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

The following is an update of selected state health policy developments in Pennsylvania for the week of March 21-25, 2022.  (Some of the language used below is taken directly from state documents.)

Hospital buildingGovernor Wolf

  • The Wolf Administration has announced how the state will spend $225 million in federal American Rescue Plan money appropriated through Act 2 of 2022 to support the health care workforce needs of hospitals and behavioral health providers.  The money will be used in the following manner:
  • $100 million to be distributed to acute care, critical access, and children’s hospitals licensed by the Department of Health on a per-bed basis.  The funding will be used strictly for recruitment and retention payments to direct care staff.
  • $110 million to be distributed on a per-bed basis to high-volume Medical Assistance hospitals, designated critical access hospitals, and inpatient and residential behavioral health facilities for recruitment and retention payments to key staff.  In addition to their proportional share of the $100 million pool noted above, all SNAP member hospitals will share in this $110 million distribution as well.
  • $15 million to quadruple the funds available for the nurse loan forgiveness program at Pennsylvania Higher Education Assistance Agency (PHEAA), a high-demand program that received more than 20,000 applications by the March 1 deadline.

Learn more about the $225 million appropriation and how it will be spent from this Wolf administration news release and this list of funding recipients.

  • The governor’s office has published its regulatory agenda for 2022.  The agenda, which is published semi-annually, is intended to provide the regulated community advance notice of regulations under development or consideration.  Find the full regulatory agenda here.

General Assembly

  • The state House and Senate will return to Harrisburg for session next week.  The House has scheduled a non-voting session day for Monday (3/28) and voting session for Tuesday (3/29) and Wednesday (3/30).  The Senate is scheduled to be in voting session Wednesday (3/30).
  • The House Health Committee will convene on Tuesday, March 29 to consider House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
  • The House Insurance Committee will meet on Tuesday, March 29 to consider, among other bills, House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.

Department of Health

The Department of Health has expanded the Pennsylvania physician general’s standing order that enables people to go to pharmacies to obtain a dose of naloxone to include a form of eight milligram naloxone nasal spray.  Members of the general public can print a copy of this standing order and present it at their local pharmacy to obtain naloxone.  Learn more from this news release.

The Department of Health has issued a news release to remind stakeholders that there is a 30-day comment period for the proposed skilled nursing facility regulations it published on March 19.  These proposed regulations include updates to align with federal regulations and expand the information that applicants for licensure must provide to operate a new facility or take ownership of an existing facility.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce the addition of two procedure codes, 87636 and 87637, to the Medical Assistance fee schedule for use in laboratory testing for multiple respiratory pathogens, including COVID-19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin informing Medical Assistance providers that it has added CPT codes 90619 for the administration of the MenQuadfi® vaccine and 90697 for the administration of the Vaxelis® vaccine to the Medical Assistance fee schedule effective for dates of service on and after June 1, 2021.  In addition, effective June 1, 2021 it has added MenQuadfi® and Vaxelis® to the list of vaccines available through the Department of Health’s Vaccines for Children Program.  Find that March 21 bulletin here.
  • DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  The revised handbook pages take effect on April 1.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include 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.  The revised handbook pages take effect on April 1  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has updated guidance on its outpatient competency evaluation program for the psychological assessment by OMHSAS providers of incarcerated individuals awaiting adjudication.  Learn more from this updated program memo and find a referral form and a rescind form that are part of the process described in the guidance.
  • DHS has updated its list of drug companies that participate in the state’s Medicaid drug rebate program.  Find the revised list here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall in Pennsylvania.  A week ago the state’s seven-day average of new cases was 750 cases a day; today (March 25) it is 625 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 32 deaths a day a week ago but is 23 deaths a day today (March 25).
  • The decline in the number of Pennsylvania counties experiencing higher rates of community transmission of COVID-19 continues.  For the second consecutive week, no counties are experiencing a high rate of community transmission.  Last week, 21 counties were experiencing a substantial rate of community transmission; this week, just eight are.  For the first time since the fall, some Pennsylvania counties – four of them (Forest, Snyder, Sullivan, and Cameron) – are experiencing a low rate of community transmission.  The rest of the state – 55 counties – is experiencing a moderate rate of community transmission.
  • The number of Pennsylvanians hospitalized with COVID-19 has fallen 60 percent since March 1; the number in hospital ICUs because of the virus has fallen 63 percent since the beginning of the month; and the number being treated for the virus on a ventilator has fallen 69 percent since the first of the month and is at its lowest level since last July 29.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has created an informational flyer, suitable for posting in public places, with resources for individuals and their loved ones with substance use disorder, including QR code links to find treatment, order naloxone, and obtain educational materials.

Stakeholder Events

Department of Health – Advisory Health Board – March 31

The Department of Health’s Advisory Health Board will meet virtually on Thursday, March 31 at 10.00 a.m. to discuss programmatic and departmental activities.  This meeting was a previously scheduled for March 16.  For information about how to participate, see this Pennsylvania Bulletin notice, which has the original, superseded meeting date but still has the latest information on how to participate in the meeting.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy, and Critical Congenital Heart Defects subcommittees.  Learn how to join the meeting in this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues.  To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m.  Public comments will be taken after each presentation.  Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation.  There will be an additional period at the end of the meeting for additional public comments.  Go here to register to participate.

Pennsylvania Long-Term Care Learning Network – Strategies to Reduce Hospitalizations and Emergency Room Visits – April 7

The Pennsylvania Long-Term Care Learning Network, part of DHS’s Quality Strategy for Nursing
Facilities, is holding a virtual webinar “Strategies to Reduce Hospitalizations and Emergency Room Visits” on Thursday, April 7 at 2:00 p.m.  Go here to register to participate.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

 

2022-03-25T20:01:47+00:00March 25th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of March 21-25
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PA Health Policy Update for the Week of March 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of March 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The Department of Human Services appeared before the Senate and the House appropriations committees this week.  A recording of the House budget hearing can be viewed here and a recording of the Senate hearing can be viewed here.
  • The Department of Health also appeared before the Senate Appropriations Committee for its FY 2023 budget hearing.  A recording of the hearing can be viewed here.
  • The Department of Drug and Alcohol Programs will appear before the Senate Appropriations Committee next Wednesday, March 16 at 2:00 p.m.

Department of Health

In light of the Pennsylvania Department of Environmental Protection’s confirmation of higher-than-expected rates of Powassan virus in ticks located in multiple Pennsylvania counties during the 2021 surveillance season, the Department of Health has issued a health advisory to give providers background information on POW virus disease, including transmission, clinical signs and symptoms, diagnosis, and prevention.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to inform providers enrolled in the Medical Assistance program that the state is expanding the beneficiary age for which Medical Assistance payment will be made for the administration of the Flucelvax Quadrivalent vaccine to include beneficiaries ages six months and older effective October 14, 2021.

The Department of Human Services has posted presentations delivered during the February 24 Medical Assistance Advisory Committee meeting by its:

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall.  A week ago the state’s seven-day average of new cases was 1299 cases a day; yesterday (March 10) it was 954 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 65 deaths a day a week ago but was 40 deaths a day yesterday (March 10).
  • The decline in the number of Pennsylvania counties experiencing a substantial rate of community transmission of COVID-19 – the highest rate – continues.  Last week, 38 counties were in the highest rate of community transmission of COVID-19 cases; this week, only seven are.  Last week, 26 counties were experiencing a substantial rate of community transmission; this week, 37 are.  Last week, only three counties were experiencing only a moderate rate of community transmission; this week, 23 are.
  • March 9 was the first day fewer than 1000 Pennsylvanians were hospitalized with COVID-19 since August 12; March 11 was the first day fewer than 100 were on ventilators because of the virus since August 5; and March 7 was the first day fewer than 200 were in hospital ICUs because of COVID-19 since August 5.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released the new report “COVID-19 Hospitalizations ‒ March 2020 to June 2021.”  The paper looks at patients who were hospitalized with COVID-19 and discharged from Pennsylvania acute-care hospitals from March 2020 through June 2021.  It examines hospitalization rates and in-hospital mortality by month and for the entire period.  Go here for links to the news release announcing the report, key findings, county rates, patient characteristics and outcomes, and the report itself.

Stakeholder Events

Department of Health – Advisory Health Board – March 16

The Department of Health’s Advisory Health Board will meet virtually on Wednesday, March 16 at 2:00 p.m. to discuss programmatic and departmental activities.  For information about how to participate, see this Pennsylvania Bulletin notice.

Patient Safety Authority – March 17

The Patient Safety Authority will hold a virtual public meeting on Thursday, March 17 at 1:00 p.m.  Learn how to join the meeting from this Pennsylvania Bulletin notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees.  Learn how to join the meeting in this Pennsylvania Bulletin notice.

2022-03-11T22:00:40+00:00March 11th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of March 7-11
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PA Health Policy Update for the Week of February 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of February 25, 2022.  (Some of the language used below is taken directly from state documents.)

Pennsylvania State MapGeneral Assembly

The state House Appropriations Committee continued its FY 2023 budget hearings this week and the Senate Appropriations Committee began its hearings this week.  Hearings will conclude March 17.  A complete schedule of the hearings can be found here.

The Department of Health and Department of Drug and Alcohol Programs are scheduled to appear before the House Appropriations Committee next Thursday, March 3 at 10:00 a.m.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to inform Medical Assistance providers about updates related to billing and payment for the administration of monoclonal antibody therapies for the treatment of COVID-19.  This bulletin applies to all physicians, certified registered nurse practitioners, certified nurse midwives, outpatient hospital clinics, home health agencies, independent medical surgical clinics, pharmacies, and renal dialysis centers enrolled in the Medicaid program who are authorized to administer monoclonal antibody therapies to Medicaid beneficiaries in the Medicaid fee-for-service delivery system.  Providers rendering services in the Medicaid managed care delivery system should address any coding and billing questions to the appropriate managed care organization.  Learn more from this Medical Assistance Bulletin.

The Department of Human Services has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that it is implementing an alternative payment methodology to pay the Medical Assistance program fee schedule rate for the administration of COVID-19 vaccines during COVID-19 vaccine-only visit for dates of service on and after December 1, 2020 and that it will pay the enhanced Medicaid program fee schedule rate for the administration of those vaccines to homebound Medicaid beneficiaries during vaccine-only visits for dates of service on and after April 1, 2021.  Find the bulletin here.

Department of Health

Ninety-five percent of all Pennsylvanians ages 18 and older have had at least one COVID-19 vaccination and 76.2 percent ages 18 and older are now fully vaccinated, the Department of Health reports.

The Department of Health has updated its guidance on when people should receive COVID-19 vaccines and the appropriate intervals between primary doses and between primary doses and boosters.  The update is based on recent CDC guidance.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced more than $15 million in grant funding for stabilization payments to substance use disorder treatment providers to assist with pandemic-related expenses.  Through 108 grant agreements, 375 substance use disorder treatment provider locations will receive funding.  All eligible applicants that applied were awarded funding.  Learn more about the purpose of the funding and find a link to a list of organizations awarded grants in this department news release.

The Department of Drug and Alcohol Programs has posted a new FAQ for providers that combines questions from previous American Society of Addiction Medicine (ASAM) level-of-care-specific FAQ documents along with questions received through the ASAM Transition email account and technical assistance meetings with providers and stakeholders.  Find the new FAQ here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 24) was 2294 cases day; a week ago (February 17) its seven-day average was 3159 cases a day.
  • The number of new COVID-19-related deaths also declined again over the past week.  Pennsylvania’s seven-day average yesterday (February 24) was 65 deaths a day; a week ago (February 10) its seven-day average was 83 deaths a day.
  • The Department of Health reports that the percentage of available adult ICU beds fell from 22 percent to 19.6 percent during the past week and the percentage of available pediatric ICU beds fell from 8.5 percent to 7.7 percent over the same period of time, leaving just 30 unoccupied pediatric ICU beds in the state.
  • The Department of Health also reports that approximately 9.9 percent of all staffed adult ICU beds in the state are occupied by COVID-19 patients this week, down from 12.7 percent last week, and that 25.8 percent of all ventilators in the state are currently in use, down from 26.6 percent last week.
  • For the first time in recent months, all 67 Pennsylvania counties are not experiencing high rates of COVID-19 transmission:  Sullivan County is experiencing a moderate rate of community transmission and Carbon, Delaware, Dauphin, Lehigh, Monroe, and Snyder counties are “only” experiencing substantial rates of community transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 65 percent decline since February 1 in the number of Pennsylvanians hospitalized with the virus and a 28 percent decline over the past week.  The number of people on ventilators has fallen 60 percent since the first of the month and 23 percent in the past week and the number in ICUs has fallen 63 percent since the first of February and 30 percent over the past seven days.

Stakeholder Events

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

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

Centers for Medicare & Medicaid Services – RFI on Medicaid and CHIP – March 1

On February 17, CMS published a request for information on access to care and coverage for people enrolled in Medicaid and CHIP.  On Tuesday, March 1 at 3:30 p.m. (eastern) the agency will hold a webinar discuss with stakeholders its objectives in issuing the RFI and the process for submitting responses.  Go here to register to participate.

Department of Health – Advisory Health Board – March 16

The Department of Health’s Advisory Health Board will meet virtually on Wednesday, March 16 at 2:00 p.m. to discuss programmatic and departmental activities.  For information about how to participate, see this Pennsylvania Bulletin notice.

2022-02-25T21:28:43+00:00February 25th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 21-25
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PA Health Policy Update for the Week of February 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of February 14-18, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

House Chamber of the State HouseThe state House Appropriations Committee began its FY 2023 budget hearings this week.  The Senate Appropriations Committee will begin hearings next week.  Hearings will conclude on March 17.  A complete schedule of the hearings can be found here.  The following is a selection of health-related budget hearings.

  • Department of Health/Department of Drug and Alcohol Programs (House Appropriations Committee) – Thursday, March 3 at 10:00 a.m.
  • Department of Human Services (Senate Appropriations Committee) – Tuesday, March 8 at 10:00 a.m.
  • Department of Health (Senate Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.
  • Department of Human Services (House Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.
  • Department of Drug and Alcohol Programs (Senate Appropriations Committee) – Wednesday, March 16 at 2:30 p.m.

Department of Human Services

Department of Health

  • Two additional state-directed health care strike teams and another long-term care regional support team are providing requested assistance for hospitals and skilled nursing facilities caring for patients with COVID-19.  Clinical staff are supporting staff at Geisinger Wyoming Valley and Lehigh Valley Hospital – Cedar Crest.  These teams are on a two-week deployment and vary in size and scope based on the daily needs of the facilities and include registered nurses and respiratory therapists provided through a staffing firm.  Another team is working with the Pleasant Valley Manor nursing home in Monroe County, providing clinical and non-clinical support staff to allow for more rapid discharge of patients from area hospitals and freeing additional acute-care space to meet COVID-19 demands.  Supplemental staff includes RNs, LPNs, and CNAs; Pennsylvania National Guard is providing non-clinical staffing to support the facility’s existing staff and the Pennsylvania Emergency Management Agency is assisting with coordination.  Learn more from this Department of Health news release.
  • The Department of Health (DOH) has updated its information about state-sponsored COVID-19 testing sites throughout Pennsylvania, including new sites in McKean, Susquehanna, Washington, and York counties.  Go here for information about locations and hours and for a link to a map with other testing sites across the state.
  • DOH has issued an alert providing guidance to long-term-care facilities on response to exposure and outbreaks of COVID-19.  This guidance incorporates recent changes made by the CDC.
  • DOH has issued guidance on core infection prevention and control measures for long-term-care facilities during the COVID-19 pandemic and incorporates recent updates made by the CDC.  This guidance also supplements previous guidance issued by DOH.
  • DOH has reminded long-term-care facilities that they can order the oral antiviral treatments molnupiravir and Paxlovid from the strategic reserve specifically for residents of those facilities and other congregate settings and has updated an FAQ about the program.
  • DOH has published a health alert about a significant increase in the number of cases of syphilis in Pennsylvania in 2021 and offering testing and treatment recommendations for providers.  Find the alert here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 17) was 3159 cases day; a week ago (February 10) its seven-day average was 5163 cases a day.
  • The number of new COVID-19-related deaths also remains high but declined again over the past week.  Pennsylvania’s seven-day average yesterday (February 17) was 83 deaths a day; a week ago (February 10) its seven-day average was 109 deaths a day.
  • The Department of Health reports that the percentage of available adult ICU beds fell from 23.6 percent to 22 percent during the past week and the percentage of available pediatric ICU beds fell from 14 percent 8.5 percent over the same period of time, leaving just 33 unoccupied pediatric ICU beds in the state.
  • The Department of Health also reports that approximately 12.7 percent of all staffed adult ICU beds in the state are occupied by COVID-19 patients this week, down from 17.3 percent last week, and that 26.6 percent of all ventilators in the state are currently in use, down from 27.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 53 percent decline since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 49 percent since the first of the month and the number in ICUs has fallen 48 percent over that same period.

Around the State

As the number of COVID-19 cases, hospitalizations, and deaths continues to decline across Pennsylvania, newspapers are reporting on changes in their own coverage areas.  Among them:

Insurance Department

Jessica Altman has resigned as commissioner of the Pennsylvania Insurance Department; her last day on the job will be February 25.  Current department chief of staff Mike Humphreys will serve as acting commissioner.  Learn more from this Wolf administration news release.

Pennsylvania Higher Education Assistance Agency (PHEAA)

PHEAA’s PA Student Loan Relief for Nurses Program makes available to qualified applicants student loan relief of up to $2,500 for each year of work (beginning with 2020) for no more than three years, with a maximum benefit of $7,500.  To learn more about eligibility, benefits, and how to apply, go here.  Applications are due March 1.

Stakeholder Events

Medical Assistance Advisory Committee Consumer Subcommittee – February 23

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, February 23 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – February 24

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 24 at 10:00 a.m.  Go here to register to participate.  Find the meeting agenda here.

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

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

2022-02-18T22:01:36+00:00February 18th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 14-18
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PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023.  Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds.  Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds.  Proposed spending increases include:

  • rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
  • increased Supplemental Nutrition Assistance Program benefits
  • increased supplemental payments to personal care homes
  • increased county mental health funding
  • reducing the waiting list for intellectual disability services
  • expanding court-appointed child special advocates
  • expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced.  The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate.  Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease.  It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate.  Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies.  A press release issued by the governor’s office can be viewed here.

General Assembly

  • The state House and Senate convened for voting session this week.  The following is a selection of health-related bills that received consideration.
    • House Bill 1440 passed on third and final consideration by a vote of 132 to 67.  This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals.  It will now be sent to the Senate.
    • House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66.  The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.
  • The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
  • The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
  • The House Appropriations Committee will begin budget hearings next Tuesday, February 15.  The Senate Appropriations Committee will begin budget hearings the following week, on February 22.  The hearing schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program.  The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system.  Find the bulletin here.
  • DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19.  Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action.  Such comments are due within 30 days.
  • DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting.  Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic.  The update reflects a recent revision in the CDC’s guidance.  Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state.  Learn more in this DOH news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
  • To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
  • The number of new COVID-19-related deaths also remains very high but declined slightly over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
  • To date, more than 42,000 Pennsylvanians have died from COVID-19.
  • The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
  • The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

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

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

 

2022-02-11T21:54:18+00:00February 11th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 7-11
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PA Health Policy Update for the Week of January 24-28

The following is an update of selected state health policy developments in Pennsylvania for the week of January 24-28, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The General Assembly enacted House Bill 253 (Act 2), providing $225 million in federal American Rescue Plan funding to support health care professionals on the frontlines of the COVID-19 pandemic in hospitals and behavioral health care facilities.  The breakdown of the funding is as follows:
    • $100 million for one-time payments to hospitals for making retention and recruitment payments to qualified staff.
    • $110 million for one-time payments to behavioral health providers, critical access hospitals, and high Medical Assistance hospitals for making retention and recruitment payments to qualified staff.
    • $15 million to be used by the Pennsylvania Higher Education Assistance Agency (PHEAA) to fund the Pennsylvania Student Loan Relief for Nurses Program.

A press release issued by Republican leaders of the General Assembly that quotes several health systems can be found here.  A press released issued by Governor Wolf can be found here.

  • The Senate passed Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.  The bill was received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee.
  • The Senate Health and Human Services Committee convened this week and favorably reported the following bills.
    • Senate Bill 152, which provides direction to the Department of Human Services on how to distribute funding intended for women’s health and family planning services.
    • Senate Bill 956, a constitutional amendment that clarifies that there is not a right to an abortion or abortion funding in the state constitution.
    • House Bill 1420, which directs the Department of Human Services to establish a public awareness campaign to provide information about the programs and services available for first responders, health care workers, and other frontline workers suffering from mental health issues related to the COVID-19 pandemic.
  • The Senate Aging and Youth Committee favorably reported the following bills this week.
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances.
    • House Bill 996, which requires the departments of Human Services and Health to establish protocols to permit residents of long-term-care facilities to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.
  • The House Professional Licensure Committee convened and favorably reported the following bills this week.
    • House Bill 19, which establishes professional licensure for behavioral analysts.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 1862, which preserves the COVID-19 regulatory waiver that authorizes physicians with an institutional license in a teaching hospital to serve patients at more than just two facilities in a health system.

Department of Human Services

  • The Department of Human Services (DHS) has mailed letters to hospitals potentially eligible for FY 2021-22 OB/NICU DSH payments requesting verification of their current licensure status.  Courtesy electronic notification also was sent to contacts on file on January 26.  To verify that they meet the criteria for inclusion in the payment program, hospitals must sign and return the attestation form to RA-pwdshpymt@pa.gov by Friday, 2/25/22.  Any Pennsylvania hospitals that are currently licensed to provide obstetric or neonatal services and did not receive a notification should contact DHS at RA-pwdshpymt@pa.gov.
  • DHS has issued a Medical Assistance Bulletin to inform pharmacies of the addition of procedure code S5001 to the Medical Assistance Program fee schedule for dispensing oral antiviral treatments with FDA emergency use authorization for the treatment of COVID-19
    and providing instructions for pharmacies on how to submit claims for dispensing these treatments.  Learn more in this Medical Assistance Bulletin.
  • DHS has announced that it will add Aduhelm (aducanumab) and complement inhibitors to the Medical Assistance Program’s list of services and items requiring prior authorization.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report.”  The new report includes the first look at October 2021 Medicaid managed care enrollment data.

Department of Health

  • The Department of Health (DOH) has posted a notice on its message board that it will provide direct access to COVID-19 therapeutics to residents of long-term-care facilities. With the recent approval of oral antiviral medications for COVID-19 (Pfizer’s Paxlovid and Merck’s molnupiravir), DOH is holding product in strategic reserve for residents of long-term-care facilities and others in congregate care settings.  Paxlovid and molnupiravir are authorized for use in individuals who test positive for COVID-19 and are at high-risk for severe disease progression.  Upon receipt of a request for medication, supply permitting, DOH will ship the product the same day or the next day to the requesting facility.  Due to the nature of the medications, this product is only appropriate for residents within five days of the onset of symptoms.  Go here to request these oral antiviral medications from DOH.
  • DOH has issued an update of its recommendations for return to work for health care workers with confirmed or suspected COVID-19.
  • DOH has updated its guidance on work restrictions for health care workers who have been exposed to COVID-19.
  • DOH has announced changes to hospitalization data reporting on its Corvena platform to align with federal reporting requirements.  The new data fields must be completed beginning February 2 and daily thereafter.  Click here to download a Word file announcing these changes and download the Corvena data dictionary here (Excel).
  • DOH has deployed the first state-directed health care strike team to Grand View Health in Bucks County.  The team includes 10 registered nurses provided through GHR Healthcare under a contract with the Department of Health.  Learn more about the strike team concept and how it works and what this group will do at Grand View Health in this Department of Health news release.
  • DOH has introduced two new resources to help skilled nursing facilities encourage their residents and staff to receive COVID-19 vaccines and boosters:  a document on best practices and a vaccine and booster fact sheet.
  • DOH has adopted the new federal CDC standard for blood lead reference value (BLRV) from 5 μg/dL to 3.5 μg/dL.  The department explains why it adopted this new standard and what it means in this health advisory notice.

COVID-19:  By the Numbers

Stakeholder Events

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m.  The purpose of this 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 acting secretary on matters relating to the administration of this fund.  Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                      Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

Traumatic Brain Injury Advisory Board – February 4

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, February 4 at 10:00 a.m.  For information about the board, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

2022-01-28T22:39:08+00:00January 28th, 2022|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, 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 January 24-28
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PA Health Policy Update for the Week of January 10-14

The following is an update of selected state health policy developments in Pennsylvania for the week of January 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has announced the creation of the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment program, or LTC RISE, which seeks to give long-term-care facilities “…the support they need to battle COVID-19, recover, and rebuild.”  Under the program, long-term-care facilities can pursue improvement projects in the areas of infection prevention and control and emergency preparedness; building a sustainable outbreak response operation; and promoting professional development and a resilient long-term-care facility workforce.  The program is funded by a federal grant and replaces the state’s Regional Congregate Care Assistance Teams program, which expired at the end of 2021.  Learn more about LTC RISE from this Wolf administration news release and from the LTC RISE web page.

General Assembly

  • The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act.  This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.  The bill was received in the Senate and referred to the Health and Human Services Committee.
  • The House Health Committee convened on Tuesday, January 11 and favorably reported 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 reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
  • The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m.  The hearing will take place at the University of Pittsburgh at Bradford.
  • The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
  • The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
  •  The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

  • Various Department of Human Services (DHS) regulations were suspended to facilitate the state’s response to the COVID-19 pandemic.  Some of those suspensions have been lifted, so some of the temporarily suspended regulations are being enforced again.  For an updated list of regulations and their current status, organized by offices within DHS and with the most recent changes highlighted, go here.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of booster doses of COVID-19 vaccines.  To find those new codes and the rates to be paid, see this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of the Pfizer pediatric COVID-19 vaccine.  Find the procedure codes, rates, and more in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin informing providers of changes in billing procedures for certified registered nurse practitioners and physician assistants serving fee-for-service patients.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that the fee-for-service program will require prior authorization for prescribing Aduhelm (aducanumab), the new drug to treat Alzheimer’s disease.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that it has issued updated handbook pages presenting the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Xyrem (sodium oxybate)/Xywav (calcium, magnesium, potassium, and sodium oxybates) for fee-for-service patients.  Find the notice here.
  • DHS announced that it intends to continue making Medical Assistance Day One Incentive payments to qualified non-public nursing facilities in FY 2022.   These payments seek to give incentives to non-public nursing facilities to serve individuals who are Medical Assistance-eligible on the day of admission.  Learn more about how and when the payments will be made and how they will be calculated in this Pennsylvania Bulletin notice.
  • DHS is making available for public review and comment its proposed renewal application for extension of the Section 1115 Medicaid demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration.”  The effective dates of the current approved demonstration are October 1, 2017 through September 30, 2022.  The extension requested will be for an additional five years, through September 30, 2027.  Learn more about the program and the state’s planned request from this Pennsylvania Bulletin notice.
  • DHS’s Office of Child Development and Early Learning has updated its FAQ on its guidance for tuberculin skin testing and COVID-19 vaccinations for providers participating in its licensed programs.  Find that FAQ here.

Department of Health

In the past week the Department of Health announced the opening of a new COVID-19 testing site in Cambria County to go along with other recently opened testing sites in Berks, Blair, Centre, Clinton, Delaware, Luzerne and Mifflin counties.  In addition, the state has announced that a new high-volume and high-throughput COVID-19 testing site will be opening soon in Delaware County at Mercy Fitzgerald Hospital.  This site will be staffed by U.S. Department of Health and Human Services contractors with additional support from the host location, the costs for which will be eligible for reimbursement by FEMA.  The Department of Health continues to talk to federal officials about the possibility of opening an additional high-volume testing site in the south-central part of the state.

The Department of Health has announced that Credentia will serve as its new contractor to operate the Pennsylvania nurse aide registry previously operated by Pearson Vue.  Go here for the nurse aide registry search.  The Pearson Vue link no longer works as of January 3.

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

The Pennsylvania Rural Health Redesign Center Authority Board will hold its next virtual meeting on Tuesday, January 18 at 10:00 a.m.  The meeting will provide updates on a variety of topics, including model status updates, federal grant deliverables, global budget methodology, and more.  It also will address current and upcoming activities.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Infant Hearing Screening Advisory Committee – January 20

The Infant Hearing Screening Advisory Committee will hold a public meeting both in person and virtually on Thursday, January 20 at 1:00 p.m.  Agenda items will include reports by the cytomegalovirus and audiology subcommittees, an assessment of audiology training currently in development, and a review of upcoming program activities.  For information about how to join the meeting, either virtually or in person, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m.  Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m.  This meeting will be broadcast live through Commonwealth Media Services.  Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see 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 at 10 a.m.  To participate, call 412-648-8888 or 866-588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                     Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

 

2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, 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 policy|Comments Off on PA Health Policy Update for the Week of January 10-14
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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
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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
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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
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  • 2020 Safety-Net Association of Pennsylvania

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