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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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PA Health Policy Update for April 28

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

Medicaid Eligibility Redetermination 

Medicaid unwinding has officially begun, and recipients will begin to receive their renewal packets and additional communications from the Department of Human Services 90 days prior to their individual renewal date. Individuals can view their renewal dates in COMPASS and can begin the renewal application online up to 60 days early. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

General Assembly

  • The state House and Senate returned to Harrisburg on April 24 for voting session. Below is coverage of selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee held a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. A recording of the hearing can be viewed here.
    • The House Insurance Committee held a voting meeting on Monday, April 24 to consider, among other bills, SB 8 which 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. The bill advanced from committee and received a unanimous vote on final passage in the House.  SB 8 will move to the Governor’s desk for his consideration upon signature in the Senate.
    • The Senate Veteran Affairs and Emergency Preparedness Committee held a voting meeting to consider SB 81, which codifies the ability for EMS providers to leave a dose of Naloxone with an on-scene caregiver. The bill now moves to the full Senate for consideration. A recording of the meeting can be viewed here.
    • The House Health Committee held an informational meeting Wednesday, April 26 on unregulated intoxicants and psychoactive substances. A recording of the hearing can be viewed  here.
    • The House Human Services Committee held a voting meeting Wednesday, April 26 to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse. The bill was reported without amendment.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits. The bill was re-referred to the House Health Committee.

A recording of the meeting can be viewed here.

    • The House Professional Licensure Committee held an informational meeting on the Bureau of Professional and Occupational Affairs. A recording of the meeting can be viewed here.
  • The state House and Senate will return to Harrisburg for voting session Monday, May 1. Following are selected health-related proceedings.
    • The House Health Committee will hold a public hearing Tuesday, May 2 at 9:30am on HB 106, the Patient Safety Act, which sets nursing ratios. The hearing will be held in Room 523 of the Irvis Office Building and can be live streamed here.
    • The Senate Health and Human Services Committee is holding a voting meeting on Tuesday, May 2 at 11:00 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE).
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement.

The meeting will be held in Room 8E of the East Wing and will be livestreamed here. 

Department of Health 

The Department of Health issued a Health Alert (PAHAN – 693-04-28) with updated recommendations regarding the Monovalent and Bivalent mRNA COVID-19 vaccines.

Department of Human Services

  • The Department of Human Services (DHS) issued a press release highlighting how the Shapiro administration has reduced the backlog for Medicaid provider enrollment from 34,682 applicants waiting more than 30 days to less than 8,500. The press release notes the backlog has been reduced by 75 percent in the administration’s first 100 days.
  • DHS has issued Provider Quick Tip (#263) with an update notifying providers that the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS) and the Office of Long Term Living’s 180-day exception requests and other claims requiring documentation is available in the PROMISe Portal.

Stakeholder Events

PHC4 –Executive Committee & Council Meeting – May 4

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting at 9:30 a.m. and a council meeting at 10:00 a.m. on May 4, 2023. Go here for additional information and details on how to register to participate.

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.

2023-04-28T20:48:32+00:00April 28th, 2023|long-term care, Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Uncategorized|Comments Off on PA Health Policy Update for April 28
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PA Health Policy Update for April 21

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

Governor Shapiro

Governor Shapiro announced this week his administration submitted a notice of intent to temporarily add xylazine, commonly known as “tranq,” to the list of schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. This step is an effort to limit access to xylazine, which is increasingly being found in Pennsylvania’s illicit drug trade. The administration also intends to schedule nitazenes, a class of synthetic opioids, as a schedule I drug. 

General Assembly

  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 20 on The State Master Plan on Aging. A recording of the hearing can be viewed here.
  • The House Children and Youth Committee held a public hearing Thursday, April 20 on overcrowding in Pennsylvania’s Juvenile Detention Facilities. A recording of the hearing can be viewed here.
  • The state House and Senate will return to Harrisburg on Monday, April 24 for voting session. Following are selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee will hold a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. The hearing will be held in Hearing Room 1 of the North Office Building and will be livestreamed here.
    • The House Insurance Committee will hold a voting meeting on Monday, April 24 at 11:00 a.m. to consider among other bills, SB 8 which requires insurers to cover all costs associated for 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. The meeting will be held in Room B31 of the Main Capitol and will be livestreamed here.
    • The House Health Committee will hold an informational meeting Wednesday, April 26 at 9:00 a.m. on unregulated intoxicants and psychoactive substances. The hearing will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.
    • The House Human Services Committee will hold a voting meeting Wednesday, April 26 at 9:15 a.m. to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits.

The meeting will be held in Room 523 of the Irvis Office Building and will be livestreamed here.

    • The House Professional Licensure Committee will hold an informational meeting April 26 at 10:00am on the Bureau of Professional and Occupational Affairs. The hearing will be held in Room 140 of the Main Capitol and will be livestreamed here.

Department of Health

  • DOH reminded long-term care facilities that the obligation to report COVID-19 cases and deaths through the ERS will continue beyond the end of the federal PHE on May 11. These records are reportable within 24 hours of diagnosis. Only new cases should be reported and positive cases that later result in death should be amended rather than entered as a new data record.  Find details on the reporting process here.
  • DOH encouraged nursing care facilities to make every effort to help temporary nurse aides to schedule and complete the required exams to become permanent certified nurse aides as soon as possible. When the federal PHE ends on May 11, candidates will have four months to complete the required testing as long as they are enrolled in an Approved Nurse Aide Training Program and candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here.   

Department of Human Services

  • The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) April 27 meeting. In advance of the meeting, DHS also issued a briefing document outlining proposed changes and clarifications to the 340B Drug Pricing Program.
  • DHS issued proposed regulations to strengthen and clarify the Adult Protective Services Act (Act 70). Implementation of Act 70 began in 2015 but has operated under agency guidance and contract amendments rather than formal regulation. Find additional information and the proposed regulations in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into late May.  Find the updated calendar here. 

Insurance Department

The Insurance Department issued a request for comments on a proposal to suspend the reinsurance program for the state-based insurance exchange, PENNIE®, and potentially replace it with a possible “state subsidy wrap.” Additional information on the proposal and details on how to comment may be found in this Pennsylvania Bulletin notice. 

Office of the Attorney General 

Attorney General Michelle Henry joined a coalition of seventeen other Attorneys General submitting a letter in support of the Federal Trade Commission’s proposal to prevent businesses from having employees sign non-compete agreements as a condition of employment. Find additional information in this press release. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) released the agenda for its May 18 meeting. Following are certain health-related regulations IRRC will consider.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

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.

DDAP – Xylazine: A New Drug Additive – June 12

The Department of Drug & Alcohol Programs (DDAP) will host two additional sessions of “Xylazine: A New Drug Additive,” presented by Savage Sisters Recovery, in Harrisburg on June 12, 2023. Please visit the Training Management System for details and to register.

2023-04-21T20:06:37+00:00April 21st, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for April 21
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PA Health Policy Update for April 14

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

General Assembly 

  • The House and Senate Appropriations Committees concluded their budget hearings this week.
    • On Tuesday, April 11, the Department of Human Services appeared before the House Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Wednesday, April 12, the Department of Human Services appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Thursday, April 13, the Department of Health appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here.
  • The House Health Committee held an informational hearing Wednesday, April 12 on prescription drug affordability boards. A recording of the hearing can be viewed here.
  • The House Democratic Policy Committee held a public hearing Thursday, April 13 on black maternal health. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 13 on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 20 at 1:00pm on The State Master Plan on Aging. The hearing will be held in Room G-50 of the Irvis Office Building and can be livestreamed here.
  • The House Children and Youth Committee will hold a public hearing Thursday, April 20 at 10:00am on overcrowding in Pennsylvania’s Juvenile Detention Facilities. The hearing will be held in Room 515 of the Irvis Office Building and can be livestreamed here.
  • The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24.

Department of Health

The Department of Health posted new documents related to the implementation of the long-term care nursing facilities regulations that become effective July 1, 2023:

  • Guidance for long term care regulations (effective July 1, 2023)
  • LTC Licensure Regulations Provider Updates – Presentation
  • LTC Licensure Regulations Provider updates – slides

View these and other guidance documents on the dedicated webpage here.

The Department of Health issued a health advisory with information about the Pennsylvania Childhood Blood Lead Act that took effect on January 2, 2023, and requires certain blood lead assessment and testing for children and pregnant women. Find more information in the health advisory. 

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin with the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention’s (CDC) Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2023. This bulletin replaces the 2022 recommended vaccine schedule.
  • DHS issued Provider Quick Tip #41, which is an updated Medical Assistance (MA) Desk Reference with provider contacts.
  • DHS issued a Medical Assistance Bulletin to inform MA providers that DHS added Current Procedural Terminology (CPT) codes 0164A (Moderna, Inc.) and 0173A (Pfizer, Inc.) to the MA Program Fee Schedule for the administration of additional bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines.
  • DHS issued a Medical Assistance Bulletin to inform providers of updates to the Emergency Medical Condition Information Eligibility form. 

Around the State      

  • The Pennsylvania Capital Star reported on the House Appropriations Committee’s examination of Governor Shapiro’s proposed FY 2023-24 budget for DHS.
  • The Scranton Times Tribune wrote about the continued nursing shortage in Pennsylvania and its impact on the health care system.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DOH – Special Pharmaceutical Benefits Program – May 4

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, May 4, 2023, from 10 a.m. to 3 p.m. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. Go here for additional information and details on how to participate.

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.

DHS – Dual Diagnosis Conference – May 18

The Office of Developmental Programs and Office of Mental Health and Substance Abuse Services will host a state-wide Dual Diagnosis Conference virtually on May 18, 2023. The conference will include a variety of perspectives for supporting individuals who have experienced trauma. You may register here.

Pennsylvania Long-Term Care Council – 2023 Meeting Dates

The Pennsylvania Long-Term Care Council released an update list of its remaining meetings for the 2023 calendar year. Additional details may be viewed here.

2023-04-14T20:25:48+00:00April 14th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for April 14
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PA Health Policy Update for April 7

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

General Assembly

  • The House and Senate Appropriations Committees will resume budget hearings next week. 
    • On Tuesday, April 11 at 10:00 a.m., the Department of Human Services will appear before the House Appropriations Committee. The hearing will be held in the House chamber and will also be live streamed here.   
    • On Wednesday, April 12 at 9:30 a.m., the Department of Human Services will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here.  
    • On Thursday, April 13 at 9:30 a.m., the Department of Health will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here.   
    • A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.  
  • The House Health Committee will hold an informational hearing Wednesday, April 12 at 10:00 a.m. on prescription drug affordability boards. The hearing will be held in in Room 205 of the Ryan Office Building and will be live streamed here. 
  • The House Democratic Policy Committee will hold a public hearing Thursday, April 13 at 12:00 p.m. on black maternal health. The hearing will be held in Room G-50 of the Irvis Office Building and will be live streamed here. 
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 13 at 1:00 p.m. on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. The hearing will be held in Room 515 of the Irvis Office Building and will be live streamed here.
  • The state House and Senate are currently recessed.  They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings. 

Department of Health 

  • The Department of Health (DOH) published the Pennsylvania State Health Improvement Plan (SHIP) that outlines goals, objectives, and strategies to improve the health of Pennsylvania residents over the next five years. The 2023-2028 SHIP was developed in collaboration with the Healthy Pennsylvania Partnership, which is made up of nearly 300 health care professionals, associations, health systems, health and human services organizations, community collaborations, local public health agencies, and government agencies. 
  • DOH issued a health update reminding healthcare facilities, providers, and laboratories to have heightened awareness for C. auris in their patients and updating a previous alert with information on new confirmed cases in Cumberland, Erie, and Monroe counties.  C. auris has been detected in ventilator-capable skilled nursing facilities, long-term acute care hospitals, and acute care hospitals since the current outbreak began in March 2020.  Find more information in this Health Update.  
  • DOH has alerted providers and laboratories to current outbreaks of Marburg virus in Tanzania and Equatorial Guinea and recommends they consider Marburg virus in patients with recent travel to those areas.  Find details in the Health Alert here.  

Department of Human Services   

  • The Department of Human Services (DHS) announced the Centers for Medicare & Medicaid Services (CMS) approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) waiver amendment, which took effect April 1, 2023. Changes in the approved waiver include benefits counseling, home health aide services, nursing services, and occupational, physical, and speech and language therapy services. The current approved CHC Waiver can be found here. 
  • OLTL released a transition plan to phase out temporary changes to the CHC 1915(c) Waiver. Effective May 11, 2023, OLTL will phase out its emergency flexibilities to coincide with the end of the federal Public Health Emergency. 
  • DHS announced CMS has approved OLTL’s OBRA Waiver amendment, which took effect April 1, 2023, for home and community-based services. The current OBRA Waiver can be viewed here.
  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to notify dental providers enrolled in the Medical Assistance program that DHS will begin accepting the 2019 American Dental Association (ADA) Claim Form upon issuance of this bulletin and will no longer accept the 2012 ADA Claim Form for dates of service on and after June 1, 2023.
  • DHS released a Provider Quick Tip (#263) notifying providers about an electronic submission process for FFS 180-day exception requests and other claims requiring documentation will soon be available in the Promise Portal. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs and DHS jointly issued a bulletin to update the guidance in OMHSAS bulletin 06-03 dated February 10, 2006. This bulletin includes the definitions of co-occurring capable and co-occurring enhanced programs as set forth in The ASAM Criteria. The information may be used to assist SCAs, BH-MCOs, and treatment providers in identifying co-occurring capable and co-occurring enhanced programs and in referring individuals to those programs.  

Revenue Collection Update  

The Department of Revenue announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $499.4 million, or 8.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.3 billion, which is $1.1 billion, or 3.7 percent, above estimate.  

Around the State   

WHYY reported about the end of continuous Medicaid enrollment, beginning April 1, 2023, and how individuals can prepare for renewals.   

The Erie Times-News published an article about the drug-resistant fungus, Candida auris, which was found in a patient at a health care facility in Erie County.    

Stakeholder Events  

PHC4 – Data Systems Committee – April 10 

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Data Systems Committee meeting on April 10 at 10:00 a.m. Go here for additional information and details on how to participate.   

DOH – State Child Death Review Team – April 20 

The State Child Death Review (CDR) Team will hold a public meeting on Thursday, April 20 from 1:00 – 3:00 p.m. Go here for additional information and details on how to participate.  

DOH – Renal Disease Advisory Committee – April 21 

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 21 from 10:00 a.m. to 12:00 p.m. Go here for additional information and details on how to participate.  

DHS – Drug Utilization Review (DUR) Board – April 26 

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.  

DHS – Medical Assistance Consumer Subcommittee – April 26 

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.  

DHS – Medical Assistance Advisory Committee – April 27 

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.  

Patient Safety Authority – April 27 

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.  

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. 

2023-04-20T17:15:29+00:00April 7th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for April 7
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  • 2020 Safety-Net Association of Pennsylvania

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