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PA Health Policy Update for the Week of March 14-18

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

Redistricting Update

The Pennsylvania Supreme Court has denied several appeals of the Legislative Reapportionment Commission’s (LRC) final state legislative district maps.  The maps will now be in place for the next decade.  The Supreme Court also modified the election calendar for petition circulation so legislative candidates will circulate petitions from March 18 to March 28.

General Assembly

  • The General Assembly concluded its FY 2023 budget hearings this week.  The Department of Drug and Alcohol Programs’ presentation before the Appropriations Committee on Wednesday was the last health-related budget hearing.  A recording of the hearing can be found here.  If you would like to view any of the past budget hearings, you can find the Senate hearings here and the House hearings here.
  • The state House of Representatives cancelled voting session next week because of the modified election calendar for petition circulation.  The House and Senate will return to session the week on March 28.

Department of Health

  • The Department of Health (DOH) has asked hospitals to complete a survey from the Legislative Budget and Finance Committee on the designation of a family caregiver for hospital inpatients.  For information about the survey and a link to the survey itself, go here.  DOH and the committee ask hospitals to complete the survey by March 31.
  • DOH has published the third of four planned packages of proposed amendments of the state’s nursing home regulations.  These proposals address matters such as initial licensure and renewal, change in ownership, location, emergency preparedness, reportable diseases, and others.  Find the proposed changes in this Pennsylvania Bulletin notice.  Written comments are due within 30 days of the proposed regulations’ March 19 publication; see the bulletin notice for information about how to submit comments.
  • DOH has shared with the state’s health care providers two documents recently updated by the federal Centers for Medicare & Medicaid Services:  updated guidance on nursing facility visiting, testing, and quarantine policies and an update to CMS guidance for nursing facilities on compliance with the federal rule requiring vaccination of staff and residents.
  • DOH continues to sponsor COVID-19 testing sites in six counties across the state.  Go here for updated information about the sites and their hours.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar for delivering Remittance Advices and corresponding checks to extend into early May.
  • DHS has updated the Medical Assistance fee-for-service fee schedule with new procedure codes for the administration of the MenQuadfi® and Vaxelis® vaccines effective for dates of service on and after June 1, 2021.  For details, see this Pennsylvania Bulletin notice.
  • DHS has updated the Medical Assistance fee-for-service fee schedule to reflect increased fees for the administration of ten COVID-19 monoclonal antibody products effective May 6 and has end-dated procedure code M0239 effective April 16, 2021.  Find the details in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall.  A week ago the state’s seven-day average of new cases was 1108 cases a day; yesterday (March 17) it was 751 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 40 deaths a day a week ago but was 32 deaths a day yesterday (March 17).
  • The decline in the number of Pennsylvania counties experiencing higher rates of community transmission of COVID-19 continues.  Last week, seven counties were in the highest rate of community transmission of COVID-19 cases; this week, none are.  Last week, 37 counties were experiencing a substantial rate of community transmission; this week, 21 are.  Last week, 23 counties were experiencing only a moderate rate of community transmission; this week, 46 are.
  • This week marked the first time since August 5 that the number of Pennsylvanians being treated on a ventilator for COVID-19 fell into double digits.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded $1.3 million in funding to expand drop-in center services for individuals with substance use disorder in areas of the state experiencing high numbers of overdose deaths.  Learn about the challenges the funding seeks to address, how the money will be used, and what organizations received the grant funding in this news release.

Office of the State Fire Commissioner

The Office of the State Fire Commissioner issued guidance this week for the EMS COVID-19 Recovery Grant Program.  Established by Senate Bill 739 (Act 10), this program will provide $25 million to support Pennsylvania’s EMS companies.  The guidance details eligible EMS companies and the certification process necessary to receive the funds.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – March 23

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, March 23 at 1:00 p.m.  Go here to register to attend.

Department of Human Services – Medical Assistance Advisory Committee – March 24

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, March 24 at 10:00 a.m.  Go here to register to attend.

Department of Health – Advisory Health Board – March 31

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

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

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

Department of Health – Health Research Advisory Committee – April 4

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

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

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

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

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

 

2022-03-18T21:10:08+00:00March 18th, 2022|Coronavirus, COVID-19, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of March 14-18

PA Health Policy Update for the Week of March 7-11

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

General Assembly

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

Department of Health

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

Department of Human Services

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

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

COVID-19:  By the Numbers

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

Pennsylvania Health Care Cost Containment Council (PHC4)

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

Stakeholder Events

Department of Health – Advisory Health Board – March 16

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

Patient Safety Authority – March 17

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

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

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

PA Health Policy Update for the Week of February 28-March 4

The following is an update of selected state health policy developments in Pennsylvania for the week of February 28-March 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced that Pennsylvania’s state-based health insurance marketplace, known as Pennie, has added a new “qualifying life event” to enable low-income Pennsylvanians to enroll in health insurance throughout the year.  Under this new qualifying life event, Pennsylvanians with an annual household income equal to or below 150 percent of the federal poverty level will be permitted to shop and enroll in health insurance through Pennie, with financial assistance available to those who qualify.  Until now, this opportunity was only available for those not already receiving coverage through Pennie.  Beginning in June, existing Pennie customers whose income is lower than or equal to the 150 percent federal poverty level can update their application and change their plan using this qualifying life event.  Learn more from this Wolf administration news release.

General Assembly

The Department of Health and the Department of Drug and Alcohol Programs appeared before the House Appropriations Committee on Thursday, March 3 to discuss their FY 2023 budget proposals.  A recording of their budget hearing can be viewed here.

Among the health-related budget hearings to be held the week of March 7 are:

  • Department of Human Services (Senate Appropriations Committee) – Tuesday, March 8 at 10:00 a.m.
  • Department of Health (Senate Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.
  • Department of Human Services (House Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.

Find a complete schedule of the budget hearings here.

In addition,

  • The legislative Rare Disease Caucus held a press conference on Monday, February 28 to recognize February 28 as Rare Disease Day.  In addition to announcing that Senator Maria Collett (D-Bucks/Montgomery) will serve as co-chair of the Rare Disease Caucus, Senator  Kim Ward (R-Westmoreland) and her colleagues highlighted Senate Bill 196/House Bill 1664 and the Pennsylvania Rare Disease Advisory Council’s “Rare Disease Needs Assessment.”
  • The House Human Services Committee held an informational hearing this week focused on traumatic brain injury care.  A recording of the hearing can be viewed here.

State Revenue Collection

The Department of Revenue reported this week that Pennsylvania’s General Fund revenue collections for February were $155.7 million, or 6.8 percent, above the official estimate.  Fiscal year-to-date collections are $28.6 billion, which is $2 billion, or 7.5 percent, more than projected.

Centers for Medicare & Medicaid Services

CMS has issued guidance to state Medicaid programs to ensure that they are prepared to initiate eligibility renewals for all individuals enrolled in Medicaid and CHIP within 12 months of the eventual end of the public health emergency and to complete renewals within 14 months.  To help consumers maintain coverage, the guidance emphasizes current rules requiring states to provide a smooth transition to other options for those who may no longer be eligible for Medicaid or CHIP.  This letter is part of a series of guidance and tools that outline how states may address the large volume of pending eligibility and enrollment actions that will need to be addressed when they restore routine operations, including terminations of coverage.  It describes how states may distribute eligibility and enrollment work in the post-public health emergency period, mitigate churn for eligible beneficiaries who lose coverage and later reenroll, and smoothly transition individuals between coverage programs.  It reiterates options for states to align work on pending eligibility and enrollment actions after the public health ends and provides that states must initiate, rather than complete, all pending actions during the 12-month unwinding period.  In addition, it informs states that they are at risk of inappropriately terminating coverage for eligible individuals if they plan to initiate a high volume of renewals in a given month and that CMS intends to collect information on all states’ plans to adopt strategies that will promote continuity of coverage and guard against inappropriate terminations.  Learn more from this CMS letter to state Medicaid officials.

Department of Health

  • The Department of Health (DOH) has unveiled what it is calling “innovative delivery models” that it hopes will “…provide options that will preserve and increase access to high quality care in areas that may be medically underserved” and “… give rural hospitals flexibility to address historic challenges so they can maintain emergency care in local communities.”  The three models DOH introduced are:
  • Outpatient emergency departments, which DOH defines as “…an outpatient location of a hospital that offers only emergency services and is not located on the grounds of the main licensed hospital.”  Go here for criteria and guidance for implementing outpatient emergency departments.
  • Micro-hospitals, which DOH defines as “…an acute care hospital that offers emergency services and maintains facilities for at least 10 inpatient beds with a narrow scope of inpatient acute care services, such as no surgical services.”  Go here for DOH guidance on operating micro-hospitals.
  • Tele-emergency departments, or tele-EDs, which DOH defines as “…an emergency department in an acute care or critical access hospital that is staffed by Advanced Practice Providers (APP) 24 hours per day/7 days per week with a physician available at all times through telecommunications but not physically present in the emergency department.”  DOH provides guidance on operating tele-EDs here.

Learn more about DOH’s innovative delivery models from the following resources:

In addition, DOH has established a web page for its innovative delivery models.

Department of Human Services

  • The Department of Human Services (DHS) has published the minutes of the February 24 meeting of its Medical Assistance Advisory Committee.  Find them here.
  • DHS has added a procedure code to the Medical Assistance fee schedule for over-the-counter COVID-19 tests.  Learn about the code, its intended use, and its effective date in this Pennsylvania Bulletin notice.
  • DHS has posted a notice informing presumptive eligibility providers that the income guidelines used to determine presumptive eligibility have been updated effective January 12, 2022 and reminding them that they can make presumptive eligibility decisions for pregnant women.  Find the notice here.
  • DHS has posted a reminder that all enrolled physicians, audiologists, pharmacies, medical suppliers, and outpatient hospital clinics that dispense hearing aid supplies to Medicaid beneficiaries must submit a copy of their renewed DOH certification to MA Provider Enrollment by March 16 to provide and bill DHS for hearing aid supplies.  Find the notice here.
  • DHS has updated its list of participating providers in its Healthy Beginnings Plus program.
  • DHS has updated its Medicaid managed care organization directory.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts have fallen significantly over the past month.  On February 1 the state’s seven-day average of new cases was 5685 cases a day; on March 1 it was 1677 cases a day.
  • The number of new COVID-19-related deaths follows the same downward trend:  Pennsylvania’s seven-day average of deaths was 155 deaths a day on February 1 but was just half that, 78 cases a day, on March 1.
  • The Department of Health also reports that approximately 7.5 percent of all staffed adult ICU beds in the state are occupied by COVID-19 patients this week, down from 9.9 percent last week, and that 24 percent of all ventilators in the state are currently in use, down from 25.8 percent last week.
  • The decline in the number of Pennsylvania counties experiencing a substantial rate of community transmission of COVID-19 – the highest rate – continues.  This past week, Delaware, Lehigh, and Perry counties were all in moderate states of community transmission and 26 other counties – Allegheny, Berks, Bucks, Butler, Carbon, Chester, Cumberland, Dauphin, Erie, Juniata, Lancaster, Lawrence, Lebanon, Luzerne, Lycoming, Mercer, Monroe, Montgomery, Montour, Northampton, Northumberland, Snyder, Sullivan, Venango, Washington, Wyoming – were experiencing “only” substantial rates of community transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 70 percent decline from February 1 to March 1 in the number of Pennsylvanians hospitalized with the virus; a 66 percent decline in the number of patients on ventilators during that same period of time; and a 67 percent month-to-month decline in the number of COVID-19 patients in hospital ICUs.

Stakeholder Events

Department of Health – Advisory Health Board – March 16

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

Patient Safety Authority – March 17

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

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

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

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

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

Pennsylvania State MapGeneral Assembly

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

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

Department of Human Services

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

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

Department of Health

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

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

Department of Drug and Alcohol Programs

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

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

COVID-19:  By the Numbers

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

Stakeholder Events

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

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

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

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

Department of Health – Advisory Health Board – March 16

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

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

PA Health Policy Update for the Week of February 7-11

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

Proposed State FY 2023 Budget

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

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

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

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

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

Governor Wolf

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

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

General Assembly

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

Department of Human Services

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

Department of Health

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

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

COVID-19:  By the Numbers

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

Stakeholder Events

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

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

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

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

 

PA Health Policy Update for the Week of January 31-February 4

The following is an update of selected state health policy developments in Pennsylvania for the week of January 31-February 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

As part of a preview of the budget proposal Governor Wolf will deliver to the legislature on Tuesday, February 8, his office has issued a news release  announcing “…his $1.7 billion plan to help Pennsylvania fully recover from the pandemic and pave the way for a successful future with support for families and workers, small businesses, the healthcare system, and statewide community revitalization through the American Rescue Plan​ Act (ARPA).”  Included in that news release is the following:

Support for Pennsylvania’s Healthcare System, $325 million

This investment would recognize healthcare workers for their heroic dedication and hard work throughout the pandemic and give healthcare providers resources to recruit and retain a skilled workforce​:

    • $250 million for long-term care recruitment and retention incentives and workforce development initiatives to grow the critical healthcare workforce​;
    • $40 million for the behavioral health workforce to expand county mental health programs; and 
    • $35 million to expand the student loan forgiveness program at PHEAA to include additional critical healthcare workers.

Redistricting Update

This afternoon the Legislative Reapportionment Commission voted 4-1 to approve new state House and Senate legislative district maps.  The final maps can be viewed here.  Pennsylvanians who are “aggrieved” by the approved maps have one month to appeal them to the Supreme Court, which has the authority to send the maps back to the commission.  Earlier this week the state Supreme Court assumed responsibility for drawing the state’s congressional district map.

House Chamber of the State HouseGeneral Assembly

  • The General Assembly will be in session next Monday (2/7), Tuesday (2/8), and Wednesday (2/9).
  • The state House and Senate will convene for a joint session on Tuesday (2/8) for Governor Wolf’s final budget address.
  • The House of Representatives is planning to consider the following health-related bills on second and third consideration next week.  Please note that this list is subject to change.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 19, which creates professional licensure for behavior analysts.
    • Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The House Health Committee will convene on Monday, February 7 to consider House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat coronavirus infections, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that the Medical Assistance program will pay for FDA-authorized over-the-counter COVID-19 tests provided to Medical Assistance beneficiaries, effective with dates of service on and after August 30, 2021.  This bulletin applies to Medical Assistance-enrolled pharmacies that serve Medical Assistance beneficiaries.  Providers serving Medical Assistance beneficiaries in physical health HealthChoices or Community HealthChoices should address any billing and payment questions with the applicable managed care organization.  Learn more from this Medical Assistance Bulletin.
  • DHS has published notice of its final $255.556 million funding allocation for various FY 2022 disproportionate share hospital (DSH) payments.  DHS is not otherwise changing the qualifying criteria or payment methodology for any of these payments.  Learn more in this Pennsylvania Bulletin notice.
  • Thirty Pennsylvania counties have received nearly $28 million in federal funding to enhance their behavioral health programs.  Administered through DHS, this one-time funding consists of money granted to states through the federal Consolidated Appropriations Act of 2021 combined with funds from Pennsylvania’s annual Community Mental Health Services Block Grant award.  The grants will target specific state priorities, including mobile crisis mental health services, telehealth, student assistance programs, start-up funding for residential treatment services and assisted outpatient treatment, and additional crisis services projects.  These projects include walk-in and remote crisis supports, expanding crisis, respite, and residential care capacity, and enhanced collaboration with law enforcement to assist with crisis response.  Learn more about the services this funding will support and which counties received grants from this news release.
  • DHS has circulated a briefing document on pharmacy prior authorization for sedative hypnotics when prescribed for Medical Assistance beneficiaries and has invited stakeholder comment.  Comments are due by February 8 and should be sent in MS Word to c-bstarr@pa.gov.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its final annual case-mix per diem payment rates for FY 2022 for non-public and county nursing facilities that participate in the Medical Assistance program.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report,” which updates the report to include January 2022 enrollment data.

Department of Health

  • Leaders of the Pennsylvania Department of Health (DOH), Department of Military and Veterans Affairs, and Pennsylvania Emergency Management Agency (PEMA) announced that they would establish four long-term care regional support sites to relieve pressure on hospitals and skilled nursing facilities due to a high number of patients with COVID-19.  Each facility will receive clinical and non-clinical support staff to open up to 30 beds to allow for more rapid discharge of patients from hospitals, when clinically safe to do so, freeing additional acute care space to meet COVID-19 demands.  A staffing firm will provide clinical staff, including RNs, LPNs and CNAs; the Pennsylvania National Guard will provide non-clinical staffing to support the facilities’ existing staff; and PEMA will assist with coordination.  The four regional support sites will open at the following skilled nursing facilities:  Vincentian Home in Pittsburgh; Lutheran Home in Hollidaysburg, Blair County; Springs at the Watermark in Philadelphia; and Clarview Nursing Home and Rehabilitation in Sligo, Clarion County.  Learn more from this news release.
  • DOH this week established new COVID-19 testing sites in Clearfield, Fayette, Monroe, Somerset, and Venango counties, joining previous sites it opened in Berks, Blair, Centre, and Clinton counties.  Learn more about individual clinic locations and hours in this DOH news release.
  • DOH has posted information about two options for DHS-certified child care facilities to report positive COVID-19 cases.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 8512 cases day; a week ago (January 27) its seven-day average was 14,025 cases a day.
  • The number of new COVID-19-related deaths also remains very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 135 deaths a day; a week ago (January 27) its seven-day average was 166 deaths a day.
  • The Department of Health reports that the percent of available adult and pediatric ICU beds in the state rose to 18.9 percent and 14.4 percent, respectively; that in approximately 22.1 percent of all staffed adult ICU beds are COVID-19 patients; and that 30.6 percent of all ventilators state-wide are in use.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 25 percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators fell 21 percent over the past week and the number in ICUs fell 25 percent.

Stakeholder Events

Public Health Advisory Council – February 7

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

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

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

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

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

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

PA Health Policy Update for the Week of January 24-28

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

General Assembly

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

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

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

Department of Human Services

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

Department of Health

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

COVID-19:  By the Numbers

Stakeholder Events

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

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

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m.  The purpose of this meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the acting secretary on matters relating to the administration of this fund.  Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

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

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

Traumatic Brain Injury Advisory Board – February 4

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

Public Health Advisory Council – February 7

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

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

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

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

PA Health Policy Update for the Week of January 17-21

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

General Assembly

  • The Senate held voting sessions on Tuesday (1/18) and Wednesday (1/19) this week and passed, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS) and eliminates the need for facilities to request an exception, and Senate Bill 861, which enters Pennsylvania into the EMS interstate compact.  Both bills will now be sent to the state House.
  • The Senate Health and Human Services Committee convened on Tuesday and favorably reported Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Health and Human Services Committee will convene again next week on Tuesday, January 25 to consider the following bills:
    • Senate Bill 152, which provides direction to the Department of Human Services on how to distribute funding intended for women’s health and family planning services.
    • Senate Bill 956, a constitutional amendment that clarifies that there is not a right to an abortion or abortion funding in the state constitution.
    • House Bill 1420, which directs the Department of Human Services to establish a public awareness campaign to provide information regarding the programs and services available for first responders, health care workers, and other frontline workers suffering from mental health issues related to the COVID-19 pandemic.
  • The Senate Aging and Youth Committee meeting previously scheduled for Tuesday, January 18 has been rescheduled for Monday, January 24 at 12:30 to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Human Services and Health to establish protocols to permit residents of long-term-care facilities to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.
  • The House Professional Licensure Committee will convene on Monday, January 24 at 10:30 a.m. to consider the following bills:
    • House Bill 19, which establishes professional licensure for behavioral analysts.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 1862, which preserves the COVID-19 regulatory waiver that authorizes physicians with an institutional license in a teaching hospital to serve patients at more than just two facilities in a health system.

Department of Human Services

The Department of Human Services has updated its schedule of Remittance Advice (RA) mailing dates and electronic RA delivery dates.  The schedule now extends into early March.

DHS has published final notice of the assessment amount, assessment methodology, and estimated aggregate impact on nursing facilities that will be subject to an assessment under the Nursing Facility Assessment Program for FY 2022.  Find that information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a health alert outlining options for treating patients with the COVID-19 omicron variant.

DOH continues to establish new sites for COVID-19 testing, adding sites this week in Greene and Pike counties.  Find information about these and other state-sponsored sites in this department news release; about plans for a new high-volume site in Hershey; and about another high-volume site in Delaware County.

DOH reports that the state has had 28,475 laboratory-confirmed flu cases and that such cases have been found in all 67 counties.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (January 20) was 20,958 cases a day; a week ago (January 13) its seven-day average was 26,224 cases a day.
  • The number of new COVID-19-related deaths also remains very high but it, too, declined over the past week.  Pennsylvania’s seven-day average yesterday (January 20) was 127 deaths a day; a week ago (January 13) its seven-day average was 120 deaths a day.
  • The Department of Health reports that from January 1, 2021 to January 4, 2022, 78 percent of reported COVID-19 cases were in unvaccinated or not fully vaccinated people; 85 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 84 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.
  • The Department of Health also reports that 31.8 percent of all staffed adult ICU beds are COVID-19 patients and 32.4 percent of all ventilators state-wide are in use.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a seven percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators and in ICUs because of the disease held steady over the past week after two months of steeply increasing numbers.
  • As a result of the decline in hospitalizations, there are a slightly more unoccupied adult ICU and medical/surgical beds in the state this week.  While the occupation rate of pediatric ICU beds increased just slightly, occupancy of pediatric and airborne isolation rates rose 7.6 percent and two percent, respectively, over the past week.  There are still only 33 unoccupied pediatric ICU beds and 501 unoccupied adult ICU beds in the state.
  • On January 18 the Department of Health elaborated on some of these figures, reporting that 31.8 percent of all staffed adult ICU beds are occupied by COVID-19 patients and 32.4 percent of all ventilators state-wide are currently in use.  Both numbers are almost identical to the previous week’s totals.
  • Media reports are mixed but suggest reason for optimism.  Around the state,
    • New cases are declining in Lancaster County but the decline in hospitalizations is more modest.
    • The new case rate is falling significantly in the Lehigh Valley but hospitalizations are down only slightly.  Even so, the city of Easton closed its city hall because of COVID-19 cases and exposures.
    • Erie County hospitals have more COVID-19 patients than at any time since the pandemic began but fewer of them are dying and fewer of them are being treated in ICU beds.  County health officials are concerned that many cases are not reflected in official counts.
    • New case figures are stabilizing in Allegheny County but the number of infants and children hospitalized is rising.
    • Both cases and hospitalizations are declining in Philadelphia and its surrounding suburban counties.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued a legislatively mandated report on the effects of the COVID-19 emergency on the state’s hospitals and health care facilities.  The report notes that “Pennsylvania hospitals and health systems reported $214,055,540 in COVID-19 related expenses and revenue losses for the period July 2021 – September 2021. These expenses and revenue losses were attributable to coronavirus and used to prevent, prepare for, and respond to the coronavirus pandemic.  Total COVID-19 related expenses and lost revenue reported by Pennsylvania hospitals and health systems through September 2021 (Jan 2020-September 2021) were $6,925,269,148.”  The report does not reflect any offsetting state and federal funding intended to help providers with these expenses and losses.  Find the report here.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

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

Medical Assistance Advisory Committee – January 27

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

Medical Marijuana Advisory Board – January 27

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

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

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

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

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

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m.  The purpose of this meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the acting secretary on matters relating to the administration of this fund.  Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

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

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

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

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

PA Health Policy Update for the Week of January 10-14

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

Governor Wolf

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

General Assembly

  • The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act.  This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.  The bill was received in the Senate and referred to the Health and Human Services Committee.
  • The House Health Committee convened on Tuesday, January 11 and favorably reported House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.  The committee also reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
  • The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m.  The hearing will take place at the University of Pittsburgh at Bradford.
  • The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
  • The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
  •  The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

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

Department of Health

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

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

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

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

Infant Hearing Screening Advisory Committee – January 20

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

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

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

Medical Assistance Advisory Committee – January 27

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

Medical Marijuana Advisory Board – January 27

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

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

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

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

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

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

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

 

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

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

Governor Wolf

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

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

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

General Assembly

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

State Revenue Collection

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

Department of Human Services

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

Department of Health

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

COVID-19:  By the Numbers

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

Stakeholder Events

Health Research Advisory Committee – January 10

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

Medical Marijuana Advisory Board – January 27

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

Special Pharmaceutical Benefits Program Advisory Council – January 27

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

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