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

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

Centers for Medicare & Medicaid Services

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

Department of Health

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

Department of Human Services

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

COVID-19: By the Numbers

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

jsteinbock2022-01-03T16:31:32+00:00January 3rd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

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

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

Governor Wolf

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

General Assembly

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

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

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

Department of Human Services

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

Learn more from this Pennsylvania Bulletin notice.

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

Department of Health

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

COVID-19: By the Numbers

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

Pennsylvania Health Care Cost Containment Council (PHC4)

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

a PHC4 summary of the report
the agency’s presentation of key findings
links to specific types of medical conditions and procedures
data on Medicare payments for specific treatments and procedures

jsteinbock2021-12-17T22:37:32+00:00December 17th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of December 6-10

The following is an update of selected state health policy developments in Pennsylvania for the week of December 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate Democratic Policy Committee held an informational hearing this week on substance use disorder treatment facilities. The hearing was co-hosted by senators Schwank, Tartaglione, and Muth. Panelists included individuals affected by the addiction crisis, treatment providers, and the Department of Drug and Alcohol Programs. Testimony offered at the hearing and a video recording may be found here.

The state House and Senate will return to session next week. The following are the relevant health committee hearings currently scheduled.

The House Health Committee has scheduled a hearing on Monday, December 13 at 9:00 a.m. to discuss COVID-19 treatment options. Chairman Kathy Rapp has indicated the committee will examine House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat COVID-19.
The Senate Health & Human Services Committee is scheduled to convene on Tuesday, December 14 at 11:00 a.m. to consider, among other bills, Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health; Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning; Senate Bill 848, which creates a chief nursing officer position in the Department of Health; Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board; and Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception. The committee also will consider House Bill 118, which establishes requirements for the final disposition of fetal remains.
The House Human Services Committee has scheduled an information hearing on House Bill 1644 for next Thursday, December 16 at 9:30 a.m. House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner. The Human Services Committee also has scheduled an 11:00 a.m. hearing to examine community participation supports during COVID-19 pandemic.

Department of Human Services

The Department of Human Services (DHS) has updated its list of regulations that have been suspended to facilitate the state’s response to the COVID-19 emergency. Find the updated list here.
The federal Centers for Medicare & Medicaid Services (CMS) has written to state Medicaid directors to encourage them to take advantage of a provision in the American Rescue Plan that authorizes their programs, beginning on April 1, 2022, to provide 12 months of postpartum Medicaid coverage to pregnant women enrolled in either their Medicaid or CHIP programs. Learn more from the CMS letter to state Medicaid directors. Pennsylvania announced in August that it would extend this coverage.
CMS has sent a letter to state Medicaid directors to help them understand provisions in the Consolidated Appropriations Act of 2021 that include new reporting requirements for non-disproportionate share hospitals (DSH) supplemental payments and a change in the methodology for calculating hospital-specific DSH limits. See that letter here.
DHS has issued a news release elaborating on Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act. This funding will support Medicaid’s home and community-based services system throughout the state. Learn more from this DHS news release.

Department of Health

The Department of Health (DOH) has issued a seasonal influenza update urging providers to encourage their patients to receive flu vaccines, offering treatment recommendations, and reminding providers that they are required to report flu cases to the state. Learn more in this department influenza update and reminder health alert.
DOH has updated two health alerts, PA-HAN-609 and PA-HAN-610, to clarify that the visitation guidance from the department applies only to skilled nursing facilities and that other types of facilities, such as personal care homes, assisted living facilities, and intermediate-care facilities, should seek guidance from their licensing agencies when it comes to COVID-19 visitation policies.
DOH has distributed communication that it received from the Centers for Medicare & Medicaid Services informing states that the federal government will not be enforcing the health care provider vaccination mandate while federal litigation is pending.

COVID-19: By the Numbers

Daily COVID-19 case counts remain near their highest levels since the beginning of the pandemic. To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths also remains high.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus all rose sharply in the past week.
These numbers reflect the growing rate of occupancy in the state’s hospitals. There currently are only 481 unoccupied adult ICU beds – 13.5 percent of the total of such beds in the state; 2019 unoccupied medical/surgical beds – 10 percent of such beds in the state; 29 pediatric ICU beds (7.7 percent); 234 pediatric beds (20.8 percent); and 919 airborne isolation beds (29.1).
Media reports confirm the challenges some communities and hospitals are facing, including this report on the situation at the nine hospitals that constitute Geisinger Health; this report on the situation in Allegheny County; this report on the situation in the Erie area; and this report on the situation throughout Pennsylvania.
The Department of Health reports that 6.7 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters. Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that nearly 170,000 boosters have been administered to city residents since August 13.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has established minimum qualifications for the positions of project director, facility director, clinical supervisor, counselor, and counselor assistant but these regulations permit persons to meet those qualifications with a degree in an “other related field.” In Licensing Alert 03-2021 the department lists “other related fields” that meet qualifications and notes that this list is not necessarily all-inclusive and that the department will review those degrees on a case-by-case basis. Find the licensing alert here.

The Department of Drug and Alcohol Programs has published its long-delayed, much discussed final standards for drug and alcohol recovery house licensure. Find them in this Pennsylvania Bulletin notice.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published its annual report on the financial performance of the state’s non-general acute-care hospitals, including rehabilitation hospitals, psychiatric hospitals, long-term acute-care hospitals, and specialty hospitals. Learn more from this PHC4 news release and the report itself. PHC4 also offers download data from the report in Excel format.

jsteinbock2021-12-10T21:44:43+00:00December 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

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

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

Governor Wolf

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

General Assembly

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

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

State Revenue Update

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

Department of Human Services

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

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

Department of Health

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

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

COVID-19: By the Numbers

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

Department of Drug and Alcohol Programs

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

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

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

Medical Assistance Advisory Committee – December 9

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

Patient Safety Authority – December 9

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

jsteinbock2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of November 8-12

The following is an update of selected state health policy developments in Pennsylvania for the week of November 8-12, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced his intention to return the decision on mask requirements in K-12 schools to local leaders on January 17, 2022. It may not take that long, though: as the Philadelphia Inquirer reports, Pennsylvania’s Commonwealth Court “…has struck down the state’s school mask mandate, ruling that acting Health Secretary Alison Beam didn’t have the authority to issue the requirement under the state’s Disease Control and Prevention Law.” The Department of Health is appealing the court’s decision.

General Assembly

The House of Representatives passed House Bill 1561 and House Bill 1563 on third and final consideration this week. 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 more easily share patient mental health and substance use disorder treatment information. Both bills were sent to the Senate and referred to its Health & Human Services Committee.
The Senate Majority Policy Committee held an informational meeting this week to examine COVID-19 vaccine mandates and their impact on the workforce. Testimony offered at the hearing and a video recording may be viewed here.
The Senate Health & Human Services Committee met twice this week and favorably reported the following bills:
- Senate Bill 471, which prohibits the implementation of COVID-19 vaccine mandates;
- House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment; and
- Senate Bill 938, which clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.

Recordings of both committee meetings may be viewed here.

The Senate Aging & Youth Committee favorably reported House Bill 1260, which increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples.

Department of Human Services

The Department of Human Services has issued updated requirements on the information needed to evaluate prior authorization requests for certain medications, based on actions taken by its Pharmacy and Therapeutics Committee during its September 14 meeting:

Department of Health

The Department of Health (DOH) has issued a health advisory echoing the federal decision that a pediatric formulation of the Pfizer vaccine has been approved for children from the ages of five to 11.

DOH has announced that information on schools participating in a free and voluntary COVID-19 screening testing program, which is available through a partnership with the company Gingko Bioworks, is now available on its web site. Go here for the DOH announcement and here for information about the program.

COVID-19: By the Numbers

The general downward trend in new daily COVID-19 cases in Pennsylvania halted over the past week with several days of more than 5000 new cases. The state’s total number of COVID-19 cases since the start of the pandemic surpassed 1.6 million this week – a figure that represents approximately 12 percent of the state’s population.

The number of new COVID-19-related deaths remains high. 196 new deaths were reported on Wednesday – the highest single-day figure since late January. This week Pennsylvania surpassed 32,000 COVID-19-related deaths.

All 67 Pennsylvania counties are currently experiencing a high rate of COVID-19 transmission.

The number of Pennsylvanians hospitalized because of COVID-19 has fallen five percent since the beginning of November; the number in hospital ICUs has fallen nine percent; and the number on ventilators because of the virus has fallen 11 percent.

72.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people. 70,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Stakeholder Events

Pharmaceutical Assistance Advisory Board – November 15

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

Health Research Advisory Committee – November 15

The Department of Health’s Health Research Advisory Committee will hold a virtual public meeting on Monday, November 15 at 1:00 p.m. For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Pennsylvania Rural Health Redesign Center Authority Board – November 16

The Department of Health’s Pennsylvania Rural Health Redesign Center Authority Board, which is charged with administering the Pennsylvania Rural Health Model, will hold a virtual public meeting on Tuesday, November 16 at 10:00 a.m. For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Newborn Screening and Follow-Up Technical Advisory Board – November 18

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Thursday, November 18 at 10:00 a.m. For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee Meeting – December 2

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will hold a virtual public meeting on Thursday, December 2 at 10:00 a.m. To register to participate, go here.

jsteinbock2021-11-12T22:01:57+00:00November 12th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for the Week of November 1-5

The following is an update of selected state health policy developments in Pennsylvania for the week of November 1-5, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration announced that “Pennie,” the state’s new health insurance exchange, has now begun operations as this year’s Affordable Care Act open enrollment period begins. Find Pennie here.

General Assembly

The House and Senate will be in session next week on Monday (10/8), Tuesday (10/9), and Wednesday (10/10). The following health care-related committee meetings have been scheduled:
- The Senate Majority Policy Committee will hold an informational meeting on Monday, November 8 at 10:00 a.m. to examine COVID-19 vaccine mandates and their impact on the workforce. The hearing will be live-streamed here.
- The Senate Health & Human Services Committee will convene on Monday, November 8 at 12:30 p.m. to consider Senate Bill 471, which prohibits the mandatory vaccination of Pennsylvania residents by the state or as a condition of employment. The committee will also consider House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment.
- The Senate Aging & Youth Committee will meet on Tuesday, November 9 at 12:00 p.m. to consider, among other bills, House Bill 1260, which increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples.

The House of Representatives is planning to consider a few key behavioral health bills next week, including House Bill 1561 and House Bill 1563, which 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 more easily share patient mental health and substance use disorder treatment information. The House is also planning to consider House Bill 1308, which enables local communities and agencies to establish overdose fatality review teams.

Department of Human Services

The Department of Human Services (DHS) has issued updated requirements on the information needed to evaluate prior authorization requests for certain medications based on actions taken by its Pharmacy and Therapeutics Committee during its September 14 meeting. These updated requirements take effect on January 3, 2022.
DHS has updated its collection of regulations that have been suspended as a result of the COVID-19 emergency.
DHS has announced changes in fee schedule rates for selected personal assistance services procedure codes in the Medical Assistance OBRA Waiver and the Act 150 Program. The changes in the fee schedule rates for these services will take effect on January 1, 2022. Learn about the changes in this Pennsylvania Bulletin notice.
DHS’s Office of Long-Term Living has distributed the following message to stakeholders via its Community HealthChoices listserv:

This communication is intended for Department of Human Services (DHS) Sandata Electronic Visit Verification (EVV) and DHS Aggregator users for informational purposes regarding how the DHS Aggregator will be handling the end of Daylight Savings Time (DST) which is set to occur at 2:00 AM this Sunday, November 7, 2021.

For scheduled and completed visits that occur during or crossover the end of DST, the scheduling hours will appear to be short by an hour. This is expected behavior since DHS Aggregator times are calculated based on Coordinated Universal Time (UTC). Provider agencies and/or administrators should not adjust visit times related to DST. Visits during this event will continue to be calculated based on the actual visit times so there are no issues with billing requirements.

Any questions related to this can be submitted to RA-PWEVVNOTICE@pa.gov

Department of Health

The Department of Health has rescinded a May 26, 2021 order that required skilled nursing facilities to make weekly reports of specified data on supplies and equipment. The department has launched a new data dashboard with facility-level COVID-19 resident and staff cases, deaths, and vaccination rates that uses data that nursing homes are already required to report to the federal government. The Survey 123 reporting requirement was eliminated effective October 29, 2021.

COVID-19: By the Numbers

While there has been a modest downward trend in new COVID-19 cases in recent weeks, the past two days have seen the two highest single-day counts of new cases since mid-October.
Approximately 32,710 of the state’s total cases to date have been among health care workers.
The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly three times greater this year than in 2020. Between October 27 and November 2, 2020 there were 1,683 COVID-19 cases in school-aged children compared to 4,918 cases in the same age group during the same week this year.
In licensed nursing and personal care homes there have been 79,250 resident cases of COVID-19 to date and 17,449 cases among employees for a total of 96,699 at 1,642 facilities in all 67 counties.
The number of new COVID-19-related deaths remains high but did not rise during the past week.
Sixty-six of Pennsylvania’s 67 counties currently are experiencing high rates of community transmission of COVID-19; Philadelphia County is experiencing “only” a substantial rate of community transmission.
The number of Pennsylvanians hospitalized, in hospital ICUs, and on ventilators because of COVID-19 has fallen slightly since the first of the month.
72.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people. 38,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The state’s Independent Regulatory Review Commission has approved the Department of Drug and Alcohol Programs’ proposed regulations for drug and alcohol recovery house licensure. See the approval in this Pennsylvania Bulletin notice.

Stakeholder Events

Pharmaceutical Assistance Advisory Board – November 15

Health Research Advisory Committee – November 15

Pennsylvania Rural Health Redesign Center Authority Board – November 16

Newborn Screening and Follow-Up Technical Advisory Board – November 18

Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee Meeting – December 2

jsteinbock2021-11-05T21:56:42+00:00November 5th, 2021|Affordable Care Act, Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for the Week of October 25-29

The following is an update of selected state health policy developments in Pennsylvania for the week of October 25-29, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate passed Senator Vogel’s telemedicine bill (Senate Bill 705) this week by a vote of 46-4. The bill has been received in the House and referred to the Insurance Committee.
The House of Representatives unanimously passed House Bill 1260, which, among other things, increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples. The bill has been received in the Senate and referred to the Aging & Youth Committee.
The House Human Services Committee met on Tuesday, October 26 and favorably reported the following bills:
- House Bill 1561 and House Bill 1563 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 more easily share patient mental health and substance use disorder treatment information.
- House Bill 1995 clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.
- House Bill 1308 enables local communities and agencies to establish overdose fatality review teams.

The House and Senate will be in recess the week of November 1.

Department of Human Services

The Department of Human Services’ (DHS) Office of Mental Health & Substance Abuse Services (OMHSAS) has posted a Behavioral Health Telehealth Frequently Asked Questions (FAQs) memorandum in response to inquiries regarding recent OMHSAS behavioral health telehealth policy changes in OMHSAS-21-09 Guidelines for the Delivery of Behavioral Health Services Through Telehealth.

DHS has published Medical Assistance physical health managed care enrollment data for September.

Department of Health

The Department of Health (DOH) has issued recommendations for COVID-19 vaccination booster doses.
DOH has updated its quarantine recommendations for persons exposed to COVID-19. These recommendations are distinct from quarantine and isolation recommendations applicable to health care personnel.
DOH has advised long-term-care facilities on steps they should take as soon as possible to begin scheduling appointments for eligible individuals to receive COVID-19 vaccination boosters. (Note: this link opens to download.)
DOH has launched a new dashboard to provide a comprehensive view of the impact of COVID-19 on residents and staff in 688 nursing homes across the state. Learn more from this DOH news release and go here to see the new dashboard. The new dashboard will be updated every Friday.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained steady over the past week.

The number of new COVID-19-related deaths remains high but did not rise during the past week. The state surpassed 31,000 deaths from COVID-19 this week.

Two Pennsylvania counties – Philadelphia and Sullivan – currently are experiencing “only” substantial rates of community transmission of COVID-19; the remaining 65 counties are experiencing high levels of community transmission.

The number of Pennsylvanians hospitalized, in hospital ICUs, and on ventilators because of COVID-19 has remained steady throughout October.

71.6 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people. 43,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Insurance Department

The Insurance Department has notified all basic insurance coverage insurers and self-insured participating health care providers that the annual assessment to be levied for calendar year 2022 shall be 12 percent applied to the prevailing primary premium for each participating health care provider. Learn more from this Pennsylvania Bulletin notice.

Stakeholder Events

Health Care Cost Containment Council – November 4

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

Organ Donation Advisory Committee Meeting – November 4

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

Traumatic Brain Injury Advisory Board – November 5

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

Pharmaceutical Assistance Advisory Board – November 15

Health Research Advisory Committee – November 15

Pennsylvania Rural Health Redesign Center Authority Board – November 16

Newborn Screening and Follow-Up Technical Advisory Board – November 18

Stakeholder Events Materials

Medical Assistance Advisory Committee

Pennsylvania’s Medical Assistance Advisory Committee met on Thursday, October 28. The Office of Medical Assistance Programs, Office of Long-Term Living, Office of Mental Health & Substance Abuse Services, and Office of Developmental Programs all made presentations. Go here for links to those presentations.

jsteinbock2021-10-29T21:31:31+00:00October 29th, 2021|Coronavirus, COVID-19, HealthChoices, Pennsylvania Bulletin|Comments Off

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

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

Governor Wolf

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

General Assembly

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

Department of Human Services

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

Department of Health

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

COVID-19: By the Numbers

The daily number of new COVID-19 cases declined slightly this week.

The number of new COVID-19-related deaths remains high but did not rise during the past week.

Every county in Pennsylvania continues to experience a high level of COVID-19 transmission.

The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
71.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people. 3000 Philadelphians and 58,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Pennsylvania Rural Health Model

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

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

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

Medical Assistance Advisory Committee – October 28

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

Special Pharmaceutical Benefits Program Advisory Council – October 28

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

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Health Care Cost Containment Council – November 4

Organ Donation Advisory Committee Meeting – November 4

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

Traumatic Brain Injury Advisory Board – November 5

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

Pharmaceutical Assistance Advisory Board – November 15

jsteinbock2021-10-22T21:03:04+00:00October 22nd, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of October 4-8

The following is an update of selected state health policy developments in Pennsylvania for the week of October 4-October 8, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration announced the recipients of more than $12 million in federal funding for services and supports designed to improve outcomes for individuals in recovery from substance use disorder. The grants are part of $55 million in federal funding awarded to Pennsylvania through the federal SAMHSA Substance Abuse Prevention and Treatment Block Grant Program COVID-19 Supplemental Awards.

General Assembly

Senate Bill 397 and Senate Bill 398 were signed by Governor Wolf; they are now Act 78 and Act 79, respectively. These bills add a physician assistant to the State Boards of Medicine and Osteopathic Medicine. They also eliminate the countersignature requirement under certain conditions, increase the number of physician assistants a physician may supervise, and streamline the written agreement. Acts 78 and 79 require the boards to promulgate rules and regulations necessary to carry out the acts within 180 days.
House Bill 1893 was passed by the House of Representatives on a party-line vote Monday. This bill makes all disease information under the Disease Prevention and Control Act of 1955 subject to the state’s right-to-know law. The bill will now head to the Senate.
The House Professional Licensure Committee met to consider a number of bills, including:
- House Resolution 142 was reported as committed. This resolution directs the Joint State Government Commission to conduct a comprehensive study and review of the State Board of Nursing.
- House Bill 889 was also reported as committed. This bill authorizes the State Board of Nursing to approve graduates of international nursing education programs to sit for the RN licensure examination provided such programs are determined to be equivalent to that which is required in Pennsylvania.
- The committee held an informational meeting on Wednesday to discuss House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals. A video transcript of the meeting can be found here.

The Senate revised its scheduled session days for the fall. Sessions previously scheduled for October 20, November 15, 16, and 17 have been canceled and November 8, 9, and 10 have been

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has issued comments on the Department of Health’s proposed update of regulations affecting long-term-care facilities. Most significant among the IRRC’s comments is a concern that the Department of Health has not fully explored the financial impact of these changes on the regulated community. The Department of Health is required to respond to the IRRC’s concerns as part of the continuing review of these regulations.

Department of Health

The Department of Health issued recommendations for certain individuals to receive a booster dose of the Pfizer COVID-19 vaccine.

The Department of Health released an updated report on post-vaccination COVID-19 events. The report found that 91 percent of reported COVID-19 cases were among unvaccinated or not fully vaccinated people and 93 percent of hospitalizations and deaths were among unvaccinated or not fully vaccinated people.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained high this week.
The Department of Health reported 93 new COVID-19-related deaths yesterday. County-specific information and a statewide map are available on the COVID-19 Data Dashboard.
There are 2,930 Pennsylvanians hospitalized with COVID-19. Of that number, 680 are in an intensive care unit with COVID-19. The trend in the 14-day moving average number of hospitalized patients continues to rise. The full 14-day moving average since the start of the pandemic can be found here.
According to the CDC, as of Wednesday, October 6, 69.3 percent of Pennsylvanians age 18 and older are fully vaccinated, up from 68.2 percent last week.
The Department of Health is now publishing vaccination data by legislative district (state Senate, state House, and Congress). The data may be found here.

Economic Impact of Hospitals

The Hospital and Healthsystem Association of Pennsylvania (HAP) announced the release of a report this week on the economic impact of hospitals on the state and local economies. The report found that hospitals contribute $155 billion to Pennsylvania’s economy, support more than 615,000 jobs, and generate $38 billion in wages, salaries, and benefits. Find the report here and an executive summary here.

Around the State

Public health officials in Pittsburgh warned about the dangerous effects of vaccine misinformation, reports the Pittsburgh Post-Gazette.
Senator Scott Martin (R-Lancaster County) has criticized the Department of Health for “bullying” individuals who fail to comply with COVID-related quarantine requirements. The Department of Health maintains the letter cited by Senator Martin was taken out of context for “political gain.” The Pennsylvania Capital Star details the competing narratives.
Spotlight PA has reported that even as COVID-19 cases have increased among children, schools across Pennsylvania have not widely used a state program offering free COVID-19 testing for students.
Abortion rights are quickly becoming a prominent issue for the upcoming 2022 election season, according The Philadelphia Inquirer.
The Associated Press detailed efforts by the Republican-controlled General Assembly to make information on COVID-19 and other diseases more readily available. Democratic lawmakers expressed concern about the unintended consequences of making this information available.

Stakeholder Events

Maternal Mortality Review Committee Virtual Public Meeting

October 20 at 9:00 a.m.

The purpose of this virtual public meeting is to discuss new and ongoing issues involving treatment of maternal mortality and Department of Health programs related to care and treatment. For information on how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Spinal Cord Research Advisory Committee

October 21, 2021 at 9:30 a.m.

The purpose of this virtual public meeting is to review the work of the committee, review the status of the current request for application, and plan the process to review the next spinal cord research applications. For information on how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Special Pharmaceutical Benefits Program Advisory Council

October 28, 2021 at 10:00 a.m.

The Special Pharmaceutical Benefits Program Advisory Council will provide program guidance and recommendations to the Department of Health’s Special Pharmaceutical Benefits Program on drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. For information on how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

jsteinbock2021-10-12T17:45:33+00:00October 12th, 2021|Coronavirus, COVID-19, long-term care, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid|Comments Off

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

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

Governor Wolf

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

General Assembly

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

Department of Human Services

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

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

DHS has updated its list of regulations suspended due to the COVID-19 pandemic. Go here to find a more comprehensive list that encompasses all of state government.
DHS has published a Medical Assistance Bulletin updating the family planning services program fee schedule effective August 23.
DHS announced plans to distribute $655 million in funding from the American Rescue Plan Act to licensed child care agencies. Providers are invited to submit applications for one-time grant funding that can be used to cover expenses and provide stabilization. Learn more about the available funding and find links to information about the application process and an FAQ in this DHS news release.
DHS has posted a “provider quick tip” explaining procedure code/modifier combinations to be used when requesting home accessibility durable medical equipment in the Medicaid fee-for-service delivery system. Find it here.

Department of Health

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

Department of Drug and Alcohol Programs

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

COVID-19: By the Numbers

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

Independent Fiscal Office

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

Around the State

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

Stakeholder Events

Special Pharmaceutical Benefits Program Advisory Council – October 28

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

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Stakeholder Events Materials

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

jsteinbock2021-10-01T20:33:49+00:00October 1st, 2021|Coronavirus, COVID-19, long-term care, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off

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