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PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21
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PA Health Policy Update for Friday, October 14

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

The Wolf Administration

Governor Wolf has announced that Pennsylvania is proposing to enter a new profit-sharing agreement with its Medical Assistance physical health managed care organizations.  Under the proposed agreement, the physical health managed care organizations would be limited to three percent profits annually with the requirement to invest additional profits in approved projects and initiatives that directly benefit the health and well-being of Pennsylvanians.  The agreement would take effect for the 2023 contract year.  Learn more about the proposal from this Wolf administration news release.

General Assembly

The state Senate will return to session next week.  Monday, October 17 is a non-voting session day. Tuesday, October 18 and Wednesday, October 19 are voting session days.  The state House will continue to be in recess next week.

The Senate Health & Human Services Committee will convene on Tuesday, October 18 to consider the following bills.

  • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services (DHS) uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
  • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to an additional ten months.
  • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
  • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification. Legislative text is not currently available.
  • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
  • House Bill 1443 permits certain diagnostic laboratory services to be marketed directly to Pennsylvania consumers.
  • House Bill 1630 grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
  • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
  • House Bill 2530 ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs.

Department of Human Services

  • The Department of Human Services (DHS) has posted information for providers about an electronic submission process that will soon be available in the PROMISe portal for fee-for-service 180-day exception requests and other claims requiring documentation.  Find DHS notice here.
  • Effective October 1, Pennsylvania has increased the income threshold for applicants for the Supplemental Nutrition Assistance Program (SNAP) to 200 percent of federal poverty income guidelines.  This will make more than 420,000 Pennsylvanians and more than 174,000 households newly eligible for SNAP and an average of $63 a month to help pay for groceries.  For additional information about these changes and where to direct individuals to apply for them, see this DHS news release.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has released “Pennsylvania Behavioral Health Telehealth Phase II Roadmap,” which offers and prioritizes recommendations for short-term and long-term implementation of telehealth services in the state.

Centers for Medicare & Medicaid Services

The federal Centers for Medicare & Medicaid Services (CMS) has approved Pennsylvania’s request for a statewide waiver to extend the October 6, 2022 deadline for temporary nurse aides (TNAs) to gain certification to April 5, 2023 or until the end of the COVID-19 public health emergency (whichever comes first).  This statewide approval applies to all nursing care facilities in Pennsylvania, so individual facilities do not need to request a waiver.  For information about how temporary TNAs can pursue certification, see this notice.

To evaluate Medicaid and the Children’s Health Insurance Program (CHIP) coverage for children, states report data to CMS about program eligibility, enrollment, operations, expenditures, program goals, and more.  CMS has published CHIP data submitted to it by Pennsylvania for FY 2021.  Find that data here.

Department of Health

The Department of Health has issued a health alert giving providers interim guidance on risk assessment and management of patients who may have been exposed to the Ebola virus.  It issued this guidance after a case of Ebola was recently diagnosed in Uganda but notes that no reported or confirmed cases have been found in the U.S.  Learn more from this health advisory.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 18 percent from the previous week (which was 20 percent less than the week before that) and the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent decrease in the seven-day rolling average of new daily COVID-19 hospital admissions (after a seven point increase the previous week).
  • Sixty-two of Pennsylvania’s 67 counties are experiencing a high rate of community transmission of COVID-19.  The remaining five counties – Adams, Centre, Lebanon, Philadelphia, and Snyder – are experiencing moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) announced that the 2022 open enrollment period is under way for licensed substance use disorder treatment providers in Pennsylvania to submit their information to be included in the Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS).  Treatment facilities currently not enrolled in ATLAS may submit their information during this open enrollment period through December 30, 2022.  In addition, current enrollees may update facility information during this period.  For additional information, see this DDAP news release.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released its state ambulatory surgery center financial analysis for 2021.  Its report shows that the average total margin for ambulatory surgery centers increased 1.61 percentage points, from 23.36 percent in fiscal year 2020 to 24.97 percent in FY 2021.  The average statewide operating margin for ambulatory surgery centers increased 1.58 percentage points, from 22.29 percent in FY 2020 to 23.87 percent, in FY 2021.  Learn more from this PHC4 news release and the PHC4 report “Financial Analysis 2021:  Ambulatory Surgery Centers.”  Go here for downloadable data in Excel format (this link opens to a download).

Stakeholder Events

Department of Health – Special Supplemental Nutrition Program for Women, Infants and Children Advisory Committee – October 18

The Department of Health’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory Committee will meet virtually on October 18 at 1:00 to elect officers and discuss future suggestions and next steps for the committee.  For information about participating in the meeting and obtaining an agenda, see this Pennsylvania Bulletin notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Renal Disease Advisory Committee – October 21

The Department of Health’s Renal Disease Advisory Committee will hold its quarterly meeting in person and virtually on Friday, October 21 at 10:00.  For information about participating in the meeting, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

2022-10-14T19:19:31+00:00October 14th, 2022|COVID-19, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, October 14
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PA Health Policy Update for Friday, October 7

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

Behavioral Health Commission for Adult Behavioral Health

The Wolf administration has released the recommendations of its Behavioral Health Commission for Adult Behavioral Health, which was created to advise the General Assembly on how to spend $100 million in one-time federal American Rescue Plan Act funding, including to support adult behavioral health needs addressed in the state’s 2022-2023 fiscal code.  The commission recommended that the $100 million be used in the following manner:

  • $37 million to stabilize, strengthen, and expand the workforce
  • $23.5 million to improve the criminal justice and public safety systems
  • $39 million to expand capacity for services and supports
  • $500,000 for a future study of the impact of this spending

The commission’s recommendations are only advisory; the General Assembly will consider its recommendations in the coming weeks and decide if and how to appropriate the $100 million.

Find a Wolf administration news release about the report here and the report itself here.

Department of Human Services

The Department of Human Services has announced its intent to allocate funds for FY 2023 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Medical Assistance program and to provide financial relief to hospitals during the COVID-19 pandemic.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  Learn more from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its interim infection prevention and control recommendations for health care settings to reflect recent changes in federal CDC recommendations.
  • DOH  has shared information on severe manifestations of monkeypox among patients who are immunocompromised due to HIV or other conditions.  This is the same alert issued last week by the CDC.
  • DOH has added to its naloxone standing orders that enable residents and first responders to obtain naloxone products to help combat the rise of overdoses in Pennsylvania a non-prefilled syringe with two single-dose vials of liquid naloxone that is injectable.  Residents can present a copy of the state’s standing order, which can be found here, at their local pharmacy to obtain the naloxone.  The medication also is available for free for personal use through a statewide mail-based naloxone program.
  • DOH has issued an advisory about lead exposure in adults.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 20 percent from the previous week and the number of deaths fell 10 percent.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a seven percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • For the first time in several months, all, or almost all, of Pennsylvania’s 67 counties are not experiencing a high rate of community transmission.  Currently, 60 counties are still experiencing a high rate of community transmission while six counties – Forest, Centre, Lycoming, Union, Snyder, and Delaware – are experiencing “only” a substantial rate of community transmission and Philadelphia’s rate is now classified as moderate.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 26,385 confirmed cases of monkeypox in the U.S. as of October 6, up only slightly from 25,613 cases on September 29.  789 of those cases were in Pennsylvania, up from 713 a week ago.
  • As of October 3, 495 of those Pennsylvania monkeypox cases were in Philadelphia, up from 475 on September 25.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued the research brief “Hospitalizations for Opioid Overdose, 2016 – 2021” that looks at trends among state residents, ages 15 and older, who have been admitted to Pennsylvania acute-care hospitals for opioid overdoses.  Find a news release about the report here and the report itself here.

Centers for Medicare & Medicaid Services

CMS’s Center for Medicare and Medicaid Innovation has released materials presenting its evaluation of year two of the Pennsylvania Rural Health Model, which seeks to improve access to hospital services and improve population health in underserved rural communities.  New evaluation materials include a summary of the evaluation of the program’s second year; the full report; the report’s executive summary; and an appendix to the report.  Learn more about the Pennsylvania Rural Health Model, including a list of its participating hospitals, from the program’s web page.

Stakeholder Events

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

2022-10-07T21:24:30+00:00October 7th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for Friday, October 7
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PA Health Policy Update for Friday, September 30

The following is an update of selected state health policy developments in Pennsylvania for the week of September 26-30, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that it has added CPT codes for administering COVID-19 pediatric boosters.  The new codes can be used immediately.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to advise providers of the addition of procedure codes to the Medical Assistance fee schedule for the provision of private duty nursing services, which are provided through home health agencies to beneficiaries under 21 years of age.  The additions take effect on October 1.  Find that bulletin here.
  • DHS’s Office of Long-Term Living has launched its American Rescue Plan Act of 2021 funding reporting portal.  The online portal will be available beginning on September 30, 2022 for Office of Long-Term Living providers to submit costs associated with American Rescue Plan funding distributed in 2021, as required by the state.  Learn more from this announcement of the portal’s launch and from DHS’s guide on to how to use the portal.
  • DHS has updated its data on physical health HealthChoices enrollment and participation in the Medical Assistance Transportation Program.  Find the update here.

Department of Health

  • The Department of Health (DOH) has issued new guidance for health care providers and their employees who have been exposed to or contracted COVID-19.  The first addresses the return to work for health care workers with confirmed or suspected cases of COVID-19 and the second describes work restrictions for health care workers who have been exposed to COVID-19.  Both are introduced to align state standards with recently revised guidance from the federal Centers for Disease Control and Prevention.
  • DOH has updated its definition of how it defines whether individuals are up to date on their COVID-19 vaccinations.  Go here to see the updated definition and learn about the department’s rationale for this change.
  • DOH has issued a health alert to notify providers, laboratories, infection control specialists, and local health departments about an unvaccinated adult with poliovirus infection and acute flaccid paralysis.  Wastewater testing in treatment facilities in Rockland County, New York, which is adjacent to Pennsylvania, and surrounding counties also identified related poliovirus, indicating that the virus is circulating in the community and others may become ill.  DOH urges providers to consider polio as a possible cause of sudden onset of limb, facial, oropharyngeal, or respiratory muscle weakness; to contact their local or state health department to discuss such cases; and to encourage any unvaccinated patients to receive polio vaccines.  Learn more from this health alert.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of 10-20 percent.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 191 admissions a day over the past week, a slight reduction from the previous week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Snyder County is currently experiencing “only” a substantial rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued Licensing Alert 02-22 to inform drug treatment programs about the process for establishing mobile narcotic treatment programs.  Find the alert here.

Insurance Department

The state Insurance Department has released Pennsylvania’s 2023 individual and small group Affordable Care Act health insurance rates.  The release also shares changes in the number of insurers offering coverage to Pennsylvanians and offers information about federal rate subsidies.  Learn about the newly released information and find a link to the rates and insurers themselves in this Insurance Department news release.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 25,613 confirmed cases of monkeypox in the U.S. as of September 29, up only slightly from 23,364 cases on September 21.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 25, 475 of those Pennsylvania monkeypox cases were in Philadelphia, up from 446 on September 18.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Stakeholder Events

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

2022-09-30T21:16:03+00:00September 30th, 2022|COVID-19, HealthChoices, long-term care, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for Friday, September 30
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PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for voting session this week.  The following is an overview of certain health-related legislative activity.

  • The House of Representatives unanimously passed House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.  The bill was received in the Senate and referred to the Aging & Youth Committee.
  • The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
  • The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania.  A recording of the hearing and witness testimony may be viewed here.
  • The Senate Banking & Insurance Committee favorably reported Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
  • The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

  • The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
  • The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
  • The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
  • DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered.  This policy took effect on September 20.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix.  The update took effect on September 19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax.  The update is effective as of July 13.  Find that bulletin here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2.  Find that notice here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1.  Find that notice here.
  • DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the state’s nursing facility assessment program beginning in FY 2023.  Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers.  Learn more from this Pennsylvania Bulletin notice.
  • DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

  • DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding.  The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead.  Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of about 10 percent.
  • To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 195 admissions a day over the past week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26.  Find that notice here.
  • The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures:  coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement.  The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay.  It also documents case volumes, hospital charges, and statewide trends and offers other statistics.  To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00.  The meeting will be held virtually. An agenda will be available here 24 hours in advance.  Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 23
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PA Health Policy Update for Friday, September 16

The following is an update of selected state health policy developments in Pennsylvania for the week of September 12-16, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for voting session this week.  The following is an overview of selected health-related legislative activity.

  • The House unanimously passed House Bill 1630, which grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers in Medicaid.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House unanimously passed 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 bill will now be sent to the Senate.
  • The House Insurance Committee favorably reported Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners’ model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
  • The House Professional Licensure Committee favorably reported House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The House Republican Policy Committee held an informational meeting on Monday to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.  A recording of the meeting and testimony submitted to the committee may be viewed here.
  • The House Human Services Committee favorably reported House Bill 2686, as amended, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
  • The House Children & Youth Committee held an informational meeting this week to examine “Child & Adolescent Fatality Trends & Community Responses.”  A video recording of the hearing may be viewed here.

The state House and Senate will be in session next Monday (9/19), Tuesday (9/20), and Wednesday (9/21).  The following is an overview of selected health-related committee meetings next week.

  • The House Insurance Committee will convene on Tuesday, September 20 at 10:00 a.m. to consider Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The Senate Health & Human Services Committee will hold an informational hearing on Tuesday, September 20 at 11:00 a.m. on the tick crisis in Pennsylvania.
  • The House and Senate Democratic Policy Committees will hold a joint hearing on Friday, September 23 to discuss Senate Bill 860 and House Bill 1848 and the need for Pennsylvania to establish a statewide rape-kit tracking system.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers of updates to the Medical Assistance program fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has extended its calendar for remittance advice (RA) electronic transfer and mailing dates into November.  Find the updated calendar here.
  • DHS has published information about improvements in how providers can update their enrollment summary in the state’s PROMISe provider internet portal.  Find the notice here.
  • DHS has revised its list of drug companies participating in the state’s Medicaid drug rebate program.  Find the updated list here.
  • In July, DHS proposed new regulations governing the delivery of psychiatric rehabilitation services, and in particular, on the use of telehealth in the delivery of those services.  Now, Pennsylvania’s Independent Regulatory Review Commission has published its analysis of the proposed regulation and shared comments submitted by stakeholders in response to the proposed changes.  Find the commission’s analysis and stakeholder comments in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to announce that it has issued an updated School-Based ACCESS Program provider handbook.  Find that bulletin and the updated handbook here.
  • DHS has posted a notice announcing to stakeholders that it has not yet calculated Medicaid hospice rates for FY 2023 and explaining its process for completing those calculations and notifying affected parties.  Find that notice here.

Behavioral Health Commission for Adult Mental Health

The Behavioral Health Commission for Adult Mental Health created to develop recommendations for how to allocate $100 million appropriated for adult mental health purposes in the state’s FY 2023 budget held its fourth public meeting this week.  The first part of the meeting focused on workforce development issues, with participants identifying the biggest challenges in workforce development as recruitment, retention, licensing, lack of funding for loan repayment and salary increases, lack of career pathways and pipelines, and burnout.

After additional discussion, commission members decided they should organize their spending recommendations into four categories:  workforce ($37 million of the $100 million available), expanding services ($36.7 million), criminal justice ($23.3 million), and other ($3 million); they also discussed priorities within each category.  The commission’s final report and recommendations should be presented to the legislature next week but no money will be spent until the General Assembly, which will only meet a few more days this year, specifically authorizes it.  Learn more about the Behavioral Health Commission for Adult Mental Health from its section of the DHS web site.

Department of Health

The Department of Health has notified licensed providers that although the CDC now considers individuals up to date with their COVID-19 vaccinations only if they have had a dose of the new bivalent booster shot, providers should continue to consider individuals up to date if they have received either a monovalent or bivalent booster shot on the recommended schedule.   Learn more from the Department of Health’s letter to providers.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, 74.5 percent of Pennsylvanians five years of age and older are now vaccinated.
  • Sixty-five of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Delaware and Philadelphia counties are currently experiencing “only” substantial rates.

Monkeypox

The CDC has posted an updated map showing the distribution of 23,117 confirmed cases of monkeypox in the U.S. as of September 15, up from 21,504 cases on September 1.  684 of those cases were in Pennsylvania, up from 624 a week ago.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs is offering online training on substance use disorder confidentiality.  This updated training incorporates changes based on passage of Pennsylvania Act 33, the Pennsylvania Drug and Alcohol Abuse Control Act, in July.  Learn how to receive the training from this Department of Drug and Alcohol Programs notice.  Participants can earn PCB continuing education credits.

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

The Rare Disease Advisory Council will hold a stakeholder summit on Thursday, September 22.  The summit will feature panels on gene therapy, newborn screening, and the results of the council’s Patient Needs Assessment Survey.  Learn more about the stakeholder summit here.

Department of Human Services – Special Populations/Dementia Issues September 22

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how facilities can help community members understand what dementia is, how it affects people, and how individuals can make a difference in the lives of those touched by dementia.  The webinar, to be held on Thursday, September 22 at 2:00, is especially recommended for community liaisons, non-clinical teams, nurse educators, service coordinators, and volunteers.  Learn more from this webinar notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-16T21:36:30+00:00September 16th, 2022|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 laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 16
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PA Health Policy Update for Friday, September 2

The following is an update of selected state health policy developments in Pennsylvania for the week of August 29-September 2, 2022.  (Some of the language used below is taken directly from state documents.)

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for August.  General Fund revenue collection exceeded estimate by $63.8 million, or 2.3 percent, for the month.  Fiscal year-to-date General Fund collections total $5.6 billion, which is $60.4 million, or 1.1 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to notify providers of updates to the Medical Assistance fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to expand the scope of eligible providers that may render certain services to include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and physicians and to add behavioral health providers to certain procedure codes and make other procedure code changes.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from the implementation of the 2022 Healthcare Common Procedure Coding System (HCPCS) procedure codes updates.  In addition, it also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance fee schedule, including setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 29, 2022.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics of updates to the Medical Assistance fee schedule for the distribution of take-home supplies of nasal or injectable naloxone to Medicaid
    beneficiaries.  Find the bulletin here.
  • DHS has published brief notices addressing extra recoupments it has returned to some providers and provider enrollment summary enhancements.
  • DHS has posted federal financial participation rate changes and continued billing requirements for community support service providers.  Find the notice here.
  • DHS has posted HealthChoices enrollment and Medical Assistance Transportation Program utilization data for July.  Find the information here.

Department of Health

  • The Department of Health (DOH) has updated its “Innovative Hospital Model” guidance to make requested changes about locations eligible to operate outpatient emergency departments.  Find that updated information here.
  • DOH has revised its guidance for contacting the Division of Acute and Ambulatory Care prior to an event or change that requires advance notification, such as addition of new equipment or occupancy.  The updated guidance includes email subjects that providers should use when sending these notices to expedite review by the Division of Acute and Ambulatory Care.  Find the updated guidance here.
  • DOH’s annual Pennsylvania Long Term Care Questionnaire is now open until Friday, October 28.  Providers that have not received an email containing login information and instructions should contact Thomas Gavrish at tgavrish@pa.gov.
  • DOH will offer free potassium iodide, or KI, tablets on Thursday, September 15 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants as part of routine preventive efforts in case of future emergencies.  Learn more from this department news release.

COVID-19:  By the Numbers

Monkeypox

  • DHS has published a Medical Assistance Bulletin to advise providers of the addition of procedure codes to use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of the monkeypox vaccines.  Find the bulletin here.
  • The CDC has posted an updated map showing the distribution of 19,465 confirmed cases of monkeypox in the U.S. as of September 1, up from 16,926 cases on August 25.  561 of those cases were in Pennsylvania, up from 465 a week ago.
  • As of August 29, 327 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Mental and Behavioral Health Considerations for Long-Term Care – September 8

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on mental and behavioral health considerations for long-term care on Thursday, September 8 at 2:00.  This presentation will explore the most common behavioral health diagnoses seen among residents living in nursing facilities and will share approaches to managing appropriate use of psychotropic medication and best practices around deprescribing.  Learn more about the event and how to participate from this notice.

Pennsylvania Health Care Cost Containment Council – September 8

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, September 8 at 10:00.  Agendas will be available here 24 hours.  The public is invited to participate. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Patient Safety Authority – September 8

The Patient Safety Authority will meet virtually on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-02T18:45:52+00:00September 2nd, 2022|COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 2
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PA Health Policy Update for Friday, August 26

The following is an update of selected state health policy developments in Pennsylvania for the week of August 22-26, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

In the wake of the governor’s signing of Act 54, the Wolf administration has written to institutional facilities and programs that will receive American Rescue Plan Act funding.  Among the recipients will be nursing facilities, personal care homes, assisted living residences, home- and community-based providers, and LIFE programs.  The correspondence outlines how much funding has been allocated to each category of recipient, notes any tasks recipients may need to complete to receive their money, explains that recipients should know how much they will receive before their money arrives, and notes that payments will be made during the fall of 2022.  Find the communication here.

The Courts

The state Supreme Court has issued an order amending the Pennsylvania Rules on Civil Procedure governing venue for medical malpractice.  The amendment eliminates the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.  The court’s order, amendment, and the Civil Procedural Rules Committee adoption report may be viewed here.  It will take effect January 1, 2023.

Pennsylvania’s Commonwealth Court has ordered the state’s Department of Health to make public information about how many medical marijuana patients have been authorized by the state to use cannabis to treat an opioid addiction.  Learn more from the Commonwealth Court decision.

Department of Health

The Department of Health announced in this Pennsylvania Bulletin notice that it will adopt the 2022 edition of the Guidelines for Design and Construction of Hospitals and Guidelines for Design and Construction of Outpatient Facilities (Guidelines) to set the standard for renovation and constructions at hospitals and ambulatory surgery facilities effective February 1, 2023.  The department had previously adopted the 2018 Guidelines and will permit hospitals and ambulatory surgical facilities to elect to use either the 2018 or 2022 Guidelines from August 1, 2022, until January 31, 2023.  After February 1, 2023, the 2022 Guidelines must be used.

The Department of Health announced details on how it will implement the Cytomegalovirus Education and Newborn Screening Act that was signed into law on June 27, 2022 in this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin implementing Act 33, which Governor Wolf signed on July 7 and took effect immediately.  Act 33 makes significant changes in the confidentiality provisions for substance use disorder treatment records under Pennsylvania law and in the Department of Drug and Alcohol Programs’ enforcement of those provisions.  Find the bulletin here.

Auditor General

The Pennsylvania Department of the Auditor General announced the release of tobacco settlement fund audits for 22 health care facilities in Allegheny, Berks, Bucks, Chester, Clarion, Cumberland, Dauphin, Luzerne, Montour, Montgomery, Philadelphia, Schuylkill, Washington, Westmoreland, and York counties.

COVID-19:  By the Numbers

Monkeypox

The Department of Health has established a “what you need to know about monkeypox” web page.  Find it here.

The CDC has posted an updated map showing the distribution of 16,926 confirmed cases of monkeypox in the U.S. as of August 25.  465 of those cases were in Pennsylvania.

As of August 22, 257 of those Pennsylvania monkeypox cases – more than half of them – were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Improving Resident Relationships in Long-Term Care– September 1

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on improving resident relationships in long-term-care facilities.  The webinar will seek to educate staff about the prevalence of resident-to-resident aggression in nursing facilities and teach webinar participants how to recognize and address it in their facilities.  The webinar will be held on Thursday, September 1 at 2:00.  Learn more about the webinar and how to participate from this notice.

Behavioral Health Commission for Adult Mental Health – September 1

The next meeting of the Behavioral Health Commission for Adult Mental Health will take place on September 1 from 1:00-6:30.  Interested individuals may attend in person or virtually.  Go here to learn more about the participation options.

Department of Health – Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee – September 7-8

The Statewide HIV Planning Group will hold a public meeting at the Best Western Premier Central Hotel and Conference Center, 800 East Park Drive, Harrisburg, PA on Wednesday, September 7, 2022, and Thursday, September 8, 2022, from 9 a.m. to 4:30 p.m.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

 

 

2022-08-29T15:44:30+00:00August 29th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, August 26
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PA Health Policy Update for Friday, August 5

The following is an update of selected state health policy developments in Pennsylvania for the week of August 1-5, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a news release reminding current HealthChoices participants that as a result of changes in that program, approximately 500,000 people must select a new health plan by August 16.  Those people have received written notices explaining the situation and their need to act.  Individuals who do not choose a new plan will have one auto-assigned to them.  Learn more about this situation, including where individuals can turn for assistance, from this DHS news release.
  • Providers also can help their Medical Assistance patients select new plans, if they need to do so, by directing them to a virtual event during which representatives from DHS, PA Enrollment Services (the state’s independent enrollment service), the Pennsylvania Health Law Project, and the Pennsylvania Health Access Network will answer questions about enrollment concerns.  The webinar will be held on Wednesday, August 10 at 2:00.  Registration is required and space is limited.  For further information and registration information, providers should direct Medical Assistance patients here.
  • While Governor Wolf signed legislation last month amending the state’s Mental Health Procedures Act to align with federal health privacy standards to permit providers, facilities, and health plans to share patient mental health and substance use disorder-related information more easily, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has informed stakeholders that it is still reviewing the new law to determine its next steps and will be in touch with stakeholders when it is prepared to act.  Learn more in the message OMHSAS sent to stakeholders about this subject.
  • DHS has published Medicaid managed care enrollment data for April, May, and June of 2022.
  • DHS has announced a grant opportunity for home health agencies that provide pediatric shift nursing services to fund the installation and use of certified electronic health record technology.  Learn more about the grant opportunity here.  Applications are due September 19.

Department of Health

  • The Department of Health (DOH) has issued guidance on the implementation of Act 87 of 2022, which amends the Health Care Facilities Act by expanding what procedures may be performed in an ambulatory surgical facility without an exception; creating a time frame in which exception requests must be denied, approved, or determined to be incomplete; and requiring an explanation of the basis for a denied or incomplete request.  Find that guidance here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments, and shared the comments of stakeholders, in response to DOH’s proposed revision of state regulations governing long-term care nursing facilities.  Those comments include IRRC questions to DOH about selected aspects of its proposed revisions.  Find the IRRC’s comments and questions in this Pennsylvania Bulletin notice.
  • DOH has announced the creation of a new Women, Infants and Children Advisory Group that will focus on providing support to foster healthier pregnancies and better postpartum care.  Learn more about the advisory group and the 16 individuals appointed to serve on it from this news release.
  • DOH has updated its alcohol-based hand rub memo, seeking to promote use of alcohol-based hand rubs by addressing misconceptions regarding their safety, use, and efficacy in health care facilities.  Find that updated memo here.
  • DOH has sent an email to all long-term-care facilities with their annual Department of Health long-term-care questionnaire.  This questionnaire is mandatory for facilities and must be completed and returned to DOH by October 28.  Facilities that have not yet received this email from Thomas Gavrish should contact him at tgavrish@pa.gov or call 717-547-3660.

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases in Pennsylvania fell 21 percent over the past week and the number of COVID-related deaths fell 29 percent.
  • The number of people hospitalized with COVID-19 and on ventilators changed only slightly in the past week but the number in hospital ICUs because of the virus rose 21 percent.
  • Sixty-five of Pennsylvania’s 67 counties are currently experiencing a high rate of community transmission of COVID-19, down from 67 counties last week.  The other two counties, McKean and Warren, are experiencing a substantial rate of community transmission.
  • The Pennsylvania Health Care Cost Containment Council (PHC4) has released COVID-19 hospitalization data for the 21-month period March 1, 2020 through December 31, 2021.  The report covers number of hospitalizations by month; age, gender, and ethnicity of hospitalized patients; the socioeconomic status of the communities in which hospitalized patients reside; in-hospital mortality rates, including by age; length of stay; and frequency of ventilator use, including by age, patient ethnicity, and the socioeconomic status of the communities in which patients resided.  Learn more from this PHC4 news release; a summary of the report’s findings; county rates (this link opens a downloadable Excel file); and patient demographics (this link also opens a downloadable Excel file).

Monkeypox

The Department of Health has posted a monkeypox fact sheet that addresses what the virus is, its symptoms, how it is transmitted, how it is treated, and how vaccines are being used to prevent it among high-risk individuals.  Find the fact sheet here.

The CDC has posted an updated map showing the distribution of 7102 confirmed cases of monkeypox in the U.S. as of August 4, a 53 percent increase in the last week.  192 of those cases were in Pennsylvania, a 68 percent increase over a week ago.

As of August 1, eighty-two of those Pennsylvania monkeypox cases were in Philadelphia.  The city has responded in part by establishing a new digital monkeypox dashboard with case and vaccination data.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has released a licensing alert that gives providers information about its process for investigating complaints about licensed drug and alcohol treatment facilities.  Find that alert here.

Insurance Department

The Insurance Department has released the requested rate filings for health insurance plans for 2023 that plans are required to file with the state.  As filed, 2023 will see increased competition and more choices for consumers in some counties.  Insurers offering plans in the individual market filed plans requesting an average state-wide increase of 7.1 percent and those currently selling in Pennsylvania’s small group market filed plans requesting an average state-wide increase of 5.2 percent.  Learn more from this Insurance Department news release and find the rate filings here.

Stakeholder Events

Department of Health – State Child Death Review Team – August 10

The Department of Health’s State Child Death Review Team will hold a virtual public meeting on

Wednesday, August 10 at 1:00.  The state’s Child Death Review Program provides training and technical assistance to local child death review teams.  Learn more about the State Child Death Review Team and how to join the August 10 meeting from this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-08-05T19:18:57+00:00August 5th, 2022|COVID-19, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, August 5
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PA Health Policy Update for Friday, July 1

The following is an update of selected state health policy developments in Pennsylvania for the week of June 27 to July 1, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

As of 2:00 p.m. on Friday, July 1, Governor Wolf and the General Assembly continue to work on finalizing Pennsylvania’s FY 2023 budget.  Despite indications that a framework for a budget agreement has been reached, the state missed its June 30 deadline to enact a spending plan.  The General Assembly is scheduled to return to session next Tuesday, July 5 to continue its work. The short-term impact of not having a budget by July 1 will be minimal; the state is obligated to maintain essential operations and cover Medicaid expenditures, state employee payroll, and debt payments.

Harrisburg, PA capital buildingGeneral Assembly

The state House and Senate cancelled session this weekend and are schedule to return to session on Tuesday, July 5.  Depending on the outcome of budget negotiations and the progress of budget-related legislation, they may have to add additional session days next week.

  • The Senate passed House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • The Senate passed Senate Bill 225 on third and final consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.  The bill was sent to the House and referred to the Insurance Committee for consideration.
  • The House passed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.
  • The House passed Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers in Pennsylvania with those permitted by the federal Centers for Medicare & Medicaid Services (CMS), on third and final consideration.  Since the bill was amended, it was sent back to the Senate for concurrence.
  • The House passed House Bill 2679 on third and final consideration.  The bill, which was subsequently sent to the Senate for consideration, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five years of age and older.
  • The House unanimously voted to concur with Senate amendments to House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.  The bill will now be sent to the governor for his signature.
  • The House passed House Bill 2293 on third consideration and final passage and sent it to the Senate for consideration.  This bill requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.

Governor Wolf

Governor Wolf has signed into law House Bill 2401, which extends regulatory waivers that went into effect over the course of the COVID-19 pandemic.  This extension will permit many waivers to remain in place until October 31, 2022 unless the waivers are related to federal exemptions.  Waivers related to federal exemptions will remain in place until the last day of the federal public health emergency or the last day the federal exemptions are authorized, whichever is later.  House Bill 2401 also 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.  Learn more from this Wolf administration news release.

Governor Wolf has signed Senate Bill 709, which establishes the CMV Education and Newborn Screening Act and requires the Department of Health to make available on its website certain information regarding cytomegalovirus (CMV), one of the most common viral infections that infants are born with in this country.  Health care providers will be required to provide parents or guardians of newborns with information on CMV and to offer a screening or referral within 21 days if the newborn child fails the initial newborn hearing screening.  Learn more from this Wolf administration news release and Senate Bill 709 (now Act 29).

Department of Human Services

  • In response to the COVID-19 emergency, the federal Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in April of 2020 issued an exemption to opioid treatment programs from the requirement to perform an in-person physical evaluation for any patient who will be treated by such programs with buprenorphine if a program physician, primary care physician, or an authorized health care professional under the supervision of a program physician determines that an adequate evaluation of the patient can be accomplished via telehealth.  Based on positive response to this practice, SAMHSA is extending this flexibility for one year from the formal end of the COVID-19 public health emergency.  Learn more from SAMHSA’s guidance.
  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services has issued a bulletin to update its guidelines for payment of behavioral health services delivered using telehealth technology.  Find the bulletin here and attachments here and here.  The new guidelines take effect immediately.
  • DHS’s Breast & Cervical Cancer Prevention & Treatment Program provides eligible individuals treatment for confirmed cases of breast and cervical cancer or pre-cancerous conditions of the breast or cervix.  DHS has posted a notice to providers reminding them how to determine whether patients may be eligible for services under the program and, if they are, how they can enroll in the program.  Find that notice here.
  • DHS has issued a Medical Assistance Bulletin informing providers that as of November 1 it will reinstate the prior authorization requirements for shift care services provided to beneficiaries under the age of 21 in the Medical Assistance fee-for-service program.  Medical Assistance managed care organizations may reinstate the prior authorization requirements for these services provided to children under the age of 21.  Providers rendering services in the managed care delivery system should contact the appropriate managed care organization regarding any questions about prior authorization requirements.  Learn more from this Medical Assistance Bulletin.
  • DHS has announced a funding opportunity for home and community-based service (HCBS) providers to improve and strengthen HCBS programs and services to better serve HCBS participants.  Under the program DHS will provide up to $40,000 for each approved request to help HCBS providers implement a series of specific types of service improvement projects.  Funding is limited to providers of services through the Community HealthChoices and OBRA 1915(c) waivers for activities that supplement HCBS services rather than supplant existing services.  Learn more about the funding program and the specific types of projects DHS is interested in supporting from this DHS news release.  For more detailed information, see this DHS description of the program, the funding guidelines, and how to apply.  Applications will be accepted until December 31 or whenever the $38 million allocated for this purpose has been committed.  All awarded funds must be spent by July 1, 2023.
  • DHS is seeking partners to help it through the public health emergency unwinding process during which people will need to re-establish their eligibility for Medical Assistance benefits.  Specifically, it seeks individuals and organizations that will help guide current Medical Assistance beneficiaries through the eligibility renewal process or direct them to other resources for possible health care coverage.  Learn more about what DHS seeks and how to participate in this undertaking from this DHS message.
  • DHS has decreased from 90 to 30 days the period of time individuals have to request a hearing appealing a Medicaid termination or denial.  The time limit previously was 30 days, was extended to 90 days at the start of the COVID-19 public health emergency, and has now been restored to 30 days.  Find the notice in this DHS memo (on page 7, in red).
  • DHS and the Department of Transportation have been awarded a $750,000 grant from the Federal Transit Administration to expand its Find My Ride online tool, Pennsylvania’s “one-stop shop” for access to human services transportation.  The program was developed collaboratively with transit agencies and streamlines the application process for the five largest transportation assistance programs in the state, including the Senior Share Ride program, the Medical Assistance Transportation Program, ADA complementary paratransit, the Persons with Disabilities Program, and the Free Transit Program.  The program enables third parties, such as family members or health care providers, to apply for services on behalf of riders.  Learn more from this Wolf administration news release.

Insurance Department

The Insurance Department has received a federal grant as part of the State Flexibility to Stabilize the Market Grant Program Cycle II.  One of the proposed projects includes studying the availability of providers in various specialties and geographic areas.  The goal of this study is to understand areas of need based on the current availability of providers to accept new patients and the amount of time it takes to get an appointment with these providers and to assess network adequacy considerations based on the findings.  The Insurance Department is seeking public comment from organizations, consumer advocates, providers, and consumers about their experience with getting appointments or finding available specialists.  Learn more about the project and the areas of medical specialty the analysis may consider, and on which the department is interested in comments, in this Pennsylvania Bulletin notice.  Comments are due by August 5.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder.  Last year the program awarded $599,000 to 12 organizations and this year the Department of Drug and Alcohol Programs plans to award approximately three to five grants of up to $600,000 each to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.  Learn more about this funding opportunity from this department news release and a program overview that describes eligible applicants and outlines the application process.  Applications are due by July 29 for projects that begin on October 1 and end by September 30, 2023.

COVID-19:  By the Numbers

  • After four weeks of falling case counts the number of new reported COVID-19 cases rose over the past week.
  • During this past week, Pennsylvania’s total of COVID-19 cases since the beginning of the pandemic rose past three million.
  • COVID-19-related deaths rose slightly during the week.
  • The number of Pennsylvanians hospitalized with COVID-19 remained steady over the past week but the number in hospital intensive care units and on ventilators declined.
  • Thirty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 55 counties last week.  Four counties experienced a moderate rate of community transmission and the remaining 18 experienced a substantial rate.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 7

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar to help nursing facility staff recognize expressions of behavior among residents living with dementia.  The webinar will be held on Thursday, July 7 at 2:00.  Learn more about the webinar and how to participate from this notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

2022-07-01T20:16:07+00:00July 1st, 2022|COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 1
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  • 2020 Safety-Net Association of Pennsylvania

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

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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