SNAPShots

SNAPShots

PA Health Policy Update for the Week of January 3-7

The following is an update of selected state health policy developments in Pennsylvania for the week of January 3-7, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced that the state is organizing regional support sites for both hospitals and long-term-care facilities and strike teams to support hospitals facing staffing shortages.  The effort, to be coordinated by the Department of Health and the Pennsylvania Emergency Management Agency, will include the following major components:

  • Critical capacity support through the launch of regional support sites for Pennsylvania hospitals suffering from a lack of beds or staffing to meet inpatient needs.  Hospitals struggling to meet inpatient demands will have the opportunity to transfer patients to ​hospitals within these regional sites for care.  Each regional site will have increased capacity for approximately 60 days beginning in February, supported by medical support staff including physicians, respiratory therapists, and registered nurses.
  • Staffing support that will be sent directly to hospitals from the Department of Health based on identified need.  Staffing resources may include physicians, respiratory therapists, and registered nurses for short-term deployments over the next three months.
  • Expanded long-term-care capacity through the launch of regional sites to allow for more rapid discharge of patients by hospitals.  Each site will increase the state’s capacity to support long-term-care residents with additional medical staff, including registered nurses and aides.

Go here to see the announcement from the governor’s office.

General Assembly

  • The House of Representatives will hold voting session during the week of January 10 on Monday (1/10), Tuesday (1/11), and Wednesday (1/12).
  • House Bill 1280, which amends the Patient Test Result Information Act, is scheduled for second consideration on Monday and third consideration on Tuesday.  This bill would eliminate the definition of “significant abnormality” and revise the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.
  • The House Health Committee is scheduled to convene on Tuesday, January 11 at 9:30 a.m. to consider, among other bills, House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.  The committee also will consider Senate Bill 780, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.

State Revenue Collection

The Revenue Department announced that Pennsylvania collected $3.8 billion in General Fund revenue in the month of December – $464.3 million, or 13.7 percent, more than projected.  Year-to-date General Fund revenue collections total $22.6 billion, which is $1.5 billion, or 7.0 percent, above estimate.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin explaining that Medicaid will pay pharmacies for the administration of vaccines to Medicaid beneficiaries by licensed pharmacists effective November 1, 2021.  The bulletin also provides instructions for pharmacies to submit claims for the administration of vaccines by pharmacists to Medicaid fee-for-service beneficiaries.  Find the bulletin here.

Department of Health

  • The Department of Health (DOH) has issued revised guidance, applicable to the general population in a community setting, about who needs isolation or quarantine because of a diagnosis of COVID-19 or contact with someone who has been diagnosed with or is suspected of having COVID-19 and how long that isolation or quarantine must last.  Find that guidance here.
  • DOH has updated its recommended work restrictions for health care workers based on vaccination status and type of exposure.
  • DOH has recirculated a series of long-term care-specific vaccine materials that long-term-care facilities can use in their efforts to comply with federal requirements for staff vaccination.  Find the vaccine outreach toolkit here and an accompanying fact sheet here.
  • DOH has updated its long-term-care facilities COVID-19 visitation guidance FAQ.  Find it here.  (Note:  this link opens to a downloadable file.)
  • DOH has issued an alert about an outbreak of  hepatitis A in southeastern Pennsylvania.  The alert includes instructions for providers about diagnosing the condition, preserving laboratory samples, and reporting diagnosed cases to the state.
  • DOH has introduced changes in Lyme disease surveillance requirements and testing practices and has shared these changes with providers in this health alert.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts are higher than they have been at any time since the pandemic began.  The state’s total of 29,026 new cases on Thursday, January 6 was the highest single-day total since the pandemic began, breaking a new record set the previous day.
  • The number of new COVID-19-related deaths remains high.
  • To date, Pennsylvania has had 1.8 million confirmed cases of COVID-19, nearly 400,000 cases that have been classified as “probably” COVID-19, and 37,500 deaths attributed to the disease.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • From December 1 through December 31, the number of Pennsylvanians hospitalized because of COVID-19 rose 33 percent; the number in hospital ICUs because of COVID-19 rose 12 percent; and the number on ventilators because of the virus rose 23 percent.
  • This situation is reflected in the high rate of occupancy in the state’s hospitals.  There currently are only 477 unoccupied adult ICU beds – 13.4 percent of the total of such beds in the state; 2026 unoccupied medical/surgical beds – 10 percent of such beds; 41 unoccupied pediatric ICU beds (11 percent); 239 unoccupied pediatric beds (21.9 percent); and 912 unoccupied airborne isolation beds (28.4).
  • On January 4 the Department of Health elaborated on some of these figures, reporting that approximately 28 percent of all staffed adult ICU beds are occupied by COVID-19 patients and that 32 percent of all ventilators state-wide are in use.
  • Media reports confirm the challenges some communities and hospitals are facing, including limited numbers of hospital beds, staffing challenges, and difficulty getting enough COVID-19 testing materials.  For examples, see these reports about conditions in the Philadelphia area (here, here, and here), the Pittsburgh area (here and here), and central Pennsylvania.
  • According to the CDC, as of Thursday, December 30, 74.1 percent of Pennsylvanians age 18 and older are fully vaccinated.

Stakeholder Events

Health Research Advisory Committee – January 10

The Department of Health’s Health Research Advisory Committee will hold a virtual public meeting on Monday, January 10, 2022 at 2:30 pm via Microsoft Teams at (267) 332-8737 with Conference ID: 994 021 882#.  Learn more from this Pennsylvania Bulletin notice.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold virtual meetings on the following days at 10:00 am:  Thursday, January 27, 2022; Tuesday, March 22, 2022; Thursday, May 26, 2022; Thursday, July 28, 2022; Tuesday, September 27, 2022; and Tuesday, November 22, 2022.  These virtual meetings will be broadcasted live for the public through Commonwealth Media Services. Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27, 2022 at 10 am.  To participate dial in by location at (412) 648-8888 or (866) 588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

2022-01-07T21:14:24+00:00January 7th, 2022|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 coronavirus, Pennsylvania Medicaid COVID-19|Comments Off on PA Health Policy Update for the Week of January 3-7
Read More

PA Health Policy Update for the Week of December 27-30

The following is an update of selected state health policy developments in Pennsylvania for the week of December 27-30, 2021.  (Some of the language used below is taken directly from state documents.)

Centers for Medicare & Medicaid Services

CMS directed state survey agencies in certain states, including Pennsylvania, to begin surveying for compliance with the agency’s November 5, 2021 final rule requiring vaccination of health care staff. Click here to read the guidance to states and find provider-specific guidance documents.  CMS has authorized state surveyors to find facilities out of compliance with the rule within 30 days of the issuance of this guidance if less than 100 percent of all staff have received at least one dose of a COVID-19 vaccine.

Department of Health

  • The Department of Health (DOH) and the Pennsylvania Emergency Management Agency announced that the federal Department of Health and Human Services will be sending “strike teams” to Scranton Regional Hospital and Wellspan York to increase acute care capacity. In addition, EMS “strike teams” will be deployed in those regions to support the increased capacity.
  • DOH, in partnership, with the Department of Human Services, announced it will be transitioning its Regional Congregate Care Teams (RCATs) to the new LTC RISE (Long-term Care Resiliency, Infrastructure Supports, and Empowerment) program, effective January 1, 2022. This program will continue to provide long-term-care facilities with COVID-19 outbreak response support.  Additional information on the LTC RISE program may be found here.
  • DOH issued updated guidance to providers on COVID-19 treatment options with direction to limit the use of sotrovimab because of a current nationwide supply shortage.  This particular monoclonal antibody should be reserved for eligible outpatients at the highest risk who are diagnosed with the omicron variant of COVID-19 or exposed to local settings where omicron is prevalent.
  • DOH updated its recommendations for when health care personnel with COVID-19 infection could return to work and its contingency and crisis strategies for providers mitigating staff shortages.
  • DOH updated its guidance on isolation and quarantine periods for COVID-19 for the general population.

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of community-based care management services to the Medical Assistance fee schedule and its intent to seek CMS approval to add to the Medicaid state plan community-based care management services provided by Centers of Excellence for opioid use disorders.  See details in the Pennsylvania Bulletin notice here.
  • DHS has issued a Medical Assistance Bulletin to add to the MA fee schedule procedures codes for the administration of  booster doses of the Janssen and Moderna COVID-19 vaccines.
  • DHS has issued a Medical Assistance Bulletin with information on two CPT codes added to the MA fee schedule for the administration of Pfizer’s pediatric COVID-19 vaccine.
  • DHS has issued a Medical Assistance Bulletin about reimbursement of licensed pharmacists administering vaccines to Medicaid fee-for-service beneficiaries.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.9 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • Nearly all Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 remains high.  There currently are only 533 unoccupied adult ICU beds – 15.1 percent of the total of such beds in the state; 2369 unoccupied medical/surgical beds – 11.9 percent of such beds in the state; 40 pediatric ICU beds (10.7 percent); 234 pediatric beds (23.4 percent); and 991 airborne isolation beds (31.0 percent).
  • DOH reports that 6.9 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than 1.05 million people fully vaccinated and that 224,000 boosters have been administered to city residents since August 13.

 

2022-01-03T16:31:32+00:00January 3rd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 27-30
Read More

PA Health Policy Update for the Week of December 13-17

The following is an update of selected state health policy developments in Pennsylvania for the week of December 13-17, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration requested support from the Federal Emergency Management Agency (FEMA) for Pennsylvania’s health care system in its continued battle against COVID-19.  In particular, it has asked for staffing support for clinical and non-clinical professionals and continued pandemic response support.  Learn more from this Wolf administration news release.

General Assembly

  • The Senate unanimously passed House Bill 1260, which expands eligibility for the PACENET prescription program from $27,500 to $33,500 for single individuals and from $35,500 to $41,500 for married couples.  The bill has been sent to the governor.
  • The House Health Committee held an informational hearing on Monday to discuss the various COVID-19 treatment options available.  House Bill 1741, which provides for prescribing and dispensing to treat COVID-19 off-label drugs approved by the FDA for other purposes, received a considerable amount of attention during the hearing.  Chairman Kathy Rapp indicated the committee may move the bill in early 2022.  You can view a recording of the hearing here.
  • The Senate Health & Human Services Committee convened on Tuesday and favorably reported the following bills:
    • Senate Bill 200, which expands early intervention services for infants and mothers;
    • Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health;
    • Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning;
    • Senate Bill 848, which creates a chief nursing officer position in the Department of Health;
    • Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board;
    • Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception; and,
    • House Bill 118, which establishes requirements for the final disposition of fetal remains.

You can view the committee’s agenda and a video recording here.

  • The House Human Services Committee held an informational hearing on House Bill 1644 on Thursday.  The bill directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.  The Human Services Committee also held an informational hearing on community participation supports during COVID-19 pandemic.  You can view a recording of the hearing here.
  • The state House and Senate appropriations committees released their FY 2023 budget hearing schedules.  The schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has updated its schedule for Remittance Advices, adding January dates and pay dates that go into early February.  Find it here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its intention to allocate funds in FY 2021-2022 for several classes of Medicaid inpatient disproportionate share hospital (Medicaid DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  The department does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  The allocations include:
    • $1.057 million in total funds for DSH payments to qualifying acute-care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue, and are located in an area of the state with a disproportionate need for Medicaid services
    • $1.585 million for DSH payments to qualifying acute-care general hospitals to promote access to acute-care services for Medicaid-eligible persons in less urban areas
    • $18.293 million for DSH payments to Medicaid-enrolled acute-care general hospitals that qualify as a trauma center
    • $111.585 million for DSH payments to qualifying Medicaid-enrolled acute-care hospitals that promote access to comprehensive inpatient services for Medicaid-eligible persons by providing an adequate supply of health care professionals who have been trained in high-volume Medicaid-enrolled hospital settings
    • $9.377 million for DSH payments to qualifying acute-care general hospital burn centers
    • $14.119 million for DSH payments to qualifying acute-care general hospitals providing obstetrical and neonatal services
    • $0.500 million for DSH payments to qualifying teaching hospitals that provide psychiatric services to Medicaid beneficiaries
    • $34.356 million for DSH payments to critical access and qualifying rural hospitals
    • $0.695 million for DSH payments to qualifying acute-care general hospitals that provide surgical services to patients with cleft palate and craniofacial abnormalities
    • $0.737 million for DSH payments made to qualifying Medicaid-enrolled acute-care general hospitals that provide a high volume of inpatient services to Medicaid-eligible and low-income populations
    • $4.333 million for DSH payments to qualifying acute-care general hospitals that qualify as academic medical centers
    • $23.946 million for DSH payments to qualifying acute-care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals
    • $7.397 million for DSH payments to qualifying acute-care general hospitals that participate in an academic medical program
    • $5.290 million for supplemental payments to qualifying acute-care general hospitals that provide medical and surgical ocular services to Medicaid beneficiaries
    • $0.900 million for supplemental payments to qualifying acute-care general hospitals that provide a substantial portion of their inpatient services to Medicaid beneficiaries

Learn more from this Pennsylvania Bulletin notice.

  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization.  Find the bulletin here.

Department of Health

  • Department of Health (DOH) acting secretary Alison Beam will leave that job at the end of the year.  She will be replaced by department deputy secretary Keara Klinepeter.  Learn more from this Wolf administration news release.
  • DOH announced that the state is opening free outdoor drive-up COVID-19 testing sites in Berks, Blair, Centre, Clinton, Jefferson, Luzerne and McKean counties.  For locations and hours, see this department news release (and this separate notice for the site in Blair County).
  • DOH has introduced a new “post-vaccination data” web page on which it will provide data on so-called breakthrough cases of COVID-19:  cases, hospitalizations, and deaths.  The web page reports that from January 1 through December 6, 2021, 85 percent of reported COVID-19 cases in Pennsylvania were in unvaccinated or not fully vaccinated people; 87 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 86 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.  For additional information and a more detailed breakdown of these and other numbers, see the department’s new post-vaccination data web page.
  • DOH has posted a notice on its message board about the transition from the Regional Congregate Care Teams to a new program that will support response operations at long-term-care facilities that experience COVID-19 outbreaks.  Find that message here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments on DOH’s proposed amendments of regulations governing long-term-care facilities.  In addition to specific comments, the IRRC stated its agreement with many others in the regulated community that have urged DOH to reevaluate its approach of promulgating several packages of proposed regulations and instead consider submitting a comprehensive regulatory update regarding long-term care.  Find the IRRC comments in this Pennsylvania Bulletin notice.
  • DOH has issued its monthly report detailing its nursing home inspection and sanction activities.  Learn more from this department news release and the department’s November report.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 has risen 18 percent since December 1; the number in hospital ICUs because of COVID-19 has risen 13 percent; and the number on ventilators because of the virus has risen 16 percent since the start of the month.
  • This situation is reflected in the high rate of occupancy in the state’s hospitals.  There currently are only 484 unoccupied adult ICU beds – 13.7 percent of the total of such beds in the state; 2106 unoccupied medical/surgical beds – 10.5 percent of such beds in the state; 34 pediatric ICU beds (9.0 percent); 191 pediatric beds (16.8 percent); and 938 airborne isolation beds (29.6).
  • Media reports confirm the challenges some communities and hospitals are facing, including this story in the Philadelphia Inquirer; a situation that the director of the 911 call center in Westmoreland County calls “desperate;” and reported capacity and hospital discharge problems in western and rural Pennsylvania.
  • DOH reports that 6.8 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that 186,000 boosters have been administered to city residents since August 13.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published Hospital Performance Report – 2020 Data, which presents volume and outcome information about a variety of medical conditions and surgical procedures performed by the state’s  general acute-care hospitals.  Learn more from the following resources:

 

2021-12-17T22:37:32+00:00December 17th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 13-17
Read More

PA Health Policy Update for the Week of November 29-December 3

The following is an update of selected state health policy developments in Pennsylvania for the week of November 29 to December 3, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced a plan to spend approximately $1.2 billion in American Rescue Plan Act federal funding to support Medicaid’s home and community-based services (HCBS) system, giving more Pennsylvanians access to critical services in their communities.  This temporary funding enhancement will be directed toward Medicaid-funded essential care services to seniors, adults with intellectual and physical disabilities, adults with behavioral health needs such as substance use disorder or mental illness, and children with chronic complex medical needs.  The American Rescue Plan Act provides states with a temporary, one-year, 10 percent increase in the rate at which the federal government matches state spending for certain Medicaid-covered home and community-based services.  To learn more about how Pennsylvania plans to spend this money, see this Wolf administration news release.  For more on Pennsylvania’s plan, go here.  A week after this announcement, the federal government approved the state’s plan for using this money, as the Department of Human Services reported to stakeholders.

General Assembly

The House Republican Policy Committee held a hearing this week examining the health care staffing crisis.  Representatives from the Hospital & Healthsystem Association of Pennsylvania (HAP), Penn State Health, Geisinger, the Pennsylvania Health Care Association (PHCA), SEIU Healthcare, and the Pennsylvania State Nurses Association testified.  Hearing testimony and a video recording may be viewed here.

Two members of the General Assembly – House majority leader Kerry Benninghoff (R-Mifflin) and Representative Mark Gillen (R-Berks) – have tested positive for COVID-19.

Financial paperworkState Revenue Update

Revenue collections continue to exceed estimates. The Department of Revenue reported this week that Pennsylvania collected $6.6 billion in General Fund revenue in November, which was $217.9 million, or 3.4 percent, more than anticipated.  For the year to date Pennsylvania has collected $18.7 billion in General Fund revenue, which is $1.0 billion, or 5.7 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin explaining that it intends to allocate $106.130 million in total funds for disproportionate share hospital payments (Medicaid DSH payments) to qualifying acute-care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the state and $88.994 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms.  Go here to see the Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin updating its dental fee schedule.  The update is effective as of August 23, 2021.

Department of Health

The state Supreme Court has temporarily restored the Department of Health’s (DOH) order requiring students, teachers, and staff to wear masks in Pennsylvania school districts.  Read the court’s ruling here.  The ruling only put a hold on Commonwealth Court’s decision to issue a stay of the order; the Supreme Court will still need to consider the governor’s appeal of the Commonwealth Court decision.

DOH has established new walk-in COVID-19 testing sites in Berks, Centre, Clinton, Crawford, Jefferson, and Susquehanna counties.  Learn more from this news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts are on the rise in Pennsylvania.  Wednesday’s 7606 new cases and Thursday’s 9143 new cases are the highest single-day totals in the state since the second week of January.  To date, more than 1.75 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.  To date, more than 33,000 Pennsylvanians have died from COVID-19.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which declined during the first two weeks of November, rose significantly during the last two weeks of the month.  As the month came to a close, COVID-19 related hospitalizations were up 43 percent over the beginning of the month, ventilator cases were up 32 percent, and COVID-19 patients in hospital ICUs also were up 32 percent.
  • 231,000 Pennsylvanians were recorded as completing a vaccine regimen during the month of November.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs released Policy Bulletin 21-05, which documents modifications to the Standard General Terms & Conditions, Fiscal and Operations Manual, and Substance Abuse Prevention and Treatment Block Grant (SAPTBG) provisions.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, December 8 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m.  Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m.  Go here for information about registering and participating.

2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 29-December 3
Read More

PA Health Policy Update for the Week of October 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of October 18-22, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed an executive order calling on the state’s Department of Labor & Industry to “study the feasibility of implementing Occupational Safety and Health Administration (OSHA) standards” in state offices and requiring that for profit entities that do business with the state pay “…a minimum wage that meets or exceeds” the state’s minimum wage and offer paid sick leave to their employees.  Go here to see that executive order and here to see a Wolf administration news release about it.

House Chamber of the State HouseGeneral Assembly

  • The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Navigating Healthcare Consolidation.”  Co-hosted by chairman Ryan Bizarro and northeast delegation chair Rep. Maureen Madden, the hearing focused on the market dynamics that contribute to health care consolidation and the effect consolidation has on communities, patients, and employees.  Representatives from the hospital community, organized labor, and patient advocacy groups testified.  A press release issued following the hearing may be viewed here and testimony offered at the hearing may be viewed here.
  • The House and Senate will be in session next Monday (10/25), Tuesday (10/26), and Wednesday (10/27).  As of October 22, the following health care-related committee meetings have been scheduled for next week:
    • The House Aging & Older Adult Services Committee will meet on Tuesday, October 26 to consider, among other bills, House Bill 1356, which amends the Human Services Code to increase the reimbursement rate for guardians of older adults.
    • The House Human Services Committee will meet on Tuesday, October 26 to consider House Bill 1561 and House Bill 1563.  These bills, which amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, seek to align them with HIPAA and give providers, facilities, and insurers the ability to more easily share patient mental health and substance use disorder treatment information.  The committee also will consider House Bill 1308, which enables local communities and agencies in Pennsylvania to establish overdose fatality review teams.  Finally, the committee will consider House Bill 1995, which clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.

Department of Human Services

  • The Department of Human Services (DHS) has added November dates to its calendar of when it will be issuing Remittance Advices (RAs) and corresponding checks.  Find the updated calendar here.
  • DHS has updated its information about provider enrollment and revalidation changes during the COVID-19 emergency.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin advising providers of updates of certain error status codes for personal care services subject to electronic visit verification, effective for claims received on or after October 22, 2021.  The bulletin also gives providers an updated Provider Assistance Center contact e-mail address for their use.  Go here to find this Medical Assistance Bulletin.
  • DHS’s Office of Mental Health and Substance Abuse Services has informed providers that certain regulatory requirements for on-site inspections have been reinstated as of October 18, 2021.  This includes visitation requirements, the right to enter and inspect, and the requirement to undergo an annual inspection.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) of the procedure for submitting claims to DHS for a take-home supply of naloxone distributed to Medical Assistance beneficiaries.  Find that bulletin here.
  • The federal Centers for Medicare & Medicaid Services (CMS) has issued guidance on coordinating care provided by out-of-state providers for children with medically complex conditions, including a description of best practices and other implementation considerations related to coordination of care from out-of-state providers for children with medically complex conditions.  Go here to see CMS’s guidance memo to state Medicaid programs.

Department of Health

The Department of Health has published an update on point-of-care COVID-19 antigen tests and the interpretation of test results.  The updated guidance replaces previous department guidance.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases declined slightly this week.
  • The number of new COVID-19-related deaths remains high but did not rise during the past week.
  • The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
  • 71.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people.  3000 Philadelphians and 58,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first evaluation of its Pennsylvania Rural Health Model, a federally approved program that seeks “…to improve population health outcomes, increase access to high-quality care, and improve the financial viability of acute care hospitals in rural Pennsylvania.  Designed to reduce the risk of rural hospital closures, the Model seeks to stabilize participating hospitals’ finances by providing a predictable revenue stream through global budgets.”  Go here and scroll down for information about the model and links to additional resources.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – October 28

The Medical Assistance Advisory Committee will meet on Thursday, October 28 at 10:00 a.m.  Go here to register to participate virtually.

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m.  To participate:

Health Care Cost Containment Council – November 4

The Health Care Cost Containment Council will meet via teleconference on Thursday, November 4 at 10:00 a.m.  The public is invited to participate.  See this Pennsylvania Bulletin notice about how to join the meeting.

Organ Donation Advisory Committee Meeting – November 4

The Organ Donation Advisory Committee will hold a virtual meeting on Thursday, November 4 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Traumatic Brain Injury Advisory Board – November 5

The Traumatic Brain Injury Advisory Board will hold a virtual meeting on Friday, November 5 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m.  To participate virtually or by phone, go here for further information.

 

2021-10-22T21:03:04+00:00October 22nd, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of October 18-22
Read More

PA Health Policy Update for the Week of September 27-October 1

The following is an update of selected state health policy developments in Pennsylvania for the week of September 27-October 1, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Tom Wolf announced that the state’s open data portal now includes COVID-19 vaccination rates by legislative district.  The vaccination data by legislative district excludes districts fully or partially located in Philadelphia County, which is a separate CDC-designated vaccine jurisdiction.   The legislative district dashboard will be updated monthly.  Find the data here.

General Assembly

  • House Bill 1861 (Act 73) was unanimously passed by the House and Senate and signed by Governor Wolf.  This legislation extends the COVID-19 regulatory waivers and flexibilities issued by the Department of Health, Department of Human Services, and the Bureau of Professional and Occupational Affairs at the Department of State until March 31, 2022.  The bill also extends certain waivers issued by the Department of Drug and Alcohol Programs.  These waivers were previously set to expire on September 30, 2021.  In addition to the extension, Act 73 requires state agencies to publicly issue a report on their respective suspended regulations by May 1, 2022.  Similar to Act 21 (House Bill 854), which extended the waivers to September 30, 2021, state agencies retain the authority to terminate a suspension before March 31, 2022.  If an agency does so, it must notify the General Assembly.
  • House Bill 1774 (Act 72) was passed by the House and Senate and signed by the governor.  The bill amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP), extending the sunset date to December 31, 2028 and granting the Department of Labor & Industry access to the prescription drug monitoring program.
  • Senate Bill 397 and Senate Bill 398, which modernize Pennsylvania laws governing physician assistants and their oversight, were passed by the House and Senate and sent to the governor on Wednesday, September 29.
  • The House will be in session next week on Monday (10/4), Tuesday (10/5), and Wednesday (10/6).  The Senate is currently in recess until October 18.  As of Friday afternoon the following relevant committee meetings have been scheduled for next week:
    • The House Professional Licensure Committee will convene for a voting meeting on Monday, October 4 at 10:00 a.m. to consider, among other bills, House Resolution 142, which requires the Joint State Government Commission to conduct a review of the State Board of Nursing, including the “Authorization to Test” process.  The committee also will meet on Wednesday, October 6 for an informational meeting on House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin notifying providers of its intent to permanently expand access to telemedicine and establish guidelines for services rendered via telemedicine.  The bulletin applies to providers enrolled in the Medical Assistance program who deliver physical health services to Medical Assistance fee-for-service beneficiaries.  Highlights of the Bulletin include:
    • DHS will permit providers to use audio-only telecommunication when the beneficiary does not have access to video capability or for an urgent medical situation.
    • Services rendered via telemedicine to Medical Assistance fee-for-service beneficiaries will be reimbursed at the same rate as if the services were rendered in person.
    • This bulletin only applies to Medical Assistance fee-for-service.  Medical Assistance managed care plans “may, but are not required to” permit the use of telemedicine services.  They also may negotiate reimbursement for services rendered via telemedicine.
    • Out-of-state licensed practitioners who render services via telemedicine to Medical Assistance fee-for-service beneficiaries in Pennsylvania must meet licensing requirements established by the Department of State and be enrolled in the Medical Assistance program.

This new policy takes effect on September 30, 2021.  See the Medical Assistance Bulletin establishing this new policy here.

Department of Health

  • The Department of Health (DOH) has updated its guidance on hospitals’ responses to COVID-19.
  • DOH and Department of Community and Economic Development have announced a new $5 million grant program to help grassroots organizations encourage vaccine-hesitant populations to get the COVID-19 vaccine.  The COVID-19 Vaccine Outreach Grant Program will provide grants up to $100,000 to non-profit organizations and child care and educational institutions.  These grants will support grassroots outreach efforts including local media buys, creation of outreach and training materials, sponsorship of vaccine-related community events, equipment rental to assist with scheduling vaccine appointments, and more.  Learn more about the program and how to apply for grant funding from the departments’ joint announcement of this initiative and this program overview and accompanying guidelines on the Department of Community and Economic Development’s web site.
  • Based on recommendations from the CDC, DOH has updated its guidance on the use of antibody testing in determining quarantine status.  Find that updated guidance here.
  • DOH has published a health advisory echoing a CDC message that pregnant people should receive COVID-19 vaccines to prevent serious illness, deaths, and adverse pregnancy outcomes from COVID-19.  Find that advisory here.
  • DOH issued a message to long-term-care facilities regarding staff vaccination and testing requirements.  Read that notice here.
  • DOH updated its guidance for long-term-care facilities responding to an outbreak of COVID-19 among residents, including removing recommendations for quarantine of fully-vaccinated personnel in most circumstances.
  • DOH has updated infection control and prevention strategies for long-term-care facilities that supplement general guidance for all health care facilities that was issued last month.  Key changes include removal of the sections on source control, eye protection, and physical distancing measures recommended for vaccinated and unvaccinated health care personnel and residents.
  • DOH has awarded $1 million in grants to six recipients focused on spinal cord injury research.  Learn about the research the money will support and the recipients of the grant funding in this department news release.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs sent out guidance on June 14, 2021 about three temporary regulatory suspensions granted through the governor’s declaration of a disaster emergency due to the COVID-19 pandemic.  House Bill 1861, which was signed into law this week by Governor Wolf, further extends those regulatory suspensions from September 30, 2021 until March 31, 2022 unless terminated sooner.  These three regulatory suspensions and an additional relevant suspension by the Department of State that also is extended until March 31, 2022 are summarized in this chart.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week.
  • The number of new COVID-19-related deaths also remains high.  Yesterday’s total of 97 deaths was the highest single-day figure since mid-February.
  • For the fourth consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
  • According to Pennsylvania’s COVID-19 dashboard, only 44 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
  • The number of Pennsylvanians hospitalized because of COVID-19 rose seven percent in the past week and rose 53 percent during the month of September; the number on ventilators rose 19 percent in the past week and 63 percent since September 1; and the number in hospital intensive care units rose five percent in the past week and 44 percent during September.
  • 68.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.2 million people – up from 68.2 percent last week.  7000 Philadelphians and 32,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Independent Fiscal Office

Pennsylvania’s Independent Fiscal Office has released a research brief that uses preliminary data for 2020 and 2021 (through September) to compute excess deaths above pre-COVID-19 historical trends in the state for those two years.  After accounting for a notable increase in homicides and overdoses, the analysis finds 20,700 excess deaths in 2020 and projects 6,700 excess deaths for 2021. For 2020 the analysis finds that decedents age 65 or older comprised 86 percent of excess deaths.  Find that report here.

Around the State

  • “Beginning in October 2021, the Pennsylvania Department of Human Services (DHS) will begin terminating state-funded Medicaid coverage for individuals who are found ineligible for the program. This is true despite the ongoing federal Public Health Emergency (PHE), which prevents Medicaid terminations for the majority of Medicaid recipients,” the Pennsylvania Health Law Project reports.
  • With Pennsylvania hospitals serving so many COVID-19 patients, some are transferring behavioral health patients and diverting incoming patients with behavioral health issues elsewhere, according to WITF.
  • Pennsylvania reportedly will allocate $6.5 million in federal funds to support and retain nurses, the Pennsylvania Capital-Star reports.
  • Central Pennsylvania is facing a blood supply shortage.  Lancaster Online offers the details.
  • A lack of clarity about the state’s response to federal rules about the use of medical marijuana to treat addiction had led to confusion in Pennsylvania, Spotlight PA suggests in a recent report.
  • Pennsylvania is one of six states in which the proportion of children with elevated levels of lead in their blood (5.0 percent) is more than twice the national average (1.9 percent), according to the Philadelphia Inquirer.
  • Two new hospitals opened this week:  Penn State Health’s Hampden Medical Center and AHN Wexford.
  • “Sharon Regional Medical Center announced Monday that it will discontinue its maternity and obstetrics services Wednesday, weeks before hospital officials had originally scheduled the department’s closure,” the Sharon Herald reported.
  • Centre County officials are considering funding a feasibility study to evaluate whether they should establish a county health department, the Centre Daily Times reports.

Stakeholder Events

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 from 10:00 a.m.–12:00 p.m. to participate:

Stakeholder Events Materials

On September 23 the Medical Assistance Advisory Committee (MAAC) met virtually.  Among the materials presented during that meeting were:

 

2021-10-01T20:33:49+00:00October 1st, 2021|Coronavirus, COVID-19, long-term care, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on PA Health Policy Update for the Week of September 27-October 1
Read More

PA Health Policy Update for the Week of September 20-24

The following is an update of selected state health policy developments in Pennsylvania for the week of September 20-24, 2021.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • House Republican leadership held a press conference on Monday to discuss their legislative agenda for the fall.  In addition to addressing the Wolf administration’s mask mandate for K-12 schools, they plan to work on legislation to address the opioid and addiction crises and COVID-19 regulatory waivers and flexibilities.  View the news conference here.
  • The House of Representatives sent House Bill 1861 to the Senate, where it was referred to the Health & Human Services Committee.  This bill will likely serve as the legislative vehicle for an extension of the health-related COVID-19 regulatory waivers and flexibilities set to expire on September 30, 2021.
  • The House of Representatives unanimously approved House Bill 1774, which amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP).  Specifically, the bill extends the sunset date to December 31, 2028 and grants the Department of Labor & Industry access to the prescription monitoring program.
  • Senate Bill 397 and Senate Bill 398 were reported as amended by the House Professional Licensure Committee on Monday.  These two bills would modernize Pennsylvania law on physician assistants and their oversight.
  • The House and Senate will be in session again next week on Monday (9/27), Tuesday (9/28), and Wednesday (9/29).  The following health care-related committee meetings have been scheduled:
    • The House State Government Committee will convene on Monday (9/27) to consider, among other bills, House Bill 1893, which amends the Disease Control and Prevention Act of 1955 to make disease information under this act subject to the Right-to-Know Law.  The committee also will consider Senate Bill 533, which prohibits certain regulatory and administrative actions during a disaster emergency.
    • The Senate Health & Human Services Committee will convene on Monday, September 27 at 12:00 p.m. to consider House Bill 1861 (COVID-19 regulatory waiver and flexibility extension); House Bill 1774 (Achieving Better Care by Monitoring All Prescriptions Program); Senate Bill 782 (payment for FDA-approved anti-obesity drugs); Senate Bill 815 (pelvic exam consent requirement); and Senate Bill 818 (allowable ambulatory surgical center procedures).

Department of Human Services

Department of Health

  • The Department of Health has updated its interim infection prevention and control recommendations for health care settings to add new options for fully vaccinated individuals working in facilities in counties with low to moderate rates of community transmission of COVID-19.
  • The Department of Health, Department of Drug and Alcohol Programs, and the Pennsylvania Commission on Crime and Delinquency have written to Pennsylvania hospital officials advising them on how they can secure a supply of Narcan to support hospital- and community-based naloxone distribution efforts to help in the fight against overdose-related deaths.  See their letter here.
  • Acting Secretary of Health Alison Beam has signed an order to ensure that vaccine providers are prepared to start COVID-19 booster shots as soon as the CDC issues federal guidance to do so.  The order requires vaccine providers, as possible, to provide online scheduling for vaccination appointments; provide a telephone number to assist with scheduling appointments; offer walk-in appointments; and work with local Area Agencies on Aging and Medicaid managed care plans to help schedule appointments for eligible adults and people who cannot leave their homes to get vaccinated.  Learn more from the Department of Health’s announcement about the order and the order itself.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week.  Today the number of Pennsylvanians who have contracted COVID-19 surpassed 1.4 million.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is 12.2 times greater this year than in 2020.  Between September 15 and September 21, 2020 there were a total of 650 COVID-19 cases in school-aged kids compared to 7,928 cases in the same age group during the same week in 2021.
  • According to Pennsylvania’s COVID-19 dashboard, only 41 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
  • The number of new COVID-19-related deaths also remains high.  Yesterday the number of Pennsylvanians who have died from COVID-19 rose past 29,000.
  • For the third consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
  • The number of Pennsylvanians hospitalized because of COVID-19 rose 13 percent in the past week and has risen 44 percent since the first of the month; the number on ventilators has risen 14 percent in the past week and 38 percent since the first of the month; and the number in hospital intensive care units has risen 12 percent in the past week and 37 percent since the beginning of September.
  • 68.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.1 million people – up from 67.5 percent last week.  10,000 Philadelphians and 74,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; some of the 74,000 were added to the ranks of the vaccinated as the result of a Department of Health adjustment of its vaccination data.

Around the State

  • “Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again,” reports Spotlight PA, which takes a closer look at some of the waivers that have been in place in Pennsylvania, what they do, and what the stakes might be if they are not renewed.
  • Emergency department volume at Children’s Hospital of Pittsburgh and Excel Health Frick Hospital has risen so much that the hospitals have erected tents to help them handle growing numbers of patients, according to the Pittsburgh Tribune-Review.
  • Mobile clinics operated by the organization Latino Connection are making a special effort to provide COVID-19 vaccines to Hispanic communities around the state, the Allentown Morning Call reports.
  • Black Doctors COVID-19 Consortium, a group launched to ensure access to COVID-19 vaccines for Philadelphia’s African-American community, will extend its scope of endeavor and open a primary care clinic to help address health disparities and inequities.  The Philadelphia Inquirer explains the group’s evolution.
  • “A new study from Penn State shows Pennsylvania could avoid billions of dollars in health damages by joining a regional cap and trade program targeting power plant emissions… The team at Penn State used four types of damage estimates to find that the commonwealth could reduce health impacts caused by power plant pollution by between $18 and 40 billion dollars over the next nine years by joining the Regional Greenhouse Gas Initiative (RGGI).”  StateImpact Pennsylvania explains.
  • Spotlight PA has posted an update on its reporting on what it calls the “…growing dementia care crisis in one of the nation’s most rapidly aging states…”  Read it here.
  • “Mental health agencies in Bucks, Dauphin, Carbon, Monroe and Pike counties are using new grant funding to test out a program designed to help people who live with serious mental illness and are at risk of ending up in jail.”  Learn more from this WITF story.
  • An EMS organization serving parts of Lancaster County is encountering funding problems – a situation found in other parts of the state as well, according to the Pennsylvania Capital-Star.

 

2021-09-24T20:29:14+00:00September 24th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 20-24
Read More

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

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

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.
2021-09-10T21:48:42+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 on PA Health Policy Update for the Week of September 6
Read More

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.

2021-08-20T21:33:37+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 on PA Health Policy Update for the Week of August 16-20
Read More

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:

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

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

 

 

 

 

2021-08-16T15:17:35+00:00August 16th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of August 2-6
Read More

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

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

Go to Top