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PA Health Policy Update for September 8

The following is an update of selected state health policy developments in Pennsylvania from September 4 – 8.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

General Assembly

  • The House Commerce Committee held an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. A recording of the hearing can be viewed here.
  • The House Republican Policy Committee held a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” More information on the hearing can be found here.
  • The House Health Committee will hold a public hearing on Wednesday, September 20 at 9:30am on HB 1657, which amends the Clean Indoor Air Act. The legislation would clarify the definition of a workplace, expand the definition of smoking to include e-cigarettes, and give all localities the ability to enact smoke-free ordinances that exceed minimum state standards. The hearing will be held in Room 523 of the Irvis Office Building and will be livestreamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule for the provision of pediatric home health aide services by family members employed by home health agencies. Learn more in this Pennsylvania Bulletin notice.
  • DHS has published Provider Quick Tip #207 advising health care providers of updates to the procedure codes that are subject to the MA cost avoidance process under Act 62. The purpose of the updates is to bring procedure code descriptions in alignment with national procedure code descriptions. The changes became effective September 5, 2023.
  • The Office of Long-Term Living (OLTL) has announced that Public Partnerships, LLC, has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA) for financial management services for Fee-for-Service OLTL-administered programs related. The new contract became effective September 1, 2023.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the start of its state-wide stakeholder engagement tour. The kick-off event was held in northeastern Pennsylvania in partnership with the Columbia, Montour, and Snyder Drug and Alcohol Program. DDAP’s goal is to gather feedback that will help craft the agency’s plan for increased community and treatment provider engagement while also gaining stakeholder insight to assist the agency’s work on regulation reform.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $27.1 million, or 0.9 percent, less than anticipated. Fiscal year-to-date collections total $5.8 billion, which is $27.2 million, or 0.5 percent, below estimate.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

2023-09-08T20:37:35+00:00September 8th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 8
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PA Health Policy Update for September 1

The following is an update of selected state health policy developments in Pennsylvania from August 28 – September 1.  (Some of the language used below is taken directly from state documents.)

Fiscal Year 2023-2024 Budget Update 

The state Senate convened for voting session Wednesday, August 30 and passed the remaining legislative piece of the Fiscal Year (FY) 2023-2024 budget – the Fiscal Code. House Bill 1300, which passed by a vote of 29-18, will now be sent to the House of Representative for consideration. A Fiscal Note outlining the provisions contained in the legislation can be found here. The Fiscal Code advanced by the Senate is not agreed to by House Democratic leaders and the House is currently not scheduled to return to Harrisburg until September 26. 

General Assembly

The House Commerce Committee will hold an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. The informational hearing will be held in Room 515 of the Irvis Office Building and will be livestreamed here.

The House Republican Policy Committee will hold a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” The hearing will be held at the Pennsylvania College of Technology in Williamsport and will be live streamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin advising providers of updates to the Medical Assistance (MA) program fee schedule as a result of the 2023 Healthcare Common Procedure Coding System (HCPCS) updates. DHS is also adding other procedure codes and making changes to procedure codes currently on the MA program fee schedule. These changes are effective for dates of service on and after September 5, 2023.
  • DHS has published Provider Quick Tip #268 to remind prescribers and providers that certain procedure codes and modifier combinations require prior authorization.
  • DHS has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule, which are a result of the 2023 HCPCS updates.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 716) regarding respiratory syncytial virus (RSV). The advisory provides important information about recommended monoclonal antibodies and recently approved vaccines for RSV. 

Medicaid Continuous Coverage Unwinding 

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – September 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a meeting at 10:00 a.m. on Thursday, September 7, 2023. The public is invited to participate. Contact rgreenawalt@phc4.org for participation instructions. 

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

2023-09-05T13:44:35+00:00September 1st, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for September 1
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PA Health Policy Update for August 25

The following is an update of selected state health policy developments in Pennsylvania from August 14 – 25.  (Some of the language used below is taken directly from state documents.)

Fiscal Year 2023-2024 Budget Update

The Senate will return to Harrisburg for voting session Wednesday, August 30 at 1:00 p.m. to consider the remaining pieces of the FY 2023-2024 budget. The Senate Republican Caucus spokesperson released the following statement:

“Our work to complete the necessary budgetary implementation legislation continues… We are in communication with House leaders, and we remain hopeful the House will also choose to reconvene before September 26.”

Senate President Pro Tempore Kim Ward released a statement noting that funding for emergency medical services and hospital and health system relief would be on the agenda when they reconvene. The House has not scheduled voting session days prior to September 26, and it is unclear when an agreement on the final budget implementation language will be reached.  

Governor Shapiro

The Shapiro administration has announced it is taking the first step to implement the Nurse Licensure Compact by allowing nurses with multi-state licenses to practice in Pennsylvania beginning September 5. Learn more by reviewing the Department of Health’s health care facility-specific guidance and the Board of Nursing’s Nurse Licensure Compact website. 

General Assembly

The House Commerce Committee will hold an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. The informational hearing will be held in Room 515 of the Irvis Office Building and will be livestreamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) Program fee schedule. The changes are effective for dates of service on and after September 5, 2023. Learn more in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through September. Find the updated calendar here.

Department of Health  

The Department of Health (DOH) has updated its staffing calculation tool for long-term care facilities. Use of this tool is not required but may be useful when calculating the required number of nursing hours as well as staff ratios. Click here to download the tool (Excel spreadsheet) and here to download the instructions (Word document). 

Department of Aging

The Department of Aging has announced it is soliciting stakeholder feedback to assist in the development of the state’s Master Plan for Older Adults. The department has partnered with the University of Pittsburgh to distribute a survey in an effort to develop a profile of the needs of older adults and adults with disabilities that will inform the state’s planning process.  

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced its intent to hold technical assistance webinars regarding substance use disorder (SUD) confidentiality and the impact of Act 33. In preparation, DDAP has requested stakeholders complete their SUD Confidentiality Survey by September 22, 2023. If you are interested in attending one of the webinars, you may email  RA-DAASAM@pa.gov to be notified when they’re scheduled.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Counsel (PHC4) has released a new research brief, Severe Maternal Morbidity in Pennsylvania. The brief examines severe maternal morbidity among patients hospitalized in Pennsylvania for delivery between 2016 and 2022. PHC4’s press release announcing the report may be found here. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

2023-08-25T21:35:39+00:00August 25th, 2023|Financial, Medicaid Eligibility Redetermination , Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for August 25
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PA Health Policy Update for August 4

The following is an update of selected state health policy developments in Pennsylvania from July 31 – August 4.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update

Governor Shapiro signed House Bill 611 – the FY 2023-2024 General Appropriations Act – into law yesterday shortly after it was formally signed in the Senate and sent to his desk. The enactment of House Bill 611 will enable funding to be disbursed to, among other entities, county governments and school districts. The Governor and the General Assembly still need to finalize enabling legislation (i.e., code bills) in order for the budget to be fully enacted. Read more in this press release issued by the Governor’s office. 

General Assembly

The Center for Rural Pennsylvania held a public hearing on rural hospital and healthcare sustainability to explore difficulties facing rural hospitals and health systems. Details from the hearing, including the agenda and testimony, may be viewed here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin updating guidelines for the delivery of physical health services via telehealth. The bulletin applies to all providers enrolled in the Medical Assistance (MA) Fee-for-Service program.
  • DHS has issued Provider Quick Tip # 85 with information about the department’s Breast & Cervical Cancer Prevention & Treatment Program.
  • DHS has shared the following information from the Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting on August 2.

Centers for Medicare and Medicaid Services

CMS has issued new guidance to state Medicaid programs as they work to return to normal operations after the end of COVID-19 flexibilities. Specifically, this guidance announces an update of CMS’s policy regarding the end date for flexibilities approved in states’ section 1915(c) Home and Community-Based Services waiver Appendix K amendments.  Under CMS’s prior policy, these flexibilities were set to expire six months after the expiration of the COVID-19 public health emergency, but in this letter CMS explains that these flexibilities may remain in effect for a longer period of time.  

Department of Health 

The Department of Health (DOH) has recently issued two Health Advisories (PAHAN – 713 & PAHAN –711) alerting providers of possible measles exposure in Blair, Clearfield, and Montgomery Counties.

DOH has issued a Health Advisory (PAHAN – 712) notifying providers of a nationwide shortage of Penicillin G benzathine (Bicillin L-A®). 

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Counsel (PHC4) has announced it launched a new website. The new website, which is aimed at increasing consumer engagement, may be found here. 

Revenue Collection Update 

The Department of Revenue announced Pennsylvania collected $2.9 billion in General Fund revenue in July, the first month of the 2023-2024 fiscal year. Note, the July collection data does not include a comparison against anticipated amounts because the official estimate for the 2023-2024 fiscal year has not been certified. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

2023-08-04T18:51:26+00:00August 4th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for August 4
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PA Health Policy Update for July 21

The following is an update of selected state health policy developments in Pennsylvania from July 17 – 21.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Governor Shapiro

The Governor’s Budget Office has issued a Budget Impasse FAQ that contains information relevant to commonwealth vendors, grantees, and other stakeholders.

Pennsylvania Executive Order 1996-1 requires all agencies under the jurisdiction of the governor to submit for semi-annual publication an agenda of regulations under development or consideration.  These agendas are compiled to give the regulated community advance notice of regulatory activity.  Learn more about what the agencies are contemplating and find contact information for seeking additional information from this Pennsylvania Bulletin notice. 

General Assembly

The Center for Rural Pennsylvania will hold a public hearing Thursday, August 3 at 9:00am on rural hospital and healthcare sustainability to explore difficulties facing rural hospitals and health systems. The hearing will be held at the University of Pittsburgh at Bradford and will be livestreamed here. More information on the hearing and a tentative agenda can be found here. 

Department of Human Services

  • The Department of Human Services (DHS) has announced Pennsylvania will receive an estimated $42 million in federal funding from CMS through the Money Follows the Person (MFP) program to continue existing activities and support new initiatives focused on serving individuals in the community. Find additional information in this press release.
  • DHS has issued Provider Quip Tip #263 notifying providers that an electronic submission process is available in the Promise Portal for Office of Medical Assistance fee-for-service (FFS) and Office of Long-Term Living (OLTL) 180-day exception requests and other claims requiring documentation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through August. Find the updated calendar here.
  • The Executive Board approved a reorganization of DHS. Additional information and a revised organizational chart is available in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (2023 – PAHAN – 708) alerting health care providers to have heightened clinical suspicion of Jamestown Canyon virus (JCV) infection in persons with clinically compatible symptoms (similar to West Nile and Powassan virus). 

Department of Aging 

The Department of Aging held its third regional town hall to seek input on Pennsylvania’s Master Plan for Older Adults, which will be a 10-year, state-led strategic plan designed to transform the infrastructure and coordination of services for older Pennsylvanians. Governor Shapiro’s executive order directing the department to develop the plan is available here. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new Cardiac Procedures Report. The report focuses on the performance of acute care hospitals for five types of cardiac procedures. Find the report and a press release issued by PHC4 here. 

Stakeholder Events 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

 

2023-07-21T20:21:56+00:00July 21st, 2023|Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for July 21
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PA Health Policy Update for July 14

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

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

FY 2023-2024 Budget Update 

It remains unclear when a final agreement will be reached on the FY2023-2024 budget; however, it appears unlikely an agreement will be reached in the immediate future. This week, Senate Majority Leader Joe Pittman sent a letter to House Majority Leader Matt Bradford outlining the Senate’s position on the current budget impasse. 

General Assembly

The House of Representatives adjourned from voting session Friday, July 7 until Tuesday, September 26 or unless sooner recalled by the Speaker.

Both chambers released their fall voting session schedules and indicated that they would return to Harrisburg sooner if a budget agreement is reached. Find the House’s schedule here and the Senate’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has provided final notice of its FY 2022-2023 funding allocation for several classes of disproportionate share hospital (DSH) and supplemental payments to qualifying acute care general hospitals. The department is not changing the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published the minutes of the June 22, 2023 Medical Assistance Advisory Committee (MAAC) meeting. 
  • DHS has published a notice of recission in the Pennsylvania Bulletin for its statement of policy clarifying the term “within a provider’s office” due to the promulgation of the Interrelationship of Providers final-form rulemaking. The final rule deleted language previously prohibiting co-located providers from enrolling in the Medical Assistance (MA) program.
  • DHS has issued a correction to its previously published annual list of exceptional Durable Medical Equipment, which included an incorrect email address. Find the revised Pennsylvania Bulletin notice here.

Stakeholder Events 

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee – August 2

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will take place on Wednesday, August 2 from 10:00 a.m. to 1:00 p.m. in-person and via webinar. The meeting location is the Department of Education Building’s Honors Suite, 1st floor, 333 Market Street, Harrisburg. Register here to attend.

2023-07-14T20:00:14+00:00July 14th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for July 14
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PA Health Policy Update for June 30

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

FY 2023-2024 Budget Update 

As of 4:00 p.m. Friday, June 30 Governor Shapiro and the General Assembly have not enacted a final Fiscal Year (FY) 2023-2024 spending plan despite being hours away from the state’s constitutionally mandated deadline. The Senate is preparing to vote on a $45.5 billion spending plan, but the Democratic leaders of the House haven’t signaled support for the measure. Negotiations are ongoing. 

Shapiro Administration

Dr. Val Arkoosh officially became Secretary of the Department of Human Services (DHS) in accordance with the Pennsylvania Constitution this week. Find additional information in this press release issued by the DHS.

Governor Shapiro officially recalled the nomination of Dr. Debra Bogen to serve as Secretary of Health. The recall followed a confirmation hearing held by the Senate Health & Human Services Committee. A recording of the confirmation hearing for Dr. Bogen, as well as Dr. Arkoosh, can be viewed here. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings. Please note the House and Senate remain in session as of 4:00 p.m. Friday, June 30. As a result, this is not an exhaustive list of legislative proceedings.

  • The House passed HB 106, “The Patient Safety Act,” on third and final consideration Wednesday, June 28 by a vote of 119 – 84. The bill, which would implement specific nurse-to-patient ratios, was amended on second consideration to decrease the penalties for violations and create a grant program – funded by the penalties paid by hospitals – for nursing recruitment and retention for rural and high Medical Assistance hospitals. The amendment also delays the ability of the Department of Health to impose penalties on rural and high Medical Assistance hospitals for two years and extended the effective date for the remainder of hospitals to one year, instead of six months. The bill now goes to the Senate for consideration.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 27 to consider HB 479, which requires both the Medical Assistance Capitation and Fee-for-Service programs to pay for all loaded ambulance miles at $4 per loaded mile beginning on January 1, 2025. A recording of the meeting can be viewed here.
  • The Senate Banking and Insurance Committee held a voting meeting Tuesday, June 27 to consider SB 739, which defines telemedicine, offers guidelines outlining who can provide telemedicine services, and addresses insurance company reimbursement for these services. The bill was reported as amended. A recording of the meeting can be viewed here.
  • The House Human Services Committee met this week to consider the following bills:
    • HB 1515, to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments. The bill was reported as committed.
    • HB 1218, which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bill was reported as amended.

A recording of the meeting can be found here.

  • The House Human Services Committee is expected to reconvene for a voting meeting Friday, June 30 at the call of the chair to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The meeting will be held in Room 60 East Wing and livestreamed here.
  • The House Aging and Older Adult Services Committee is expected to hold a voting meeting at the call of the chair Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Department of Human Services

  • The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) in this Pennsylvania Bulletin notice.
  • DHS has issued several Medical Assistance Bulletins related to prior authorization guideline changes. Following are the various bulletins.
  • DHS has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program periodicity schedule and coding matrix.
  • DHS has issued a Remittance Advice Alert to regarding the department’s delay in implementing Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals.

Department of Health

  • The Department of Health (DOH) has published answers to frequently asked questions about new long-term care facility regulations that come into effect on July 1, 2023.
  • DOH has provided a staffing ratio calculation tool to assist long-term care facilities planning for compliance with new regulatory requirements as of July 1. Use of the tool is not required but may be useful when calculating the required number of nursing hours as well as the staff ratios. Click here for instructions, which opens in a Word document, and here for the tool, which opens as an Excel spreadsheet.
  • DOH has issued a Health Advisory (2023 – PAHAN – 707) to share information and notify clinicians, public health authorities, and the public about locally acquired malaria cases and concern for a potential rise in imported malaria cases associated with increased international travel during the summer.
  • DOH has issued a Health Advisory (2023 – PAHAN – 706) to request that clinicians continue to test for influenza in patients with respiratory illness throughout the summer due to the severity of recent human infections with avian influenza A(H5N1). 

Stakeholder Events 

PHC4 – Council Meeting – July 6

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet on Thursday, July 6 at 10:00 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-30T20:28:31+00:00June 30th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for June 30
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PA Health Policy Update for June 23

The following is an update of selected state health policy developments in Pennsylvania from June 20 – 23.  (Some of the language used below is taken directly from state documents.)

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings.

  • The Senate voted to confirm Governor Josh Shapiro’s nominees for the Department of Drug and Alcohol Programs, Dr. Latika Davis-Jones, and Pennsylvania Insurance Department, Michael Humphreys. A recording of the Senate Health and Human Services Committee confirmation hearing can be viewed here. A recording of the Senate Banking and Insurance Committee confirmation hearing can be viewed here.
  • The General Assembly passed SB 262, which requires the Maternal Mortality Review Committee to publish severe maternal mortality data. The bill will now be sent to the governor.
  • The House unanimously passed HB 1209 and HB 1407, which enable Pennsylvania to meet its obligations under the 1998 Master Settlement Agreement (MSA) with tobacco product manufacturers and ensure the state is able to continue receiving funds from the tobacco settlement for health-related programs.
  • The Senate adopted SR 46 to establish the Task Force on Women Veterans’ Health Care to study the health care and access issues facing women veterans.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which requires an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition. The bill was reported as amended, to include xylazine.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership. The bill was reported as committed.
    • SB 817, which creates a primary care workforce initiative for Federally Qualified Health Centers (FQHCs). The bill was reported as committed.

A recording of the meetings can be viewed here.

  • The House Human Services Committee held a voting meeting Wednesday, June 22 at 11:30am to consider HB 850, which requires the Departments of Health and Human Services to apply for a waiver if the U.S. Department of Agriculture’s Food and Nutrition Service creates and makes a waiver available to the states that would allow those receiving SNAP and WIC to use those programs for menstrual hygiene products. The bill was reported as amended. A recording of the meeting can be viewed here.

The House and Senate will return to Harrisburg for voting session Monday, June 26.

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to inform Medical Assistance (MA) providers that DHS has added CPT code 0174A to the MA Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July. Find the updated calendar here.
  • DHS has announced the proposed Nursing Facility Assessment Program details for FY 2023-24, including 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. Find additional information in this Pennsylvania Bulletin notice. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume one of its annual analysis of the financial performance of Pennsylvania’s acute-care hospitals.  The analysis found that hospital total margins across the state decreased 7.59 percentage points in FY 22. Go here to find a PHC4 news release describing the agency’s report, the report itself, and a link to downloadable data from the report. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) submitted comments to the Department of Human Services on their regulation #14-543: Protective Services for Adults. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Go here for details on how to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-23T21:27:26+00:00June 23rd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 23
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PA Health Policy Update for May 26

The following is an update of selected state health policy developments in Pennsylvania from May 22 – 26.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) has updated its online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Governor Shapiro

On Thursday Governor Shapiro signed Executive Order 2023-09 directing the Department of Aging to prepare and develop a Master Plan for Older Adults, which will serve as a 10-year roadmap to meet the needs of Pennsylvania’s senior population and improve commonwealth services for older Pennsylvanians. Find additional information in this press release issued by the governor’s office. 

General Assembly 

The state House returned to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.

  • The House Health Committee held a voting meeting Monday, May 22 to consider, among several resolutions, HB 1131 sponsored by Representative Lisa Borowski, which would remove the requirement for counties to operate state health centers in counties establishing their own local health departments. The bill was unanimously reported as committed. A recording of the meeting can be viewed here.
  • The House Human Services Committee held a voting meeting Tuesday, May 23 to consider, HB 849 sponsored by Representative Mike Schlossberg, to allocate funding for the Behavioral Health Commission on Adult Mental Health’s recommendations for funding, and HB 931 sponsored by Representative Eddie Day Pashinski, to establish the Kinship Care Legal Assistance Grant Program, which was reported as amended. HB 849 was reported as amended and the amended text can be found here. A recording of the meeting can be viewed here.

The state House and Senate will return to Harrisburg for voting session Monday, June 5. The following are selected health-related proceedings.

  • The House Human Services Committee will hold a joint hearing with the House Veteran Affairs and Emergency Preparedness Committee Monday, June 5 on the next generation of emergency and mental health response. The hearing will be held at 10:30am in Room 140 of the Main Capitol and will be live streamed here.
  • The House Health Committee will hold a voting meeting Tuesday June 6 to consider HB 106, the Patient Safety Act, which sets nursing staffing ratios and HB 754, which provides a standard notice to each nursing home resident and their designated representatives at the time of their admission into a nursing home facility that they have the option of having legal representation to assist with the application for Medicaid benefits. The meeting will be held at 10:00am in Room 205 of the Ryan Office Building and will be live streamed here.
  • The Senate Health and Human Services Committee will hold a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. The hearing will be held in Room 8E-A East Wing and will be live streamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (2023 – PAHAN – 697) with information from the Centers for Disease Control and Prevention (CDC) regarding an outbreak of suspected fungal meningitis among U.S. patients hospitalized in Texas. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of certain procedure codes to the Medical Assistance (MA) program fee schedule for the administration of additional bivalent doses of the SARS-CoV-2 vaccines manufactured by Moderna and Pfizer. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced updates to the MA program fee schedule for evaluation and management (E&M) procedure codes, including making adjustments to the fees for some procedure codes. These updates are effective for dates of service on and after June 1, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes G0312 and G0315 to the MA program fee schedule for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and novel coronavirus (COVID-19) vaccine counseling only visits. Find additional information in this Pennsylvania Bulletin notice.
  • Materials from the May 24 meeting of the Consumer Subcommittee of the Medical Assistance Advisory Committee viewed here.
  • Materials from the May 25 meeting of the Medical Assistance Advisory Committee meeting may be viewed here. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) released its initial revenue estimate for FY 2023-2024. The IFO estimates General Fund revenues of $45.292 billion for FY 2023-2024, which is a 1.3 percent increase over the current fiscal year. Find the report and corresponding presentation here.  

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission posted the following final regulations for public comment.

Stakeholder Events

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-05-28T01:20:56+00:00May 26th, 2023|Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 26
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PA Health Policy Update for May 5

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

Medicaid Eligibility Redetermination 

The Department of Human Services (DHS) published the first section of an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code.

Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Governor Shapiro

Governor Shapiro signed the first bill of his administration on Monday. Act 1, formerly Senate Bill 8, requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. View this press release for additional information.

The Shapiro administration announced today that all commonwealth agencies completed a comprehensive review of their respective licensing, certification, and permitting processes as directed in the governor’s January 31 executive order. The administration will now work to establish “efficient processing times” for all permits and licenses. 

General Assembly

  • The state House and Senate returned to Harrisburg on May 1 for voting session. Below is coverage of selected health-related proceedings.
    • The House Health Committee held a public hearing Tuesday, May 2 on HB 106, the Patient Safety Act, which sets nursing staffing ratios. A recording of the hearing can be viewed here.
    • Representative Jennifer O’Mara (D-Delaware), Representative Eddie Day Pashinski (D-Luzerne) and Senator Carolyn Comitta (D-Chester) held a press conference Wednesday on hospital closure reform. More information can be found here.
    • The House Republican Policy Committee held a public hearing Thursday, May 4 on hospital pricing transparency. A recording of the hearing can be viewed here.
    • The Senate voted to confirm Governor Josh Shapiro’s nominee for the Secretary of Aging, Jason Kavulich, this week. A recording of the confirmation hearing in the Senate Aging and Youth Committee can be viewed here.
    • The Senate Health and Human Services Committee held a voting meeting on Tuesday, May 2 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act. The bill was unanimously reported as committed.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events. The bill was unanimously reported as committed.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE). The bill was unanimously reported as committed.
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk. The bill was unanimously reported as committed.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams. The bill was unanimously reported as amended.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here.

  • The state Senate will return to Harrisburg for voting session Monday, May 8. The state House is recessed and will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.
    • The House Aging and Older Adult Services Committee will hold an information meeting Wednesday, May 10 at 10:00am to receive updates from local Area Agencies on Aging and to discuss scams targeting older adults. The meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here. 

Office of the Attorney General 

Attorney General Michelle Henry issued the following Frequently Asked Questions (FAQ) document regarding medication abortion and mifepristone access in Pennsylvania. 

Department of Health 

The Department of Health’s (DOH) Division of Newborn Screening and Genetics, with support of the Newborn Screening and Follow-up Technical Advisory Board, is proposing that Guanidinoacetate Methyltransferase (GAMT) deficiency screening be added effective January 1, 2024 to the supplemental conditions mandated for screening. Additional information can be viewed in this Pennsylvania Bulletin notice. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to increase the funding and amend the payment methodology for the COVID-19 disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for FY 2022-23. Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its intent to allocate funding and amend the qualifying criteria and payment methodology allocation for DSH payments to acute-care general hospital trauma centers. These payments will amount to $18.034 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its funding allocation for FY 2022-23 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance (MA) Program, and to provide financial relief to hospitals during the COVID-19 pandemic. Learn more from this Pennsylvania Bulletin notice.
  • DHS published updates to the Medical Assistance (MA) Program Fee Schedule for administration of a booster dose of the SARS-CoV-2 vaccine manufactured by Novavax. Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced the temporary extension of the Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. The APM will be extended beyond the end of the federal PHE to September 30, 2024. Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued an updated Provider Quick Tip (#263) regarding the electronic submission process in the PROMISe Portal for Office of Medical Assistance Fee-for-Service (FFS) and Office of Long Term Living (OLTL) 180-day exception requests and other claims requiring documentation.

Revenue Collection Update

The Department of Revenue announced Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $51.1 million, or 0.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $37.9 billion, which is $1.2 billion, or 3.3 percent, above estimate. 

Stakeholder Events

DOH – WIC Advisory Board – May 10

The WIC Program Advisory will meet on May 10 from 1:00 p.m. – 2:00 p.m. Additional information and details on how to participate can be viewed in this Pennsylvania Bulletin notice. 

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DOH – HIV Community Prevention Planning Committee – May 18

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, May 17 and Thursday, May 18. For information on how to participate, review this Pennsylvania Bulletin notice.

DHS – Medical Assistance Consumer Subcommittee – May 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on Wednesday, May 24 at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – May 25

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, May 25 at 10:00 a.m.  Go here to register to participate.

 

2023-05-05T21:19:20+00:00May 5th, 2023|Federal Medicaid issues, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 5
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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