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

The following is an update of selected state health policy developments in Pennsylvania for the week of June 21-25, 2021.  (Some of the language used below is taken directly from state documents.)

State-Wide Mask Mandate

The Department of Health announced that it is lifting its order requiring universal face coverings at 12:01 a.m. on Monday, June 28.   See the announcement here.  The department continues to urge Pennsylvanians to follow CDC guidance for wearing a mask where required by law, rule, and regulations, including health care, local business, and workplace guidance.  For the protection of themselves and others, individuals who have not yet been vaccinated or are partially vaccinated are still encouraged to wear a mask when in public.

Legislative Update

The following are health care bills that have received third and final consideration in the state House and/or Senate as of Thursday, June 24. Both chambers will hold voting session on Friday and Saturday and we anticipate there will be additional health care-related measures passed. We will provide an update following the end of session on any pertinent bills.

  • Senate Bill 115 – establishes the Nurse Licensure Compact Act, which upon enactment makes the Commonwealth a party to the Nurse Licensure Compact with all other states that have joined the compact. The bill was passed by the House 146-55 and sent to the Governor’s desk.
  • Senate Bill 425 – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions, or medications and devices. The bill was unanimously passed by the House on June 24th and sent to the Governor’s desk.
  • Senate Bill 484 – adds the chair of the State Veterans’ Commission or a designee to the Pennsylvania Long-term Care Council. The bill was unanimously passed by the House on June 24th and sent to the Governor’s desk.
  • Senate Bill 618 – prohibits the use of vaccine passports by government entities. It also prohibits institutions of higher education from requiring proof of vaccination against COVID-19 to use a service, enter a building, or undertake an activity, including attending class in person. In addition, the bill further restricts the Secretary of Health’s ability to implement certain disease control measures for individuals who have not been exposed, potentially or otherwise, to a contagious disease. The bill was signed in the state House and Senate on June 24th and sent to the governor. The governor has indicated he will veto

Department of Human Services

Department of Health

Effective at midnight on June 23, 2021, the Department of Health terminated its order requiring skilled nursing facilities to complete a vaccine needs assessment survey since those facilities are now reporting to the federal government.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline significantly.  The 174 new COVID-19 cases reported on Wednesday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
  • The number of COVID-19 deaths continues to decline significantly as well.
  • For the week from June 11 through June 17 the state’s overall COVID-19 test positivity rate was 1.4 percent, down from 1.9 percent last week and 2.9 percent the week before.
  • Sixty-four counties had a positivity rate lower than five percent, up from 62 last week, and no counties had a positivity rate greater than 20 percent for the eighth consecutive week.
  • Thirty-seven counties are currently experiencing low levels of community transmission of COVID-19, up from 22 last week; the remaining 30 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
  • Since June 1 the number of Pennsylvanians hospitalized with COVID-19 has fallen 62 percent; the number on a ventilator has fallen 54 percent; and the number in hospital intensive care units has fallen 70 percent.
  • 5.3 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard.  Growth in this number has slowed significantly over the past month and only about 150,000 new vaccinations were reported in the past week. Another 760,000 people have been vaccinated in Philadelphia.  According to the state, 59.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.2 percent of the entire population has now received at least the first dose of a vaccine.

Around the State

Two Pennsylvania children’s hospitals ranked among the best ten such hospitals in the U.S. in the latest rankings published by U.S. News & World Report:  Children’s Hospital of Philadelphia ranked second and UPMC Children’s Hospital of Pittsburgh ranked ninth.

Two Pennsylvania-based health insurers, Highmark and Independence Blue Cross, are among five Blues plans joining forces in a new venture called Evio, a for-profit venture that will seek to make prescription drugs more affordable and improve health care outcomes.  Learn more here.

Stakeholder Events

  • Maternal Mortality Review Committee

June 28 at 8:00

This meeting will be held via conference call.  The purpose of the meeting is to discuss new and ongoing procedural issues relating to the review process for the committee.  To join the call, dial +1 (267) 332-8737 and when prompted, enter the following conference code: 522 321 931#.

  • DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

  • Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar.  Public comments will be taken after each presentation and questions can be entered in the chat box.  Interested parties can participate in the following ways:

Webinar registration – go here

Dial in:  1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

  • Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting.  The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

  • Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728#   United States, Pittsburgh

(866) 588-4789,,785376728#   United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Medical Assistance Advisory Committee Meeting – June 24

Deputy DHS Secretary Sally Kozak announced that DHS will perform readiness reviews of the managed care organizations selected to participate in the latest HealthChoices program procurement.  The procurement remains the subject of litigation so DHS will stop short of negotiating with the managed care organizations until there is a final decision in that case.

Stakeholder Events Materials

DHS has posted four presentations offered at the June 24 meeting of the Medical Assistance Advisory Committee.  Those presentations were delivered by its:

 

Pennsylvania Health Policy Update for the Week of June 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of June 14-18, 2021.  (Some of the language used below is taken directly from state documents.)

Pennsylvania’s COVID-19 Disaster Declaration

With the certification of November’s election results, Governor Wolf’s COVID-19 emergency disaster declaration has officially ended but most of the regulatory waivers issued during the emergency will remain in effect until the end of September.  Learn more here.

Update on State FY 2021-2022 Budget

The General Assembly continues to work toward a final budget agreement, with both the House and Senate beginning to position bills that could ultimately serve as vehicles for a final budget agreement by June 30.  The Senate sent a General Fund appropriations bill (Senate Bill 255) to the House earlier this week and scheduled a Finance Committee meeting on Monday, June 21 to consider a fiscal code bill (House Bill 1348).  We will continue to keep you apprised of any relevant budget updates.

House Chamber of the State HouseLegislative Update

The following are health care bills that received third and final consideration in the state House and/or Senate during the week of June 14.  We are tracking other health care bills as they move through the legislative process as well.

  • House Bill 1082 requires the Department of Health to establish and maintain an Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder toolkit.  The toolkit, among other things, shall include best practice and cognitive assessment tools, primary care workforce education resources, and materials on the importance and value of early detection and timely diagnosis.  The House passed the bill 201-1 and sent it to the Senate for consideration.
  • House Bill 1428 permits a resident, or their guardian, to authorize the installation and use of video surveillance devices in long-term-care nursing facilities provided certain conditions are met.  The House passed the bill 160-42 and sent it to the Senate for consideration.
  • House Bill 1429 adds a new section to the state Crimes Code providing for the offense of financial exploitation of an older adult or care-dependent person.  It also clarifies that district attorneys have the right to investigate and institute criminal proceedings for any violation of this new section.  The House unanimously passed the bill and sent it to the Senate for consideration.
  • House Bill 1431 adds a new section to the Crimes Code that defines as abuse and establishes as a misdemeanor the use of social media by employees who post pictures of care-dependent individuals without permission.  The House passed the bill 198-4 and sent the bill to the Senate for consideration.
  • Senate Bill 445 permits a person renewing a driver’s license, identification card, or vehicle registration electronically through the Department of Transportation’s web site to contribute $5 to the Pennsylvania Breast Cancer Coalition for breast cancer research.  The House passed the bill unanimously and sent the bill to the governor for his consideration.
  • Senate Bill 416 establishes the certified registered nurse anesthetist (CRNA) designation in the commonwealth.  The legislation grants an individual licensed to practice professional nursing and who meets the requirements of this act the right to use the CRNA designation exclusively.  The Senate passed the bill unanimously and sent it to the House for consideration.
  • House Bill 649 requires the Department of Health, in consultation with the Department of Human Services, to establish protocols to permit an essential caregiver to provide in-person physical and emotional support to a congregate care facility resident during a declaration of disaster emergency.  The Senate passed the bill 32-18 and sent it to the governor.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline.  With 277 new COVID-19 cases reported, yesterday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
  • The number of COVID-19 deaths continues to decline significantly.
  • For the week from June 4 through June 10 the state’s overall COVID-19 test positivity rate was 1.9 percent, down from 2.9 percent last week and 3.8 percent the week before.
  • Sixty-two counties had a positivity rate lower than five percent, up from 55 last week, and no counties had a positivity rate greater than 20 percent for the seventh consecutive week.
  • Twenty-two counties are currently experiencing low levels of community transmission of COVID-19, up from 13 last week; 53 counties are experiencing moderate levels of community transmission; and only one county (Potter) is currently experiencing a substantial level of community transmission, the same number as last week.
  • In just 17 days since June 1 (as of Thursday, June 17), the number of Pennsylvanians hospitalized with COVID-19 has fallen 54 percent; the number on a ventilator has fallen 44 percent; and the number in hospital intensive care units has fallen 54 percent.
  • 5.2 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard.  Growth in this number has slowed significantly over the past three weeks. Another 760,000 have been vaccinated in Philadelphia.  According to the state, 58.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 61.1 percent of the entire population has now received at least the first dose of a vaccine.

Department of Human Services

The American Rescue Plan offers a temporary 10 percent increase in federal Medicaid matching fund for certain state Medicaid expenditures for home and community-based services (HCBS).  DHS has submitted a preliminary spending plan to the federal Centers for Medicare & Medicaid Services (CMS) as part of the process of seeking approval for this additional funding and has invited stakeholder comment on its proposal.  Comments are due July 6.  Go here to see DHS’s announcement of this endeavor; go here to see a Wolf administration news release on the subject; and go here to see DHS’s preliminary spending plan.

DHS has updated its list of mailing dates for the most current four Remittance Advices and corresponding checks.

Department of Drug and Alcohol Programs

In response to the COVID-19 pandemic, the Department of Drug and Alcohol Programs suspended three of its regulations governing narcotic treatment programs:  one limiting the supply of medicine  those programs can dispense at one time to their patients; another requiring those programs to meet patients in person before prescribing buprenorphine; and the third requiring them to have a physician on the premises.  While the governor’s declaration of a disaster emergency has been terminated, the department has advised all stakeholders that these three regulations will remain suspended until September 30.  Go here for more information.

The Department of Drug and Alcohol Programs has issued an alert clarifying the requirements that licensed providers must meet to use certain medications, including methadone, buprenorphine, and naltrexone.

Around the State

  • Of the more than 600,000 residents of Allegheny County who are fully vaccinated, according to county health officials, only 420 have contracted COVID-19 – so-called breakthrough cases; only 11 of the 420 required hospitalization.  The Pittsburgh Tribune-Review provides the details.
  • Demand for COVID-19 vaccinations is falling in the Lehigh Valley and throughout Pennsylvania and the Allentown Morning Call offers the numbers to prove it.
  • While COVID-19-related hospitalizations have declined state-wide they are rising in Erie and Crawford County.  GoErie looks into why.
  • Cumberland County has made masks optional for staff and visitors at any county facility except the Claremont Nursing and Rehabilitation Center and Cumberland County Prison, according to the Carlisle Sentinel.
  • The city of Pittsburgh has announced plans for its workforce to return to city offices, the Pittsburgh Business Times reports.
  • “The company responsible for administering Pennsylvania’s contact tracing program has called on current and former employees to help it locate and secure documents online that might still contain the personal information of those who were contacted, “ according to Spotlight PA, which added that “…a lawyer for Insight Global asked them to contact the company’s information security team if they had any paper or electronic records, internet links and files, or Google Drive documents related to the program.”  The company was fired because of data leaks.
  • Black maternal morbidity rates in Philadelphia are among the highest in the country, the Pennsylvania Capital-Star reports.
  • “Medical marijuana sales in Pennsylvania topped more than $900 million over one year during the COVID-19 pandemic, and could soon see $3 billion in total sales with just a few operating years under its belt,” the Delaware County Daily Times writes, adding that “According to figures provided by the Pennsylvania Department of Health, sales from growers/producers to dispensaries have reached almost $1.2 billion and sales from dispensaries to patients have crested $1.7 billion.”

Pennsylvania Bulletin

The latest issue of the Pennsylvania Bulletin is now available.  It includes new items from the Department of Human Services, Department of Health, the General Assembly, and others.  Find it here.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar.  Public comments will be taken after each presentation and questions can be entered in the chat box.  Interested parties can participate in the following ways:

Webinar registration – go here

Dial in:  1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

2021-06-18T19:18:59+00:00June 18th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2022 budget|Comments Off on Pennsylvania Health Policy Update for the Week of June 14-18

New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

The Pennsylvania Department of Human Services has issued a new Medical Assistance Bulletin titled “Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans.”
According to the document,

The purpose of this Medical Assistance (MA) Bulletin is to remind hospitals of the requirements for the Hospital Uncompensated Care Program (Program) and reinforce the responsibility of hospitals to actively engage patients when determining eligibility for the Program.

See the entire Bulletin here.
 

2018-01-08T06:00:47+00:00January 8th, 2018|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

DHS Reorganizes

The Pennsylvania Department of Human Services (DHS), which administers the state’s Medicaid program, has reorganized both the department as a whole and its Office of Medical Assistance Programs.
Pennsylvania_Bulletin_logoNew tables of organizations for both entities have been published in the Pennsylvania Bulletin. Find them here.

2015-09-01T06:00:43+00:00September 1st, 2015|Pennsylvania Bulletin|Comments Off on DHS Reorganizes

No Observation Rate Yet for PA Medicaid

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin continuing its current payment methodology under the state’s Medicaid program but noting that it still has not developed an observation rate for the program.
Last year the state indicated that it wanted to establish such an observation rate, but it has not yet done so.  The new notice states that

The Department also announced its intent to establish an observation rate for hospital cases for which an inpatient admission is not medically necessary, but medical observation of a patient is required. The Department received multiple public comments concerning an intended observation rate. At this time, the Department plans to develop a payment policy and rates for observation services and will provide an opportunity for public comment in a future notice of intent.

At the time the state expressed an interest in developing an observation rate, the Safety-Net Association of Pennsylvania wrote to the Department of Public Welfare expressing support for the concept.  Read SNAP’s letter here.
Find the entire Pennsylvania Bulletin notice here.

2014-05-19T06:00:51+00:00May 19th, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on No Observation Rate Yet for PA Medicaid

PA Seeks Federal OK for Medicaid Expansion

The Corbett administration is asking the federal government to authorize the expansion of the state’s Medicaid program to serve another 500,000 people.
Healthy Pennsylvania, the reform plan unveiled by the Corbett administration in September, calls for expanding eligibility for Medicaid as envisioned in the federal Affordable Care Act but providing coverage to newly eligible individuals through private insurers
Under the plan, most newly eligible recipients would select state-subsidized insurance through the federal health insurance marketplace and receive the same benefits as regular commercial customers.
Healthy Pennsylvania also calls for streamlined benefits packages, enrollee premiums, and a work search requirement.
The formal unveiling of the plan is linked to the state’s application to the federal government for a waiver from selected federal Medicaid requirements.  While states routinely request such waivers, each waiver is subject to individual scrutiny and negotiation between the state and federal governments after a period of public comment at the state level.
To learn more about the Healthy Pennsylvania proposal, see this Philadelphia Inquirer article.  The administration also has published a description of its proposed application for the federal waiver, including information about how interested parties may comment on the proposal, in the Pennsylvania Bulletin; that notice can be found here.  The complete draft waiver application can be found here.

PA Posts FY 2013 Medicaid DSH Eligibility

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin listing all hospitals eligible for Medicaid disproportionate share adjustments (Medicaid DSH) during the state’s 2013 fiscal year.  See the Pennsylvania Bulletin notice here.

2013-08-21T11:38:38+00:00August 21st, 2013|Medicaid supplemental payments, Pennsylvania Bulletin|Comments Off on PA Posts FY 2013 Medicaid DSH Eligibility

SNAP Comments on Observation Rate Proposal

The Safety-Net Association of Pennsylvania has submitted a formal comment letter to the state’s Department of Public Welfare in response to the department’s expressed interest in establishing an observation rate in the state’s Medical Assistance fee-for-service program.
DPW expressed this interest in a June 29 Pennsylvania Bulletin notice.
SNAP supports the creation of an observation rate, and in its letter it outlines how it believes DPW should go about developing a rate that is fair to hospitals.
Safety-net hospitals have a special interest in this issue because observation rate candidates enter hospitals through their emergency rooms and safety-net hospitals typically have among the busiest emergency rooms in the communities they serve.
Read SNAP’s observation rate comment letter hereSafety-Net Association of Pennsylvania logo.

2013-07-23T16:12:30+00:00July 23rd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on SNAP Comments on Observation Rate Proposal

PA Considering Medicaid Observation Rate

The Pennsylvania Department of Public Welfare is considering instituting a Medicaid observation rate for some hospital services.
According to a recently published Pennsylvania Bulletin,

The Department is considering the establishment of an observation rate for hospital cases for which an inpatient admission is not medically necessary but medical observation of a patient is required. The Department is currently considering developing criteria under which observation services provided by a hospital may be compensable under the MA Program. The Department intends to establish a comprehensive rate to cover observation services determined to be compensable under the Program.

DPW will accept written comments about this proposal for the next 30 days.
Read the Pennsylvania Bulletin notice here.

2013-07-02T06:00:31+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Proposed FY 2014 Pennsylvania state budget|Comments Off on PA Considering Medicaid Observation Rate
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