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PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20. (Some of the language used below is taken directly from state documents).

Governor Shapiro

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release.

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.

The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.

The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice.

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here.

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State

Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.

The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.

The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field.

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.

Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release.

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA). These changes are effective for dates of service on or after September 9, 2024.

DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.

DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

DHS has released an updated Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here.

Department of Drug & Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here.

Stakeholder Events

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Safety Net Admin2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for September 6

The following is an update of selected state health policy developments in Pennsylvania from September 2 – 6. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives has changed September 23, 24, and 25 to non-voting session days and added October 7, 8, and 9 as voting session days.

The House and Senate are currently recessed until Monday, September 30 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding new procedure codes based on clinical review, provider requests, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the FDA. DHS is also making changes to prior authorization requirements as a result of clinical review. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced updates to the Family Planning Services program fee schedule, effective for dates of service on and after July 1, 2024. Find additional information, including the procedure codes, in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has announced it is conducting its annual questionnaire of long-term care facilities for the data reporting period of July 1, 2023 through June 30, 2024. The mandatory questionnaire must be completed and electronically submitted to DOH by Friday, October 25. If a long-term care facility did not receive an email on September 4^th with a link to the questionnaire, please contact Aicha Hassane Noma at ahassaneno@pa.gov or email RA-dohbhssurveys@pa.gov.

Secretary of Health Dr. Debra Bogen visited the Meadville Area Ambulance Service this week to discuss the administration’s ongoing emergency medical services (EMS) recruitment and retention efforts and other investments in EMS professionals across Pennsylvania, including the expansion of a PILOT program to introduce high school students to the EMS profession and the launch of a $1 million tuition assistance program. Find additional information in this press release.

DOH has announced it is extending the deadline for the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) Provider Readiness Survey to September 20. The survey can be accessed here.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $53.9 million, or 1.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $5.9 billion, which is $53.9 million, or 0.9 percent, above estimate.

Around the State

Spotlight PA has published an article about the state Supreme Court and a number of cases related to abortion, gun control, and climate change that are awaiting decisions.

An article published in The Center Square highlights the concerning closure of several independent pharmacies and the Auditor General’s recently released PBM audit for Medicaid prescription drug benefits.

PennLive has reported on recent polling of Pennsylvania voters that shows Vice President Harris and former President Donald Trump are in a close race. The article also highlights polling for the Pennsylvania U.S. Senate race between incumbent Senator Bob Casey and challenger David McCormick.

Stakeholder Events

DOH – WIC State Advisory Board Meeting – September 10

The Department of Health has issued a correction notice in the Pennsylvania Bulletin with a revised link to join the board’s meeting scheduled for Tuesday, September 10 at 1:00 p.m.

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority Board – September 19

The Patient Safety Authority has announced a meeting of the authority’s board to be held virtually on Thursday, September 19 at 1:00 p.m. The meeting is open to the public. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-09-06T20:01:48+00:00September 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for August 30

The following is an update of selected state health policy developments in Pennsylvania from August 26 – 30. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration, including leadership from the Departments of Human Services, Health, Drug & Alcohol Programs, and the Pennsylvania Insurance Department, has announced it is beginning the process of developing a state-wide maternal health strategic plan, which will address high rates of maternal mortality and ensure pregnant women in Pennsylvania receive necessary prenatal and postpartum care. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has provided final notice of the fee schedule rates for targeted support management and services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and Department-established fees for residential ineligible services. The rates for community-based services and residential services are effective July 1, 2024. The rates for Agency With Choice Financial Management Services and Life Sharing will be effective October 1, 2024.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has shared a comprehensive resource guide for National Suicide Prevention month. The guide offers examples of activities that organizations and/or communities can do to raise awareness of the importance of suicide prevention, including ideas for events, trainings, social media, sample local government proclamations, etc.

DHS has published its annual list of each inpatient acute care general hospital, rehabilitation hospital and private psychiatric hospital qualifying for a disproportionate share payment from July 1, 2023 to June 30, 2024 and each hospital’s respective disproportionate share payment percentage. Find the comprehensive list in this Pennsylvania Bulletin notice.

DHS has published its report on Medicaid managed care enrollment in Pennsylvania for the month of July.

Department of the Auditor General

Auditor General Tim DeFoor has released a report with results from the department’s performance audit of the Physical HealthChoices Medicaid program and its contracted pharmacy benefit manager (PBM), PerformRx, LLC. The report found Pennsylvania paid $7 million more than it should have for Medicaid prescription drug benefits during 2022. The report attributes the overspending to a lack of oversight by the Department of Human Services (DHS).

Department of State

The Department of State has announced beginning August 26 out-of-state physicians licensed by a state or territory participating in the Interstate Medical Licensure Compact (IMLC) who obtain a corresponding “letter of qualification” will be permitted to apply to the Pennsylvania state boards of Medicine and Osteopathic Medicine for expedited licensure to practice in the Commonwealth. Find additional information in this press release.

Around the State

Spotlight PA has published an article about the growing number of vaccine exemptions in Pennsylvania schools and the concerning potential for measles outbreaks.

The Auditor General’s report on the Department of Human Services (DHS) oversight of pharmacy benefit managers (PBMs) was covered in an article published by the Associated Press.

Another article by Spotlight PA highlights efforts to address the rural health care workforce crisis, including a legislative proposal being championed by Rep. Kathy Rapp (R) and Rep. Dan Frankel (D) that would provide grant funding to assist with the hiring of health care practitioners at rural facilities.

Stakeholder Events

DOH – Health Research Advisory Committee – September 12

DOH – Tobacco-Free Recovery Statewide Conference – October 9

The Pennsylvania Statewide Tobacco-Free Recovery Initiative will hold its fourth annual “Tobacco-Free Recovery is Recovery” conference on Wednesday, October 9. The conference will be held virtually. Find registration information here.

DOH – PDMP Board Meeting – October 22

PA Safety Net Admin2024-08-31T02:41:10+00:00August 30th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for August 9

The following is an update of selected state health policy developments in Pennsylvania from August 5 – 9. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has issued two Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health

The Department of Health (DOH) has announced it distributed 50,000 xylazine wound care kits to provide relief for people with xylazine-associated wounds. The kits have been distributed to more than 200 medical and harm reduction organizations across the commonwealth. Find additional information in this press release.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new research brief, Hospitalizations for Pennsylvania Children with Cancer. The research brief examines inpatient hospitalizations for Pennsylvania children who were admitted to a Pennsylvania general acute care hospital with a diagnosis of cancer.

Insurance Department

The Pennsylvania Insurance Department has announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available here. Find additional information in this press release.

Around the State

The Philadelphia Inquirer has published an article about Crozer Health’s potential sale to New Jersey-based CHA Partners, and its conversion back into a non-profit. WHYY also wrote an article about the planned sale

Vice President Kamala Harris’ decision to pick Minnesota Governor Tim Walz as her running mate over Pennsylvania Governor Josh Shapiro received a lot of media coverage this week, including this article published by The Philadelphia Inquirer.

PennWatch has published an article about the Shapiro administration’s efforts to distribute 50,000 xylazine wound care kits across the state.

Stakeholder Events

DHS – Dual Diagnosis Conference – September 11

The Office of Developmental Programs (ODP) and the Office of Mental Health and Substance Abuse Services (OMHSAS) have announced the Dual Diagnosis Conference Services, “Insidious Trauma: Context, Impact, and Considerations for Care.” The conference will be held September 11 from 10:00 a.m. to 1:00 p.m. Find additional information and registration details here.

DHS – OLTL Transportation Summit – September 17

The Office of Long-Term Living (OLTL) will host a transportation summit on Tuesday, September 17 from 9:00 a.m. to 12:00 p.m. The summit is an open forum for anyone interested in discussing transportation related issues in the Community HealthChoices (CHC) program. The summit will be held virtually. Find registration details here.

DOH – Spinal Cord Injury Research Advisory Committee – September 18

The Spinal Cord Injury Research Advisory Committee will hold a public meeting on Wednesday, September 18 from 9:30 a.m. to 11:00 a.m. The meeting will be held in person at Saint John’s Evangelical Lutheran Church (910 Allentown Road, Sellersville, PA 18960) and virtually by means of Microsoft Teams. Find additional details in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-08-10T00:03:40+00:00August 9th, 2024|Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for July 12

The following is an update of selected state health policy developments in Pennsylvania from July 8 – 12. (Some of the language used below is taken directly from state documents).

FY 2024-2025 Budget Update

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.

The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.

The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.

The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.

The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.

The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration.

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024.

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee.

Centers for Medicare and Medicaid Services

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics. In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas. For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking.

Stakeholder Events

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Safety Net Admin2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for July 5

The following is an update of selected state health policy developments in Pennsylvania from July 1 – 5. (Some of the language used below is taken directly from state documents).

FY 2024-2025 Budget Update

The Commonwealth of Pennsylvania is five days into the new Fiscal Year (FY) and still doesn’t have an enacted budget, but legislative leaders remain optimistic that an agreement will be reached in the near term. The state House of Representatives and Senate, who recessed briefly for the Fourth of July, are currently scheduled to return on Saturday, July 6 to continue work on the FY 2024-2025 budget and its related bills.

Governor Shapiro

Governor Shapiro signed House Bill 1754 into law on Monday. Now known as Act 39 of 2024, this legislation requires public and private insurers to cover biomarker testing. Find additional information in this press release.

On Wednesday Governor Shapiro signed Senate Bill 739 into law. Now known as Act 42 of 2024, this piece of legislation provides for coverage of telemedicine services. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate held voting session Monday, July 1 through Wednesday, July 3. The following is an overview of selected health care-related legislative activity that occurred.

The Senate confirmed Dr. Debra Bogen as Secretary of the Department of Health by a vote of 42 – 8 on Monday, July 1. Dr. Bogen has been serving as Acting Secretary since the beginning of the Shapiro administration. Find additional information in this press release.

The Senate passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to Governor Shapiro for his signature.

The Senate passed House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent back to the House for concurrence.

The Senate passed Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill was received in the House and referred to the Health Committee.

The House of Representatives passed House Bill 2429, which establishes an inmate reentry program operated by the Department of Human Services to provide substance use disorder treatment and case management services prior an inmate’s release from a correctional institution. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2175, which creates a permanent Office of Child Advocate. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. The bill will now be sent to the Senate for consideration.

The House and Senate are currently scheduled to return to Harrisburg for voting session Saturday, July 6.

Department of Human Services

The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) for nursing facilities. Find the list and additional information in this Pennsylvania Bulletin notice.

DHS has published two notices in the Pennsylvania Bulletin related to the implementation and reauthorization of the Philadelphia hospital assessment, including the establishment of a new class of supplemental payments and the discontinuation of certain DSH and supplemental payments.

- DSH and Supplemental Payments to Qualifying Hospitals
- Supplemental Payments to Qualifying Hospitals

DHS has published updates to the Medical Assistance (MA) program fee schedule for ophthalmology services, effective for dates of service on and after August 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued a number of Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health

The Department of Health (DOH) has requested providers who operate mobile clinics complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services.

Revenue Collection Update

The Department of Revenue has announced Pennsylvania ended Fiscal Year (FY) 2023-2024 with $45.5 billion in General Fund collections. That total is $862.9 million, or 1.9 percent, above estimate.

Stakeholder Events

DOH – WIC Advisory Board – July 9

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory will meet on July 9 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-07-08T20:21:52+00:00July 5th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for June 28

The following is an update of selected state health policy developments in Pennsylvania from June 24 – 28. (Some of the language used below is taken directly from state documents).

FY 2024-2025 Budget Update

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future.

General Assembly

The state House of Representatives and Senate were in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity.

The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.

The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.

The House of Representatives passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 194-8. The bill will now be sent to the Senate for consideration.

The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.

The Senate unanimously passed on Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently received in the House and referred to the Health Committee.

The House unanimously passed House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.

The House unanimously passed House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill will now be sent to the Senate for consideration.

The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.

The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.

The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.

The House Children & Youth Committee met on Tuesday, June 25 and favorably reported House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. A recording of the meeting is viewable here.

The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.

The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here.

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m.

Department of Human Services

The Department of Human Services (DHS) has announced the proposed assessment amount, the proposed assessment methodology and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.

DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

DHS has released an updated Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

PA Safety Net Admin2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for June 14

The following is an update of selected state health policy developments in Pennsylvania from June 10 – 14. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro signed, among other bills, Senate Bill 721 into law this week. Senate Bill 721, now known as Act 22 of 2024, establishes the Women, Infants and Children (WIC) State Advisory Board. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

The House of Representatives passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to the Senate and reported favorably from the Banking & Insurance Committee.

The House of Representatives passed House Bill 1783, which requires the Department of Health to develop and publish educational material about opioid-related overdose and requires the Department of Drug & Alcohol Programs to establish a grant program from the development, expansion, or improvement of recovery support services. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 2127, which allows clinicians to distribute information related to postpartum depression and counseling resources. It also requires the Department of Health to publish those resources on its website. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.

The House Aging & Older Adult Services Committee held an informational hearing on Senate Bill 840 and House Bill 2400, which both create an Alzheimer’s Disease and related disorders division within the Department of Aging and establish an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the hearing is viewable here.

The House Children & Youth Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.

The House Insurance Committee met on Tuesday, June 11 and favorably reported House Bill 1140, which expands access to contraceptives, and House Bill 2268, which provides coverage for speech therapy for stuttering. A recording of the meeting is viewable here.

The Senate Health & Human Services Committee met on Tuesday, June 11 and favorably reported Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions, and Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. A recording of the meeting is viewable here.

The Senate Banking & Insurance Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 1664, which prohibits insurers from restricting their method of payment to solely credit card, and House Bill 1754, which requires public and private insurers to cover biomarker testing. A recording of the meeting is viewable here.

The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 12 and favorably reported, among other bills, Senate Bill 1251, which aligns Pennsylvania’s nursing statute with federal rules regarding accreditation. A recording of the meeting is viewable here.

The House Aging & Older Adult Services Committee and the Senate Aging & Youth Committee held a combined hearing on Wednesday, June 12 regarding the status of the state’s Aging Our Way plan. A recording of the hearing is viewable here.

The House Health Committee met on Wednesday, June 12 and favorably reported the following bills.
- House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients,
- House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance.
- House Bill 2363, which expands the existing Cancer Drug Repository Program to allow both health care facilities and individuals to donate prescription drugs (other than cancer drugs) to the program.

A recording of the meeting is viewable here.

The House Human Services Committee met on Wednesday, June 12 and favorably reported House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). A recording of the meeting is viewable here.

The House Judiciary Committee met on Wednesday, June 12 and favorably reported, among other bills, House Bill 2198, which caps the fees for obtaining electronic medical records. A recording of the meeting is viewable here.

The House Aging & Older Adult Services Committee met for a voting meeting on Wednesday, June 12 and favorably reported, among other bills, House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the meeting is viewable here.

The state House of Representatives and Senate will be in recess next week. Both chambers are scheduled to return to Harrisburg, Monday June 24.

Department of Human Services

The Department of Human Services (DHS) has announced it is making available for public review and comment the Office of Long-Term Living’s proposed amendment for the OBRA waiver. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced it is making available for public comment and review the Office of Long-Term Living’s proposed renewal for the Community HealthChoices (CHC) waiver. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 753) regarding testing for influenza in persons with severe respiratory illness given the potential for severe human infections with influenza A(H5N1) viruses and the recent spread into dairy cattle.

Stakeholder Events

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-06-14T21:14:14+00:00June 14th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off

PA Health Policy Update for June 7

The following is an update of selected state health policy developments in Pennsylvania from June 3 – 7. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

The Senate passed Senate Bill 1102, which increases the availability of long-term care training courses for nurse aides and expands eligibility for individuals to take the nurse aide competency exam, by a vote of 42 – 8. The bill was subsequently sent to the House and referred to the Health Committee.

The Senate passed Senate Bill 1104, which allow high school juniors and seniors to earn up to two credits toward their graduation requirement for employment in a congregate health care setting, by a vote of 29 – 21. It was subsequently sent to the House and referred to the Education Committee.

The Senate passed Senate Bill 1165, which makes certain statutory changes that will enable the state to join, among others, the medical and nursing interstate licensure compacts, by a vote of 46 – 4. The bill will now be sent to the House for consideration.

The House passed House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange, by a vote of 106 – 96. The bill will now be sent to the Senate for consideration.

The House passed House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program, by a vote of 123-79. The bill will now be sent to the Senate for consideration.

The House passed House Bill 851, which establishes the menstrual hygiene products grant program under the Public School Code, by a vote of 117-85. The bill will now be sent to the Senate for consideration.

The House passed House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services, by a vote of 181 – 21. The bill will now be sent to the Senate for consideration.

The House Aging & Older Adult Services Committee held an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3. A recording of the meeting is viewable here.

The House Insurance Committee convened on Monday, June 3 and favorably reported, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. A recording of the meeting is viewable here.

The Senate Aging & Youth Committee met on Tuesday, June 4 and favorably reported Senate Bill 840, which creates an Alzheimer’s Disease and Related Disorders Division in the Department of Aging, and House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys. A recording of the meeting in viewable here.

The Senate Health & Human Services Committee convened on Tuesday, June 4 and favorably reported Senate Bill 1000, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients. A recording of the meeting is viewable here.

The House Children & Youth Committee met on Wednesday, June 5 and favorably reported, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.

The House Health Committee convened Wednesday, June 5 and favorably reported House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session again next Monday, June 10 through Wednesday, June 13.

Department of Human Services

The Department of Human Services (DHS) has published a Medical Assistance Bulletin to advise providers of the updates to the Medical Assistance (MA) program dental fee schedule.

DHS has issued Provider Quick Tip #207 with information about fee schedule updates to Act 62, the Autism Insurance Act, procedure codes.

Department of Health

The Department of Health (DOH) has published notice of the laboratories approved for the following services.

DOH has issued a Health Advisory (PA-HAN 752) with information about Legionella due to the anticipated seasonal increase in infections.

DOH, in partnership with the Bradbury-Sullivan LGBT Community Center and Public Health Management Corporation (PHMC), has announced the start of the Pennsylvania LGBTQ Health Needs Assessment Survey, which is a biannual survey conducted to evaluate health needs, health disparities, and barriers to care impacting LGBTQ+ Pennsylvanians.

Department of Aging

The Department of Aging has announced the release of Aging Our Way PA, which is the state’s 10-year strategic plan that will help transform service delivery and serve as a roadmap for older adult services in Pennsylvania, ensuring services meet the needs of older adults as they address everyday issues such as healthcare, transportation, housing, long-term care and social connections.

Department of State

Several of the state’s professional licensure boards have adopted a statement of policy regarding conversion therapy. Following are the respective boards’ conversion therapy statements of policy.

Stakeholder Events

Pharmaceutical Assistance Advisory Board – June 17

PA Safety Net Admin2024-06-07T20:44:00+00:00June 7th, 2024|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

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