Harrisburg on June 12, 2023. Please visit the Training Management System for details and to register.

2023-04-21T20:06:37+00:00April 21st, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for April 21
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PA Health Policy Update for April 14

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

General Assembly 

  • The House and Senate Appropriations Committees concluded their budget hearings this week.
    • On Tuesday, April 11, the Department of Human Services appeared before the House Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Wednesday, April 12, the Department of Human Services appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Thursday, April 13, the Department of Health appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here.
  • The House Health Committee held an informational hearing Wednesday, April 12 on prescription drug affordability boards. A recording of the hearing can be viewed here.
  • The House Democratic Policy Committee held a public hearing Thursday, April 13 on black maternal health. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 13 on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 20 at 1:00pm on The State Master Plan on Aging. The hearing will be held in Room G-50 of the Irvis Office Building and can be livestreamed here.
  • The House Children and Youth Committee will hold a public hearing Thursday, April 20 at 10:00am on overcrowding in Pennsylvania’s Juvenile Detention Facilities. The hearing will be held in Room 515 of the Irvis Office Building and can be livestreamed here.
  • The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24.

Department of Health

The Department of Health posted new documents related to the implementation of the long-term care nursing facilities regulations that become effective July 1, 2023:

  • Guidance for long term care regulations (effective July 1, 2023)
  • LTC Licensure Regulations Provider Updates – Presentation
  • LTC Licensure Regulations Provider updates – slides

View these and other guidance documents on the dedicated webpage here.

The Department of Health issued a health advisory with information about the Pennsylvania Childhood Blood Lead Act that took effect on January 2, 2023, and requires certain blood lead assessment and testing for children and pregnant women. Find more information in the health advisory. 

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin with the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention’s (CDC) Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2023. This bulletin replaces the 2022 recommended vaccine schedule.
  • DHS issued Provider Quick Tip #41, which is an updated Medical Assistance (MA) Desk Reference with provider contacts.
  • DHS issued a Medical Assistance Bulletin to inform MA providers that DHS added Current Procedural Terminology (CPT) codes 0164A (Moderna, Inc.) and 0173A (Pfizer, Inc.) to the MA Program Fee Schedule for the administration of additional bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines.
  • DHS issued a Medical Assistance Bulletin to inform providers of updates to the Emergency Medical Condition Information Eligibility form. 

Around the State      

  • The Pennsylvania Capital Star reported on the House Appropriations Committee’s examination of Governor Shapiro’s proposed FY 2023-24 budget for DHS.
  • The Scranton Times Tribune wrote about the continued nursing shortage in Pennsylvania and its impact on the health care system.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DOH – Special Pharmaceutical Benefits Program – May 4

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, May 4, 2023, from 10 a.m. to 3 p.m. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. Go here for additional information and details on how to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DHS – Dual Diagnosis Conference – May 18

The Office of Developmental Programs and Office of Mental Health and Substance Abuse Services will host a state-wide Dual Diagnosis Conference virtually on May 18, 2023. The conference will include a variety of perspectives for supporting individuals who have experienced trauma. You may register here.

Pennsylvania Long-Term Care Council – 2023 Meeting Dates

The Pennsylvania Long-Term Care Council released an update list of its remaining meetings for the 2023 calendar year. Additional details may be viewed here.

2023-04-14T20:25:48+00:00April 14th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for April 14
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PA Health Policy Update for April 7

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

General Assembly

  • The House and Senate Appropriations Committees will resume budget hearings next week. 
    • On Tuesday, April 11 at 10:00 a.m., the Department of Human Services will appear before the House Appropriations Committee. The hearing will be held in the House chamber and will also be live streamed here.   
    • On Wednesday, April 12 at 9:30 a.m., the Department of Human Services will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here.  
    • On Thursday, April 13 at 9:30 a.m., the Department of Health will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here.   
    • A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.  
  • The House Health Committee will hold an informational hearing Wednesday, April 12 at 10:00 a.m. on prescription drug affordability boards. The hearing will be held in in Room 205 of the Ryan Office Building and will be live streamed here. 
  • The House Democratic Policy Committee will hold a public hearing Thursday, April 13 at 12:00 p.m. on black maternal health. The hearing will be held in Room G-50 of the Irvis Office Building and will be live streamed here. 
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 13 at 1:00 p.m. on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. The hearing will be held in Room 515 of the Irvis Office Building and will be live streamed here.
  • The state House and Senate are currently recessed.  They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings. 

Department of Health 

  • The Department of Health (DOH) published the Pennsylvania State Health Improvement Plan (SHIP) that outlines goals, objectives, and strategies to improve the health of Pennsylvania residents over the next five years. The 2023-2028 SHIP was developed in collaboration with the Healthy Pennsylvania Partnership, which is made up of nearly 300 health care professionals, associations, health systems, health and human services organizations, community collaborations, local public health agencies, and government agencies. 
  • DOH issued a health update reminding healthcare facilities, providers, and laboratories to have heightened awareness for C. auris in their patients and updating a previous alert with information on new confirmed cases in Cumberland, Erie, and Monroe counties.  C. auris has been detected in ventilator-capable skilled nursing facilities, long-term acute care hospitals, and acute care hospitals since the current outbreak began in March 2020.  Find more information in this Health Update.  
  • DOH has alerted providers and laboratories to current outbreaks of Marburg virus in Tanzania and Equatorial Guinea and recommends they consider Marburg virus in patients with recent travel to those areas.  Find details in the Health Alert here.  

Department of Human Services   

  • The Department of Human Services (DHS) announced the Centers for Medicare & Medicaid Services (CMS) approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) waiver amendment, which took effect April 1, 2023. Changes in the approved waiver include benefits counseling, home health aide services, nursing services, and occupational, physical, and speech and language therapy services. The current approved CHC Waiver can be found here. 
  • OLTL released a transition plan to phase out temporary changes to the CHC 1915(c) Waiver. Effective May 11, 2023, OLTL will phase out its emergency flexibilities to coincide with the end of the federal Public Health Emergency. 
  • DHS announced CMS has approved OLTL’s OBRA Waiver amendment, which took effect April 1, 2023, for home and community-based services. The current OBRA Waiver can be viewed here.
  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to notify dental providers enrolled in the Medical Assistance program that DHS will begin accepting the 2019 American Dental Association (ADA) Claim Form upon issuance of this bulletin and will no longer accept the 2012 ADA Claim Form for dates of service on and after June 1, 2023.
  • DHS released a Provider Quick Tip (#263) notifying providers about an electronic submission process for FFS 180-day exception requests and other claims requiring documentation will soon be available in the Promise Portal. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs and DHS jointly issued a bulletin to update the guidance in OMHSAS bulletin 06-03 dated February 10, 2006. This bulletin includes the definitions of co-occurring capable and co-occurring enhanced programs as set forth in The ASAM Criteria. The information may be used to assist SCAs, BH-MCOs, and treatment providers in identifying co-occurring capable and co-occurring enhanced programs and in referring individuals to those programs.  

Revenue Collection Update  

The Department of Revenue announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $499.4 million, or 8.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.3 billion, which is $1.1 billion, or 3.7 percent, above estimate.  

Around the State   

WHYY reported about the end of continuous Medicaid enrollment, beginning April 1, 2023, and how individuals can prepare for renewals.   

The Erie Times-News published an article about the drug-resistant fungus, Candida auris, which was found in a patient at a health care facility in Erie County.    

Stakeholder Events  

PHC4 – Data Systems Committee – April 10 

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Data Systems Committee meeting on April 10 at 10:00 a.m. Go here for additional information and details on how to participate.   

DOH – State Child Death Review Team – April 20 

The State Child Death Review (CDR) Team will hold a public meeting on Thursday, April 20 from 1:00 – 3:00 p.m. Go here for additional information and details on how to participate.  

DOH – Renal Disease Advisory Committee – April 21 

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 21 from 10:00 a.m. to 12:00 p.m. Go here for additional information and details on how to participate.  

DHS – Drug Utilization Review (DUR) Board – April 26 

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.  

DHS – Medical Assistance Consumer Subcommittee – April 26 

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.  

DHS – Medical Assistance Advisory Committee – April 27 

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.  

Patient Safety Authority – April 27 

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.  

DHS – Managed Long-Term Services and Supports Subcommittee – May 12 

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here. 

2023-04-20T17:15:29+00:00April 7th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for April 7
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PA Health Policy Update for March 31

The following is an update of selected state health policy developments in Pennsylvania from March 27 to March 31.  (Some of the language used below is taken directly from state documents.) 

 General Assembly 

  • The House Health Committee met on Wednesday, March 29 and favorably reported, among other bills, House Bill 155, which removes the requirement that direct-care workers be interviewed in person for a position, and House Bill 507, which requires medical schools, teaching hospitals, and medical institutions to receive explicit patient consent for all procedures and exams performed under anesthesia by medical students or for training purposes.
  • The Departments of Health, Aging, and Drug & Alcohol Programs appeared before the House Appropriations Committee for their respective budget hearings this week. A recording of the hearings can be viewed here. 
  • The House and Senate Appropriations Committees will continue budget hearings the week of April 10. A complete schedule for the House Appropriations Committee can be viewed here, and a complete schedule for the Senate Appropriations Committee can be viewed here. 
  • The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings. 

Department of Health 

The Department of Health (DOH) is evaluating a future purchase and distribution of devices that can eliminate viruses, bacteria, mold and other pathogens from air and surfaces simultaneously. DOH would purchase and distribute the devices free of charge to small businesses, non-profit entities, and other facilities throughout the Commonwealth to mitigate the spread of COVID-19, flu, and other diseases. Long-term care facilities that are interested in receiving a device if this program moves forward should complete this application.  The application is being used to gauge interest in receiving a device and those who complete the application are not guaranteed to receive one.  

In response to the Norfolk Southern train derailment in East Palestine, Ohio, DOH announced the establishment of a community-based health resource network this week to connect Pennsylvania residents impacted by the derailment with local health care providers for long-term assistance.   

Department of Human Services   

The Office of Medical Assistance Programs (OMAP) issued a bulletin to advise providers of additions and updates to the Medical Assistance (MA) Program Fee Schedule and the issuance of updated physician and general hospital provider handbook pages regarding the prior authorization procedures for proton therapy services. These changes are effective for dates of services on and after April 1, 2023.  

The Office of Mental Health & Substance Abuse Services (OMHSAS) issued a memorandum to address stakeholder concerns about the impact of ending OMHSAS’ bulletin suspensions regarding signature requirements specific to consent for treatment, service verification, and treatment plans on March 31, 2023, and clarifying the use of audio-only for telehealth in the delivery of services licensed by OMHSAS.  

Board of Nursing  

The State Board of Nursing published Interpretations Regarding the Administration of Drugs-Statement of Policy in the Pennsylvania Bulletin. This statement of policy clarifies that registered nurses may administer a specific amount of conscious sedation medication during minor therapeutic and diagnostic procedures upon a written order of either a physician or a CRNP when either a physician or CRNP is present during the administration. This statement of policy is expected to eliminate confusion about CRNPs’ authority to order and supervise registered nurses’ administration of conscious sedation under certain circumstances.  

Around the State   

The Pennsylvania Capital-Star reported Pennsylvania long-term care facilities will share $14.2 million from the Centers for Disease Control & Prevention (CDC). The funds are intended to support workforce development, staff retention, and infrastructure improvements.   

The Pittsburgh Post-Gazette wrote about the Pennsylvania Department of Health’s budget hearing this week and noted the focus on the state’s response to the East Palestine, Ohio train derailment and Pennsylvania’s post-COVID public health landscape.   

A report issued by Kaufman Hall noted that hospital finances continue to struggle in the face of macroeconomic headwinds but they appear to be beginning to stabilize. Fierce Healthcare details the challenges hospitals continue to confront here.   

Stakeholder Events  

DOH – Medical Marijuana Advisory Board – April 12 

The Medical Marijuana Advisory Board will meet on April 12, 2023, from 10:30 a.m. to 12:30 p.m. Go here for additional information and details on how to participate.   

DHS – Drug Utilization Review (DUR) Board – April 26 

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.  

DHS – Medical Assistance Consumer Subcommittee – April 26 

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.  

DHS – Medical Assistance Advisory Committee – April 27 

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate. 

2023-04-05T18:10:50+00:00March 31st, 2023|COVID-19, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for March 31
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PA Health Policy Update for March 24

The following is an update of selected state health policy developments in Pennsylvania from March 18 to March 24.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The House Appropriations Committee will hold a budget hearing next Tuesday, March 28 at 10:00 for the Department of Health and at 1:00 for the Department of Drug and Alcohol Programs.  The hearings will be held in the House chamber and also will be live-streamed here.  A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.
  • The House Health Committee will convene on Wednesday, March 29 to consider, among other bills, House Bill 155, which removes the requirement that direct-care workers be interviewed in person for a position, and House Bill 507, which requires medical schools, teaching hospitals, and medical institutions to receive explicit patient consent for all procedures and exams performed under anesthesia by medical students or for training purposes.
  • The state House and Senate are currently recessed.  They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings.

Department of Human Services

Department of Health

  • The Department of Health has added Mucopolysaccharidosis Type II Disorder (MPS II) screening to the supplemental conditions mandated for screening and follow-up under the state’s newborn screening program effective July 1.  Learn more from this Pennsylvania Bulletin notice.
  • The Department of Health, which last month joined the Department of Agriculture and Department of Environmental Protection in establishing a temporary physical presence in Darlington Township, Beaver County to assist residents affected by the Norfolk Southern train derailment in East Palestine, Ohio, has announced that the three departments will maintain a weekly presence there to continue addressing the needs and concerns of local residents.  Learn more about when the departments will be on site and what services they will offer from this Department of Health news release.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced an expansion of its free substance use disorder prevention and education tool “Just Five.”  Learn more about the expansion of this tool and its new components from this Department of Drug and Alcohol Programs news release.

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported in Pennsylvania fell 26 percent last week after 19 percent declines in each of the two previous weeks.  The number of weekly deaths is holding steady.
  • In the past week the state surpassed 2.9 million confirmed cases of COVID-19; another 637,000 cases are considered “probable.”
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 fell 10 percent last week after falling 14 percent the previous week and 16 percent the week before that.  The number of COVID-19 patients on ventilators rose slightly in the past week and the number in hospital ICUs fell slightly.
  • The CDC reports a 10 percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 after an 18 percent decline the previous week and a 13 percent decline the week before that.
  • For the week ending March 22, one Pennsylvania county (Sullivan) experienced a low rate of community transmission of COVID-19; 28 counties experienced a moderate rate of community transmission of COVID-19; 23 counties experienced a substantial rate of community transmission; and 15 counties experienced a high rate of community transmission.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting April 5

The Medical Assistance Advisory Committee’s managed long-term services and support subcommittee will hold a public meeting on Wednesday, April 5 at 10:00 in Harrisburg.  For information about how to join the meeting in person or participate remotely, see this DHS notice.

Department of Health – Spinal Cord Research Advisory Committee Meeting – April 10

The Department of Health’s Spinal Cord Research Advisory Committee will meet in Sellersville and be available for participants virtually on Monday, April 1 at 1:00.  For information about the committee, the location of the meeting, and how to join virtually, see this Pennsylvania Bulletin notice.

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

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

2023-03-24T20:58:02+00:00March 24th, 2023|COVID-19, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for March 24
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PA Health Policy Update for February 24

The following is an update of selected state health policy developments in Pennsylvania from February 18-24.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state House convened for a special session this week and approved two measures addressing the statute of limitations for victims of childhood sexual abuse – House Bill 1 and House Bill 2.  Both pieces of legislation provide a two-year window for victims of childhood sexual abuse to file civil claims.
  • The state House and Senate will meet for regular session next week – Monday, February 27 through Wednesday, March 1.
  • The Senate Banking & Insurance Committee is scheduled to meet on Tuesday, February 28 to consider Senate Bill 8, which requires insurers to cover costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  It also requires insurers to cover all costs associated with a supplemental breast screening by MRI or ultrasound for women at increased risk of breast cancer pursuant to Act 52 of 2020.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar for the delivery of Remittance Advice (RA) notices, electronic fund transfers, and mailing reimbursement checks into early April.  Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin advising providers that it will begin covering shadow nursing for private duty/shift nursing services provided to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after January 1, 2023.  The bulletin includes a procedure code and rate information.  Find the bulletin here.
  • DHS has released its physical health managed care program enrollment report for January.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has sent a notice to stakeholders explaining that with adoption of the federal Consolidated Appropriations Act of 2023, Congress has eliminated the “DATA-Waiver Program.”  For DEA registrants, this means that DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder; all prescriptions for buprenorphine only require a standard DEA registration number; there are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine; and in Pennsylvania, no current state laws or regulations prohibit practitioners from adopting this change.  The law also introduced new training requirements for all prescribers that will take effect on June 21.  States now await further guidance on these requirements.  Go here to see the message the Department of Drug and Alcohol Programs shared with stakeholders.

COVID-19:  By the Numbers           

  • The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week declined slightly compared to last week.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs rose 17 percent.
  • The CDC reports a 13 percent increase in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
  • For the week ending February 22, two Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 13 counties experienced a substantial rate of community transmission; and the remaining 52 counties experienced a high rate of community transmission – all the same numbers as last week.

Stakeholder Events

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

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

Pennsylvania Health Care Cost Containment Council – March 2

The members of PHC4 will hold a public meeting on Thursday, March 2 at 10:00.  For further information about the location of the meeting and its agenda, see this Pennsylvania Bulletin notice.

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

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

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

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

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

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday March 22 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – March 23

The Medical Assistance Advisory Committee will hold its next public meeting virtually on Thursday, March 23 at 10:00.  Go here to register to participate.

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

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

2023-02-24T20:10:53+00:00February 24th, 2023|COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 24
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PA Health Policy Update for January 27

The following is an update of selected state health policy developments in Pennsylvania from January 21-27.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • The Legislative Budget and Finance Committee (LBFC) met this week and approved the release of a report entitled “Prescription Drug Pricing Under the Medical Assistance Managed Care Program.”  Act 120 of 2020 directed LBFC to conduct a study analyzing prescription drug pricing in the Medical Assistance managed care program; review reimbursement practices by PBMs (pharmacy benefit managers) to pharmacies and to PBMs by MCOs; investigate and compare reimbursement rates by PBMs to independent pharmacies and to chain pharmacies; and study state laws and best practices adopted by other states regarding PBMs and pharmacy reimbursement.  Find the report here.
  • Although the House has not adopted a rules package or formally established standing committees for the 2023-2024 legislation session, the Republican caucus announced its selections for committee chairs this week.  Representatives Kathy Rapp and Tina Pickett will remain Republican chairs of the Health Committee and the Insurance Committee, respectively, while Doyle Heffley will be the new Republican chair of the Human Services Committee.  In addition, Representative Carl Metzger will be the Republican chair of the Professional Licensure Committee, Steven Mentzer will be the Republican chair of the Aging & Older Adult Services Committee, and Linda Schlegel Culver will be the Republican chair of the Children & Youth Committee.  Find the full list of Republican committee chairs here.
  • The state House Democratic Policy Committee convened in Pittsburgh for an informational hearing examining the health care staffing crisis.  Find the meeting agenda and testimony offered during the hearing here.

Department of Human Services

  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin providing guidance for the implementation of Act 65 of 2020, which governs who can provide consent for voluntary mental health treatment of minors who are 14 years of age and less than 18 years of age in both inpatient and outpatient settings.  Act 65 also addresses which individuals may grant consent for the release of a minor’s medical records.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has increased fees for certain ambulance transportation services on the Medical Assistance fee schedule effective with dates of service on or after January 1, 2023.  Find that bulletin here.
  • DHS has published final notice of the assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the Nursing Facility Assessment Program for FY 2023.  Learn more about which types of facilities to which the assessment applies and how much their 2023 assessment will be from this Pennsylvania Bulletin notice.
  • At the January 26 meeting of the Medical Assistance Advisory Committee, DHS’s Office of Long-Term Living offered a presentation on the efforts of the managed care plans that serve Community HealthChoices members to redetermine the eligibility of their current participants in the wake of the upcoming end of continuous Medicaid eligibility and vaccination rates among Community HealthChoices participants.  Find that presentation here.
  • DHS has updated its physical health managed care enrollment report.

Department of Health

Pennsylvania’s Executive Board has approved a reorganization of the Department of Health.  Find an organizational chart that reflects this reorganization in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania held steady over the past week, remaining higher than prior to Thanksgiving, and the number of new daily deaths rose more than 50 percent over the past week after a decline of 50 percent the week before.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined seven percent last week after a 14 percent decline the previous week; the number on a ventilator because of the virus remained steady; and the number in hospital ICUs fell 15 percent after a six percent decline the week before.
  • The CDC reports a slight decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 25, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; 15 counties are experiencing a substantial rate of community transmission; and the remaining 48 counties are experiencing high rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

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

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

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

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

 

2023-01-27T21:38:47+00:00January 27th, 2023|COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 27
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PA Health Policy Update for January 20

The following is an update of selected state health policy developments in Pennsylvania from January 14-20.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

  • Josh Shapiro was sworn in as Pennsylvania’s 48th governor on Tuesday.  Much of the governor’s inaugural speech focused on preserving democracy.  He also highlighted the need for unity and emphasized bringing people together.  Find a transcript of the governor’s speech here.
  • On Wednesday Governor Shapiro issued his first executive order, which prioritizes work experience, skill, and competency for state jobs and highlights that 92 percent of the state’s jobs do not require a four-year college degree.
  • Information about the Shapiro administration’s health-related agency nominees can be found here and a complete list of the Shapiro administration appointments made to date can be found here.

General Assembly

The state Senate convened for voting session this week and the House briefly convened for non-voting session.  Both chambers are now recessed.  The Senate is scheduled to return on Monday, February 27 while the House has yet to release a session calendar.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin rescinding Medical Assistance Bulletin 01-22-78, titled “340B Drug Pricing Program – Dispensing 340B Purchased Drugs,” which was issued on December 22, 2022.  Instead, Medical Assistance Bulletin 99-13-08, titled “340B Drug Pricing Program Provider Requirements and Billing Instructions – Pharmacy Services,” remains in effect.  Go here to see the new bulletin rescinding the December 22 version.
  • DHS has extended its calendar for Remittance Advice (RA) notifications and the delivery of electronic payments and checks into early March.  Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has added CPT codes 0124A, 0154A (Pfizer) and 0134A, 0144A (Moderna) to its fee schedule for the administration of a bivalent booster dose COVID-19 vaccine.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders informing them that it has extended until March 31 its requirement that providers capture consent to treat, service verifications, and approval of treatment plans for Medicaid-funded behavioral health services delivered via telehealth.  At the end of this period providers must have an electronic capability to secure auditable electronic signatures for consent and service verification.  Learn more from OMHSAS’s message to stakeholders.
  • DHS has informed stakeholders that Jennifer (Jen) Smith has joined the department as deputy secretary for OMHSAS.  Smith previously served as Secretary of the Department of Drug and Alcohol Programs.  Learn more from DHS’s message to stakeholders.
  • DHS has posted information about an electronic submission process for Medicaid fee-for-service 180-day exception requests and other claims requiring documentation that will soon be available in the PROMISE portal.  Find that information here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its peer groups, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities.  DHS used these peer groups, peer group medians, and peer group prices to determine case-mix rates for non-public nursing facilities for FY 2023.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published its final annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Learn about those rates from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its telemedicine interpretive guidance for hospitals.  Find the updated guidance here.
  • DOH has updated its FAQ on innovative care models for hospitals.  Find the updated FAQ here.  The changes, which address critical access hospitals and small rural hospitals, are highlighted in red.
  • DOH has updated its criteria and guidance for establishing an outpatient emergency department.  The changes, which address critical access hospitals, small rural hospitals, and rural emergency hospitals, are highlighted in red.  Find the updated guidance here.
  • DOH also has updated its matrix on how facilities can qualify as an innovative hospital model.  Find the updated matrix here.   Changes again are highlighted in red.
  • DOH has issued guidance requiring prospective new owners of skilled nursing facilities to inform facility residents, representatives, and employees of the possibility of a change of ownership of the facility.  Learn more from this DOH guidance.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania declined 27 percent over the past week and the number of new daily deaths, after a 50 percent increase a week ago, returned this week to its level of recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined nearly 14 percent last week after an 11 percent decline the previous week; the number on a ventilator because of the virus rose nine percent; and the number in hospital ICUs fell six percent.
  • The CDC reports a five percent decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 18, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; eight counties are experiencing a substantial rate of community transmission; and the remaining 55 counties are experiencing high rates of community transmission.

Health Care Cost Containment Council (PHC4)

PHC4 is beginning the verification process for hospital self-pay records for fiscal year 2021.  Its self-pay data reconciliation web application on the PHC4 portal enables hospitals to reconcile their self-pay records, which eventually will be provided to DHS to be used as a part of its calculation of the extraordinary expense portion under Act 77 (the state’s 2001 tobacco settlement law).  Find PHC4’s letter to hospitals here and the portal for self-pay records here.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

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

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – January 26

The Patient Safety Authority will meet virtually on Thursday, January 26 at 1:00.  For information about how to participate in this meeting, see this Pennsylvania Bulletin notice.  Registration is required.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

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

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

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

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

2023-01-20T21:47:06+00:00January 20th, 2023|340b, COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 20
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PA Health Policy Update for January 6

The following is an update of selected state health policy developments in Pennsylvania from December 23 through January 6.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Josh Shapiro announced the appointment of his first cabinet-level officials this week, including Akbar Hossain, who will serve as Secretary of Policy and Planning, and Mike Vereb, who will be Secretary of Legislative Affairs.  Hossain is currently the transition team’s executive director and prior to that served as the Shapiro campaign’s policy director.  Vereb, a long-time advisor to Shapiro, previously worked as legislative affairs director for the Office of the Attorney General. Governor-elect Shapiro also announced the appointment of his deputy chiefs of staff.  Lindsey Mauldin, who currently works for Planned Parenthood Pennsylvania, will be Deputy Chief of Staff for Health and Human Services.  Prior to joining Planned Parenthood, Mauldin coordinated Pennsylvania’s COVID-19 pandemic response efforts.  A complete list of the Shapiro-Davis administration appointments made to date may be viewed here.

General Assembly

The General Assembly convened on Tuesday, January 3 to swear in members of the House and Senate and the respective chambers’ presiding officers.  The Senate made history by electing Senator Kim Ward (R-Westmoreland) President Pro Tempore; she is the first woman to hold the position.  Senator Ward also was sworn in as Lieutenant Governor, a position she will hold until Lieutenant Governor-Elect Austin Davis is sworn in on January 17.  After what appeared to be an impasse choosing a Speaker of the state House, Representative Mark Rozzi (D-Berks) was elected by a vote of 115 to 85 to serve as Speaker.  Sixteen Republicans joined Democrats in voting for Rozzi, who committed to being an independent Speaker and not to caucus with either party.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for December.  General Fund revenue collections were $319.9 million, or 8.6 percent, above estimate for the month.  Fiscal year-to-date General Fund collections total $19.7 billion, which is $503.1 million, or 2.6 percent, above estimate.

Centers for Medicare & Medicaid Services

  • CMS has issued guidance on a way for states to address unmet health-related social needs for Medicaid beneficiaries.  This option will help states offer alternative benefits, such as housing and nutrition assistance, through the use of a service or setting that is provided to an enrollee in lieu of a service or setting covered under their state’s Medicaid plan to address a range of unmet health-related social needs to help enrollees maintain their coverage and improve their health outcomes.  Learn more from this CMS news release and this letter from CMS to state Medicaid directors.
  • CMS has issued guidance that creates an easier path to specialty care for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.  For the first time, state Medicaid and CHIP programs will be able to pay specialists directly when a beneficiary’s primary health care provider asks for advice.  For example, if a pediatrician consults with a specialty behavioral health provider about a specific patient’s needs, both providers may be reimbursed for their care – even if the patient is not present.  This move to pay for interprofessional consultations seeks to link routine care with specialty care, enabling more people to benefit from practitioners with specialized knowledge.  Learn more from this CMS news release and the guidance letter CMS sent to state Medicaid directors about this subject.
  • CMS has sent a letter to state Medicaid programs that provides a detailed description of the configuration/implementation plan, testing plan, and testing results that states will need to submit to the federal government when the public health emergency and continuous Medicaid enrollment condition end.  This document seeks to help states understand systems readiness artifacts that are routinely submitted to CMS’s state systems team during IT project and certification reviews.  See the CMS letter here.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform providers that it will reinstate provider enrollment requirements that were in place prior to the COVID-19 public health emergency, including an enrollment application fee, fingerprint-based background checks, and site visits for providers.  Providers temporarily enrolled in the program during the public health emergency who did not satisfy enrollment requirements that were suspended at the time now must satisfy those requirements.  This policy takes effect on February 27.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform providers about the procedures for dispensing 340B drugs to Medical Assistance beneficiaries and about implementation of the Medical Assistance program’s 340B drug exclusion list.  The policies took effect on January 1.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin to inform peer support service providers and Medicaid behavioral health managed care organizations that peer support services identified in beneficiaries’ individual service plans may be provided during transit.  The policy took effect on December 28.  The bulletin also includes revised provider handbook pages.  Find the bulletin here.
  • DHS has updated its COMPASS Community Partners web page with new information about steps that can be taken to help people retain health care coverage after the COVID-19 public health emergency ends, including a new FAQ and an updated public health emergency toolkit.  Learn more about COMPASS Community Partners and these new developments from this message from DHS.
  • DHS has added a new procedure code to the Medical Assistance program fee schedule for a second nurse to shadow a nurse providing private duty/shift nursing to beneficiaries under 21 years of age, effective with dates of service on and after January 1.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a summary of the December 8 meeting of the Medical Assistance Advisory Committee.  Find it here.
  • DHS has updated its telephone directory for those seeking assistance with different Medical Assistance-related issues.  Find the updated directory here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its physical health Medicaid managed care enrollment report for November.

Department of Health

  • The Department of Health has written to long-term-care facilities to inform them that it will no longer provide short-term crisis staffing support or staffing support for test swabbing missions as of January 14.  It also encourages those facilities to engage with their local LTC RISE partner, which will continue to provide COVID-19 outbreak response consultative support.  Learn more from the department’s letter to long-term-care facilities.
  • The Childhood Blood Lead Test Act signed into law on November 3 took effect on January 2.  The act provides for blood lead assessment and testing of certain children and pregnant women by health care providers; imposes duties on the Department of Health; and requires certain health insurance policies to cover blood lead tests.  Learn more about the new law from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose 21 percent over the past week.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 is the highest it has been since last February 22; the number on a ventilator because of the virus is the highest it has been since March 9; and the number in hospital ICUs is greater than it has been since March 4.
  • The CDC reports a 15 percent increase in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 since December 21.
  • As of January 5, one Pennsylvania county – Cameron – is experiencing a low rate of community transmission; 12 counties are experiencing a substantial rate of community transition; and the remaining 54 counties are experiencing high rates of community transmission of COVID-19.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin informing single- county authorities, substance use disorder treatment providers, and other substance use disorder treatment-related organizations that they may be asked to serve on a death review team and that they may be asked to provide records as part of a death review team’s duties.  Find the bulletin here.

The Department of Drug and Alcohol Programs announced an open enrollment period last October for licensed substance use disorder treatment providers in Pennsylvania to submit their information to be included in the Addiction Treatment Locator, Assessment, and Standards Platform, ATLAS.  This open enrollment period has been extended, and will now continue through January 13.  Go here to see the original notice of the open enrollment period and here to see the department’s recent communication on this subject.

Insurance Department

An Insurance Department examination of Capital Blue Cross has identified concerns with claims processing, including claims being denied for lack of prior authorization when prior authorization had already been obtained, and a coordination of benefits issue that has since been updated.  The examination also reported additional Unfair Insurance Practices Act violations involving unclear communication with members.  The exam also found mental health parity violations.  Learn more about why the department conducted the review, what it found, and how it is addressing the problems it identified from this news release.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – January 12

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, January 12 at 10:00.  For additional information about the session, see this Pennsylvania Bulletin notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – January 18

The Department of Health’s Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, January 18 at 9:00.  Interested parties may attend in person or virtually.  Learn more about the committee, where the meeting will be held, and how to participate virtually from this Pennsylvania Bulletin notice.

Department of Health – Renal Disease Advisory Committee – January 20

The Department of  Health’s Renal Disease Advisory Committee will meet in Harrisburg on Friday, January 20 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

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

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

 

2023-01-06T21:54:53+00:00January 6th, 2023|340b, COVID-19, Federal Medicaid issues, health equity, Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 6
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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