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PA Health Policy Update for Friday, November 18

The following is an update of selected state health policy developments in Pennsylvania for the week of November 14-18, 2022.  (Some of the language used below is taken directly from state documents.)

Governor-Elect Shapiro

Governor-Elect Josh Shapiro held a press conference Wednesday, November 16 along with Governor Wolf and Lieutenant Governor-Elect Austin Davis to discuss the gubernatorial transition process.  The governor-elect announced that Akbar Hossain, who previously served as his campaign’s policy director, will be executive director of the transition.  Amanda Warren, formerly director of finance for the campaign, will serve as executive director of the inauguration.  Additional transition announcements will be made in the coming weeks.  Further information about the transition will be available here.

General Election Update

State Representative Todd Stephens (R-151) conceded to his challenger, Melissa Cerrato (D), yesterday afternoon.  Representative Stephens’ concession gives Democrats the 102 seats needed to control the state House of Representatives; Republicans have 101 seats.  The initial path forward for Democratic control is unclear, however, because of three impending vacancies in the Democratic caucus that will require special elections in early 2023.

General Assembly Update

  • The state House and Senate briefly convened for voting session this week – the final voting session of the year.  Both chambers will return to Harrisburg for the commencement of the new legislative session on January 3.
  • The Senate Health & Human Services Committee held a hearing on Tuesday to examine the Behavioral Health Commission’s recommendations for the allocation of $100 million earmarked in the FY 2023 budget.  Testimony and a recording of the hearing may be viewed here.
  • The Senate Republican and Democratic caucuses held leadership elections this week for the new legislative session.  Senator Kim Ward (R-39) was elected the state’s first female Senate President Pro Tempore.  Senator Joe Pittman (R-41) was elected majority leader and Senator Scott Martin (R-13) was chosen chairman of the Appropriations Committee.  Senator Jay Costa (D-43) was re-elected by his caucus to serve as minority leader.  A complete list of the Senate Republican leadership team can be found here and a list of the Senate Democratic leadership team can be found here.

Department of Human Services

  • As of December 5, DHS is adding a new procedure code to the Medical Assistance fee schedule for COVID-19 tests provided to Medicaid beneficiaries and removing the previous code for those tests.  Learn more from this Pennsylvania Bulletin notice.
  • DHS will increase Medical Assistance fees for certain ambulance transportation services beginning on January 1.  Learn more, including the new fees, from this Pennsylvania Bulletin notice.
  • Pennsylvania’s Independent Regulatory Review Commission has received final form rulemaking from DHS that would effectively rescind a provision in existing regulations that prohibits providers from co-locating or leasing space to another provider within a provider’s office.  This change was originally proposed in July 2021 and the commission is expected to approve the change at its December 8 meeting.  Find notice of the action in this Pennsylvania Bulletin listing.
  • Next month, DHS’s Office of Long-Term Living will submit a proposed amendment to Pennsylvania’s OBRA 1915(c) home and community-based waiver to the Centers for Medicare & Medicaid Services (CMS).  To view a side-by-side comparison of the current and revised language and to see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 OBRA Waiver Amendment” under “Additional Resources.”  For additional information about the proposed amendment and how to submit written comments, see this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
  • Next month, DHS’s Office of Long-Term Living will submit to CMS a proposed amendment to Pennsylvania’s Community HealthChoices 1915(c) home and community-based waiver.  To view a side-by-side comparison of the current and revised language and see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 Community HealthChoices (CHC) Waiver Amendment” under “Additional Resources.”  Learn more about the proposed amendment from this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
  • DHS is making available for public review and comment the Office of Long-Term Living’s proposed home and community-based services provider sites that qualified for heightened scrutiny under CMS requirements.  Learn more about the types of sites to which this requirement applies and DHS’s actions to bring them into compliance with federal standards from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania over the past week declined 18 percent while the number of deaths remains unchanged.  The state is now averaging more than 1400 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs fell 16 percent from the last week after two weeks of rising totals.
  • The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of November 18, 27 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 34 are experiencing substantial rates of community transmission; and six counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has published “Financial Analysis 2021:  Rehabilitation • Psychiatric • Long-Term Acute Care • Specialty:  An Annual Report on the Financial Health of Pennsylvania Non-GAC Hospitals.”  The report’s highlights include:

  • During FY 2021, the operating margin for rehabilitation hospitals was 9.19 percent, for psychiatric hospitals was negative 2.86 percent, for long-term acute-care hospitals was 8.98 percent, and for specialty hospitals was negative 11.76 percent.
  • During FY 2021, the total margin for rehabilitation hospitals was 12.04 percent, for psychiatric hospitals was negative 3.02 percent, for long-term acute-care hospitals was 7.76 percent, and for specialty hospitals was 9.9 percent.
  • As a group, the foregone dollar value of uncompensated care for non-general acute-care hospitals decreased 6.19 percent, or $1.1 million, from $18.7 million during FY 2020 to $17.7 million in FY 2021.  Uncompensated care as a percentage of net patient revenue in FY 2021 among non-general acute-care hospitals ranged from 0.22 percent for long-term acute-care hospitals to 1.44 percent for psychiatric hospitals.

Learn more about the PHC4 report from this news release and the report itself.  In addition, go here to download data from the report in Excel format.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually.  For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-11-18T22:22:41+00:00November 18th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, November 18
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PA Health Policy Update for Friday, November 4

The following is an update of selected state health policy developments in Pennsylvania for the week of October 31 to November 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed 66 bills into law this week and vetoed one, Senate Bill 736.  The following is a selection of health care-related bills signed into law by the governor.

  • House Bill 220, which is now Act 101 of 2022, specifies that a person does not need to test positive for drugs to begin addiction treatment.
  • House Bill 1393, which is now Act 111 of 2022, seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.
  • House Bill 2293, which is now Act 128 of 2022, requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2527, which is now Act 135 of 2022, expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.
  • House Bill 2800, which is now Act 143 of 2022, amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • Senate Bill 225, which is now Act 146 of 2022, streamlines and standardizes the process for prior authorization of medical services.  The Insurance Department has issued a news release about this new law.
  • Senate Bill 522, which is now Act 150 of 2022, requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.

General Election

The 2022 general election will be held on Tuesday, November 8.  Pennsylvanians will be voting for one U.S. Senate seat, 17 U.S. House of Representatives seats, governor, half of the 50 state Senate seats, and all 203 state House seats.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals’ response to COVID-19 to reflect the October 31 expiration of the COVID-19 state regulatory waivers and flexibilities. Find the updated guidance here.  At the same time, the Department of Human Services (DHS) has updated its list of regulations that have been suspended in response to the COVID-19 public health emergency.  Find the updated list here and scroll down to see the latest regulation suspensions that have expired; they are highlighted in red.
  • DOH has issued a health advisory about the increase in the number of cases of respiratory syncytial virus (RSV) nationally and in the state.  The alert describes the virus, outlines testing and treatment recommendations, and asks providers to report laboratory-confirmed RSV cases to DOH through Pennsylvania’s electronic reportable disease surveillance system,  PA-NEDSS.  It also urges providers to report outbreaks or clusters of severe respiratory illness, regardless of etiology, to the state and local health departments.  Find the advisory here.
  • DOH has issued a news release outlining the changes in the state’s regulations for skilled nursing facilities that have been approved by Pennsylvania’s Independent Regulatory Review Commission and now await review by the state’s Attorney General.
  • DOH has released a request for applications for its Long-Term Care Quality Investment Pilot, which will distribute approximately $11.7 million in federal funds to long-term-care facilities, including skilled nursing facilities, personal care homes, assisted living facilities, and intermediate-care facilities for the purpose of building resilience.  These funds are designed to be invested in key areas such as workforce development and retention, infection prevention control, emergency preparedness, and improvements to facility infrastructure.  To apply for this funding, facilities must participate in the state’s LTC RISE program’s quality improvement projects and cannot be located in Philadelphia.  Find the state’s request for applications here and learn about LTC RISE here.  The application deadline is December 31.

Department of Human Services

  • The Department of Human Services (DHS) announced that Pennsylvania has received approval from the federal Centers for Medicare & Medicaid Services (CMS) to extend its postpartum coverage period for mothers and birthing people eligible for Medicaid because of their pregnancy from 60 days to 12 months.  Learn more from this DHS news release.
  • DHS has extended into early January of 2023 its Remittance Advice calendar for mailing checks and electronically sending Medicaid payments.  Find the updated calendar here.
  • In response to the passage and signing of House Bill 1630 (now Act 98), which addresses, among other things, the delivery of some mental health and substance use services, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders to advise them of some of the new law’s implications and to list the sections of the Pennsylvania Code the new law repeals.  Find the OMHSAS message to stakeholders here.
  • DHS has issued a Medical Assistance Bulletin advising providers who are not a recognized provider type under the Medical Assistance program that they now may enroll in the program for the purpose of billing for cost-sharing for services provided to beneficiaries who receive both Medicare and Medicaid.  This bulletin also provides information on how to complete and submit an enrollment application.  Find the bulletin here.
  • DHS has added a procedure code to the Medical Assistance fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for:

These requirements take effect on January 9, 2023.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose 12 percent after a decline of 12 percent the week before; the number of deaths rose slightly.  The state is averaging more than 1800 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs (172) is at its highest level since early March.
  • The CDC reports a modest increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a 15 percent decrease last week.
  • As of November 4, 54 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 13 are experiencing substantial rates of community transmission; and Cameron County is experiencing a moderate rates of community transmission.

Stakeholder Events

Department of Health – State Child Death Review Team – November 9

The Department of Health’s State Child Death Review Team will hold a public meeting in Harrisburg on Wednesday, November 9 at 10:00.  The state’s Child Death Review Program provides training and technical assistance to local Child Death Review teams.  This meeting will focus on suicide deaths.  For information about the location of the meeting and the Child Death Review Team, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-11-04T20:15:28+00:00November 4th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on PA Health Policy Update for Friday, November 4
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PA Health Policy Update for Friday, October 28

The following is an update of selected state health policy developments in Pennsylvania for the week of October 24-28, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed House Bill 1630 into law earlier today.  Act 98, as it is now known, gives the Pennsylvania Auditor General authority to audit and review pharmacy benefit managers (PBMs) that subcontract with Medicaid managed care organizations.  In addition, the bill abrogates a number of regulations to permit the following:

  • audio-only outpatient psychiatric services
  • telehealth services in outpatient drug and alcohol clinic services
  • virtual supervision for psychiatric rehabilitation services
  • physician assistants and nurse practitioners to order home care, home health services, and personal care services under the supervision of a physician

House Chamber of the State HouseGeneral Assembly

The state House and Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate unanimously passed House Bill 2293, which requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities, and sent it to the governor for his signature.
  • The Senate also unanimously passed House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and sent it to the governor for his signature.
  • The House passed Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services, on third and final consideration Wednesday.  The Senate subsequently voted to concur with the House amendments and sent it to the governor for his signature.
  • The House passed Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning, on third and final consideration Wednesday.  The Senate concurred with the House amendments and sent it to the governor for his signature.
  • The Senate passed House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA, on third and final consideration and sent it to the governor for his signature.
  • The Senate passed House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment.  The House subsequently concurred with the Senate’s amendment, which added language that enables counties to establish overdose death or suicide review teams, and sent it to the governor for his signature.
  • The Senate unanimously passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania, and sent it to the governor for his signature.
  • The Senate passed Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health.  The bill was received in the House and referred to the Health Committee.

The state House and Senate are now in recess until the week on Monday, November 14.

Department of Health

Pennsylvania’s Independent Regulatory Review Commission has approved the first significant revision of the state’s nursing home regulations since the late 1990s.  Among other things, the updated regulations call for higher levels of nurse staffing and publication of changes in the ownership of nursing homes.  The Department of Health also will have to take a more rigorous approach to determining whether it will accept or reject such transactions.  Learn more from this Philadelphia Inquirer article.  A formal notice of the adoption of these new rules should be published shortly in the Pennsylvania Bulletin.

The Department of Health has lowered the age at which individuals may request a copy of their birth certificate in Pennsylvania from 18 to 16 and introduced a new waiver to enable individuals aged 16-24 who are, or have been, involved in foster care or juvenile justice to obtain their birth certificate without the $20 fee; the same fee waiver will apply to homeless persons.  Learn more from this Department of Health news release.

Department of Human Services

  • The federal Centers for Medicare & Medicaid Services (CMS) has approved Pennsylvania’s application to extend Medicaid and CHIP eligibility for newborns and their mothers to 12 months of postpartum care, an option temporarily available to states under the American Rescue Plan.  Learn more from this CMS news release.
  • The Department of Human Services (DHS) has issued the publication “5 Things to Know About the End of the Federal Public Health Emergency.”  While the Medicaid-focused publication is primarily directed to consumers, it includes explanations providers can use when interacting with Medicaid patients and resources to which those who work with Medicaid beneficiaries can direct those clients and patients.  Find that publication here.
  • DHS has posted the presentations delivered during the October 27 meeting of the Medical Assistance Advisory Committee.  See the presentations from the:
  • DHS has closed the county assistance office in the Nicetown/Ridge Avenue area of Philadelphia and is directing residents of that area to other offices in Philadelphia.  Learn more from this DHS news release.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week declined nearly 12 percent; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a 15 percent decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • The decline in the number of reported COVID-19 cases is reflected in the rate of community transmission among Pennsylvania counties – a major shift after months of virtually all counties experiencing high rates of community transmission with scattered counties occasionally experiencing only substantial rates.  As of October 26, 34 counties are experiencing high rates of community transmission; 31 are experiencing substantial rates of community transmission; and two counties – Clarion and Snyder – are experiencing moderate rates of community transmission, the first Pennsylvania counties to see their rate decline to this level in months.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published “Common Procedures Report – October 1, 2020 through September 30, 2021 Data.”  The report shares volume and outcome information for three common orthopedic procedures – spinal fusion, total hip replacement, and total knee replacement – performed in Pennsylvania acute-care hospitals that typically perform these procedures on adults.  For further information, including a news release, data, a report summary, the report itself, and more, go here.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Trauma-Informed Care – November 3

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Jewish Healthcare Foundation a webinar on trauma-informed care for skilled nursing facilities.  The webinar will be held on Thursday, November 3 at 2:00.  Learn more about the webinar and how to participate from this notice.

PHC4 – PHC4 Council Meeting – November 3

PHC4 will hold a regular council meeting at 10:00 on Thursday, November 3.  An agenda will be available here 24 hours in advance.  The public is invited to participate; contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Management Strategies When Working With Individuals With Acquired Brain Injuries – November 10

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Jewish Healthcare Foundation a webinar on understanding basic management strategies for working with individuals with acquired brain injuries.  The

webinar will be held on Thursday, November 10 at 2:00.  Learn more about the webinar and how to participate from this notice.

2022-10-28T19:54:44+00:00October 28th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, October 28
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PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage 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.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21
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PA Health Policy Update for Friday, October 14

The following is an update of selected state health policy developments in Pennsylvania for the week of October 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

The Wolf Administration

Governor Wolf has announced that Pennsylvania is proposing to enter a new profit-sharing agreement with its Medical Assistance physical health managed care organizations.  Under the proposed agreement, the physical health managed care organizations would be limited to three percent profits annually with the requirement to invest additional profits in approved projects and initiatives that directly benefit the health and well-being of Pennsylvanians.  The agreement would take effect for the 2023 contract year.  Learn more about the proposal from this Wolf administration news release.

General Assembly

The state Senate will return to session next week.  Monday, October 17 is a non-voting session day. Tuesday, October 18 and Wednesday, October 19 are voting session days.  The state House will continue to be in recess next week.

The Senate Health & Human Services Committee will convene on Tuesday, October 18 to consider the following bills.

  • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services (DHS) uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
  • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to an additional ten months.
  • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
  • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification. Legislative text is not currently available.
  • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
  • House Bill 1443 permits certain diagnostic laboratory services to be marketed directly to Pennsylvania consumers.
  • House Bill 1630 grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
  • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
  • House Bill 2530 ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs.

Department of Human Services

  • The Department of Human Services (DHS) has posted information for providers about an electronic submission process that will soon be available in the PROMISe portal for fee-for-service 180-day exception requests and other claims requiring documentation.  Find DHS notice here.
  • Effective October 1, Pennsylvania has increased the income threshold for applicants for the Supplemental Nutrition Assistance Program (SNAP) to 200 percent of federal poverty income guidelines.  This will make more than 420,000 Pennsylvanians and more than 174,000 households newly eligible for SNAP and an average of $63 a month to help pay for groceries.  For additional information about these changes and where to direct individuals to apply for them, see this DHS news release.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has released “Pennsylvania Behavioral Health Telehealth Phase II Roadmap,” which offers and prioritizes recommendations for short-term and long-term implementation of telehealth services in the state.

Centers for Medicare & Medicaid Services

The federal Centers for Medicare & Medicaid Services (CMS) has approved Pennsylvania’s request for a statewide waiver to extend the October 6, 2022 deadline for temporary nurse aides (TNAs) to gain certification to April 5, 2023 or until the end of the COVID-19 public health emergency (whichever comes first).  This statewide approval applies to all nursing care facilities in Pennsylvania, so individual facilities do not need to request a waiver.  For information about how temporary TNAs can pursue certification, see this notice.

To evaluate Medicaid and the Children’s Health Insurance Program (CHIP) coverage for children, states report data to CMS about program eligibility, enrollment, operations, expenditures, program goals, and more.  CMS has published CHIP data submitted to it by Pennsylvania for FY 2021.  Find that data here.

Department of Health

The Department of Health has issued a health alert giving providers interim guidance on risk assessment and management of patients who may have been exposed to the Ebola virus.  It issued this guidance after a case of Ebola was recently diagnosed in Uganda but notes that no reported or confirmed cases have been found in the U.S.  Learn more from this health advisory.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 18 percent from the previous week (which was 20 percent less than the week before that) and the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent decrease in the seven-day rolling average of new daily COVID-19 hospital admissions (after a seven point increase the previous week).
  • Sixty-two of Pennsylvania’s 67 counties are experiencing a high rate of community transmission of COVID-19.  The remaining five counties – Adams, Centre, Lebanon, Philadelphia, and Snyder – are experiencing moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) announced that the 2022 open enrollment period is under way for licensed substance use disorder treatment providers in Pennsylvania to submit their information to be included in the Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS).  Treatment facilities currently not enrolled in ATLAS may submit their information during this open enrollment period through December 30, 2022.  In addition, current enrollees may update facility information during this period.  For additional information, see this DDAP news release.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released its state ambulatory surgery center financial analysis for 2021.  Its report shows that the average total margin for ambulatory surgery centers increased 1.61 percentage points, from 23.36 percent in fiscal year 2020 to 24.97 percent in FY 2021.  The average statewide operating margin for ambulatory surgery centers increased 1.58 percentage points, from 22.29 percent in FY 2020 to 23.87 percent, in FY 2021.  Learn more from this PHC4 news release and the PHC4 report “Financial Analysis 2021:  Ambulatory Surgery Centers.”  Go here for downloadable data in Excel format (this link opens to a download).

Stakeholder Events

Department of Health – Special Supplemental Nutrition Program for Women, Infants and Children Advisory Committee – October 18

The Department of Health’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory Committee will meet virtually on October 18 at 1:00 to elect officers and discuss future suggestions and next steps for the committee.  For information about participating in the meeting and obtaining an agenda, see this Pennsylvania Bulletin notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Renal Disease Advisory Committee – October 21

The Department of Health’s Renal Disease Advisory Committee will hold its quarterly meeting in person and virtually on Friday, October 21 at 10:00.  For information about participating in the meeting, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

2022-10-14T19:19:31+00:00October 14th, 2022|COVID-19, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, October 14
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PA Health Policy Update for Friday, October 7

The following is an update of selected state health policy developments in Pennsylvania for the week of October 3-7, 2022.  (Some of the language used below is taken directly from state documents.)

Behavioral Health Commission for Adult Behavioral Health

The Wolf administration has released the recommendations of its Behavioral Health Commission for Adult Behavioral Health, which was created to advise the General Assembly on how to spend $100 million in one-time federal American Rescue Plan Act funding, including to support adult behavioral health needs addressed in the state’s 2022-2023 fiscal code.  The commission recommended that the $100 million be used in the following manner:

  • $37 million to stabilize, strengthen, and expand the workforce
  • $23.5 million to improve the criminal justice and public safety systems
  • $39 million to expand capacity for services and supports
  • $500,000 for a future study of the impact of this spending

The commission’s recommendations are only advisory; the General Assembly will consider its recommendations in the coming weeks and decide if and how to appropriate the $100 million.

Find a Wolf administration news release about the report here and the report itself here.

Department of Human Services

The Department of Human Services has announced its intent to allocate funds for FY 2023 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Medical Assistance program and to provide financial relief to hospitals during the COVID-19 pandemic.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  Learn more from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its interim infection prevention and control recommendations for health care settings to reflect recent changes in federal CDC recommendations.
  • DOH  has shared information on severe manifestations of monkeypox among patients who are immunocompromised due to HIV or other conditions.  This is the same alert issued last week by the CDC.
  • DOH has added to its naloxone standing orders that enable residents and first responders to obtain naloxone products to help combat the rise of overdoses in Pennsylvania a non-prefilled syringe with two single-dose vials of liquid naloxone that is injectable.  Residents can present a copy of the state’s standing order, which can be found here, at their local pharmacy to obtain the naloxone.  The medication also is available for free for personal use through a statewide mail-based naloxone program.
  • DOH has issued an advisory about lead exposure in adults.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 20 percent from the previous week and the number of deaths fell 10 percent.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a seven percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • For the first time in several months, all, or almost all, of Pennsylvania’s 67 counties are not experiencing a high rate of community transmission.  Currently, 60 counties are still experiencing a high rate of community transmission while six counties – Forest, Centre, Lycoming, Union, Snyder, and Delaware – are experiencing “only” a substantial rate of community transmission and Philadelphia’s rate is now classified as moderate.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 26,385 confirmed cases of monkeypox in the U.S. as of October 6, up only slightly from 25,613 cases on September 29.  789 of those cases were in Pennsylvania, up from 713 a week ago.
  • As of October 3, 495 of those Pennsylvania monkeypox cases were in Philadelphia, up from 475 on September 25.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued the research brief “Hospitalizations for Opioid Overdose, 2016 – 2021” that looks at trends among state residents, ages 15 and older, who have been admitted to Pennsylvania acute-care hospitals for opioid overdoses.  Find a news release about the report here and the report itself here.

Centers for Medicare & Medicaid Services

CMS’s Center for Medicare and Medicaid Innovation has released materials presenting its evaluation of year two of the Pennsylvania Rural Health Model, which seeks to improve access to hospital services and improve population health in underserved rural communities.  New evaluation materials include a summary of the evaluation of the program’s second year; the full report; the report’s executive summary; and an appendix to the report.  Learn more about the Pennsylvania Rural Health Model, including a list of its participating hospitals, from the program’s web page.

Stakeholder Events

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

2022-10-07T21:24:30+00:00October 7th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for Friday, October 7
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PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for voting session this week.  The following is an overview of certain health-related legislative activity.

  • The House of Representatives unanimously passed House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.  The bill was received in the Senate and referred to the Aging & Youth Committee.
  • The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
  • The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania.  A recording of the hearing and witness testimony may be viewed here.
  • The Senate Banking & Insurance Committee favorably reported Senate Bill 1330, which requires insurance coverage 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 Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
  • The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

  • The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
  • The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
  • The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
  • DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered.  This policy took effect on September 20.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix.  The update took effect on September 19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax.  The update is effective as of July 13.  Find that bulletin here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2.  Find that notice here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1.  Find that notice here.
  • DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the state’s nursing facility assessment program beginning in FY 2023.  Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers.  Learn more from this Pennsylvania Bulletin notice.
  • DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

  • DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding.  The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead.  Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of about 10 percent.
  • To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 195 admissions a day over the past week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26.  Find that notice here.
  • The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures:  coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement.  The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay.  It also documents case volumes, hospital charges, and statewide trends and offers other statistics.  To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00.  The meeting will be held virtually. An agenda will be available here 24 hours in advance.  Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 23
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PA Health Policy Update for Friday, September 16

The following is an update of selected state health policy developments in Pennsylvania for the week of September 12-16, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for voting session this week.  The following is an overview of selected health-related legislative activity.

  • The House unanimously passed House Bill 1630, which grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers in Medicaid.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House unanimously passed House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.  The bill will now be sent to the Senate.
  • The House Insurance Committee favorably reported Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners’ model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
  • The House Professional Licensure Committee favorably reported House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The House Republican Policy Committee held an informational meeting on Monday to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.  A recording of the meeting and testimony submitted to the committee may be viewed here.
  • The House Human Services Committee favorably reported House Bill 2686, as amended, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
  • The House Children & Youth Committee held an informational meeting this week to examine “Child & Adolescent Fatality Trends & Community Responses.”  A video recording of the hearing may be viewed here.

The state House and Senate will be in session next Monday (9/19), Tuesday (9/20), and Wednesday (9/21).  The following is an overview of selected health-related committee meetings next week.

  • The House Insurance Committee will convene on Tuesday, September 20 at 10:00 a.m. to consider Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The Senate Health & Human Services Committee will hold an informational hearing on Tuesday, September 20 at 11:00 a.m. on the tick crisis in Pennsylvania.
  • The House and Senate Democratic Policy Committees will hold a joint hearing on Friday, September 23 to discuss Senate Bill 860 and House Bill 1848 and the need for Pennsylvania to establish a statewide rape-kit tracking system.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers of updates to the Medical Assistance program fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has extended its calendar for remittance advice (RA) electronic transfer and mailing dates into November.  Find the updated calendar here.
  • DHS has published information about improvements in how providers can update their enrollment summary in the state’s PROMISe provider internet portal.  Find the notice here.
  • DHS has revised its list of drug companies participating in the state’s Medicaid drug rebate program.  Find the updated list here.
  • In July, DHS proposed new regulations governing the delivery of psychiatric rehabilitation services, and in particular, on the use of telehealth in the delivery of those services.  Now, Pennsylvania’s Independent Regulatory Review Commission has published its analysis of the proposed regulation and shared comments submitted by stakeholders in response to the proposed changes.  Find the commission’s analysis and stakeholder comments in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to announce that it has issued an updated School-Based ACCESS Program provider handbook.  Find that bulletin and the updated handbook here.
  • DHS has posted a notice announcing to stakeholders that it has not yet calculated Medicaid hospice rates for FY 2023 and explaining its process for completing those calculations and notifying affected parties.  Find that notice here.

Behavioral Health Commission for Adult Mental Health

The Behavioral Health Commission for Adult Mental Health created to develop recommendations for how to allocate $100 million appropriated for adult mental health purposes in the state’s FY 2023 budget held its fourth public meeting this week.  The first part of the meeting focused on workforce development issues, with participants identifying the biggest challenges in workforce development as recruitment, retention, licensing, lack of funding for loan repayment and salary increases, lack of career pathways and pipelines, and burnout.

After additional discussion, commission members decided they should organize their spending recommendations into four categories:  workforce ($37 million of the $100 million available), expanding services ($36.7 million), criminal justice ($23.3 million), and other ($3 million); they also discussed priorities within each category.  The commission’s final report and recommendations should be presented to the legislature next week but no money will be spent until the General Assembly, which will only meet a few more days this year, specifically authorizes it.  Learn more about the Behavioral Health Commission for Adult Mental Health from its section of the DHS web site.

Department of Health

The Department of Health has notified licensed providers that although the CDC now considers individuals up to date with their COVID-19 vaccinations only if they have had a dose of the new bivalent booster shot, providers should continue to consider individuals up to date if they have received either a monovalent or bivalent booster shot on the recommended schedule.   Learn more from the Department of Health’s letter to providers.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, 74.5 percent of Pennsylvanians five years of age and older are now vaccinated.
  • Sixty-five of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Delaware and Philadelphia counties are currently experiencing “only” substantial rates.

Monkeypox

The CDC has posted an updated map showing the distribution of 23,117 confirmed cases of monkeypox in the U.S. as of September 15, up from 21,504 cases on September 1.  684 of those cases were in Pennsylvania, up from 624 a week ago.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs is offering online training on substance use disorder confidentiality.  This updated training incorporates changes based on passage of Pennsylvania Act 33, the Pennsylvania Drug and Alcohol Abuse Control Act, in July.  Learn how to receive the training from this Department of Drug and Alcohol Programs notice.  Participants can earn PCB continuing education credits.

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

The Rare Disease Advisory Council will hold a stakeholder summit on Thursday, September 22.  The summit will feature panels on gene therapy, newborn screening, and the results of the council’s Patient Needs Assessment Survey.  Learn more about the stakeholder summit here.

Department of Human Services – Special Populations/Dementia Issues September 22

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how facilities can help community members understand what dementia is, how it affects people, and how individuals can make a difference in the lives of those touched by dementia.  The webinar, to be held on Thursday, September 22 at 2:00, is especially recommended for community liaisons, non-clinical teams, nurse educators, service coordinators, and volunteers.  Learn more from this webinar notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-16T21:36:30+00:00September 16th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 16
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PA Health Policy Update for Friday, September 9

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-9, 2022.  (Some of the language used below is taken directly from state documents.)

House Chamber of the State HouseGeneral Assembly

The state House will return to session on Monday, September 12.  The following is an overview of certain health-related committee meetings next week.

  • The House Insurance Committee will meet on Monday, September 12 at 11:00 to consider Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
  • The House Professional Licensure Committee will convene on Monday, September 12 at 11:00 to consider, among other measures, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The House Republican Policy Committee will hold an informational hearing on Monday, September 12 at 11:00 to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.
  • The House Human Services Committee will meet on Monday, September 12 at 11:15 to consider House Bill 2686, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
  • The House Children & Youth Committee will hold an informational meeting on Wednesday, September 14 at 10:00 to examine “Child & Adolescent Fatality Trends & Community Responses.”

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to notify dentists of updates to the Medical Assistance program dental fee schedule and the program’s Dental PROMISe™ Provider Handbook.  Find the bulletin here.

The Department of Human Services has updated its Pennsylvania Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health has written to administrators of long-term-care facilities to encourage them to participate in the state’s Long-term Care Resiliency Infrastructure Supports & Empowerment (LTC-RISE) initiative as a strategy to build workforce resiliency and combat burnout that has resulted from the pandemic.  Find the letter to administrators here and learn more about LTC-RISE and find contact information for LTC-RISE programs serving individual Pennsylvania regions here.

COVID-19:  By the Numbers

Monkeypox

  • The CDC has posted an updated map showing the distribution of 21,504 confirmed cases of monkeypox in the U.S. as of September 8, up from 19,465 cases on September 1.  624 of those cases were in Pennsylvania, up from 561 a week ago.
  • As of September 6, 380 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

DHS – Assessing and Managing Key Conditions in Long-Term Care – September 15

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on enhancing skills to assess and manage key conditions in long-term care.  The webinar, to be held on Thursday, September 15 at 2:00, will feature best practices from nursing facilities across the state.  This webinar also offers continuing education units for RNs, MDs, and social workers.  Learn more about the webinar and how to participate from this announcement.

Pennsylvania Cancer Control, Prevention and Research Advisory Board – September 15

The Pennsylvania Cancer Control, Prevention and Research Advisory Board will meet virtually on Thursday, September 15 at 8:30.  In addition, the Pennsylvania Cancer Coalition and the Data Advisory Committee will be holding their meetings at this time.  The purpose of these meetings is to discuss board updates and Pennsylvania Cancer Plan implementation activities.  Learn how to participate virtually from this Pennsylvania Bulletin notice.

DHS – Behavioral Health Commission for Adult Mental Health – September 16

DHS’s Behavioral Health Commission for Adult Mental Health will meet on Friday, September 16 at 9:00.  Interested parties can attend in person (in Harrisburg) or virtually.  Go here for information on how to participate in the meeting.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

2022-09-09T21:12:39+00:00September 9th, 2022|COVID-19, long-term care, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 9
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PA Health Policy Update for Friday, September 2

The following is an update of selected state health policy developments in Pennsylvania for the week of August 29-September 2, 2022.  (Some of the language used below is taken directly from state documents.)

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for August.  General Fund revenue collection exceeded estimate by $63.8 million, or 2.3 percent, for the month.  Fiscal year-to-date General Fund collections total $5.6 billion, which is $60.4 million, or 1.1 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to notify providers of updates to the Medical Assistance fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to expand the scope of eligible providers that may render certain services to include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and physicians and to add behavioral health providers to certain procedure codes and make other procedure code changes.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from the implementation of the 2022 Healthcare Common Procedure Coding System (HCPCS) procedure codes updates.  In addition, it also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance fee schedule, including setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 29, 2022.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics of updates to the Medical Assistance fee schedule for the distribution of take-home supplies of nasal or injectable naloxone to Medicaid
    beneficiaries.  Find the bulletin here.
  • DHS has published brief notices addressing extra recoupments it has returned to some providers and provider enrollment summary enhancements.
  • DHS has posted federal financial participation rate changes and continued billing requirements for community support service providers.  Find the notice here.
  • DHS has posted HealthChoices enrollment and Medical Assistance Transportation Program utilization data for July.  Find the information here.

Department of Health

  • The Department of Health (DOH) has updated its “Innovative Hospital Model” guidance to make requested changes about locations eligible to operate outpatient emergency departments.  Find that updated information here.
  • DOH has revised its guidance for contacting the Division of Acute and Ambulatory Care prior to an event or change that requires advance notification, such as addition of new equipment or occupancy.  The updated guidance includes email subjects that providers should use when sending these notices to expedite review by the Division of Acute and Ambulatory Care.  Find the updated guidance here.
  • DOH’s annual Pennsylvania Long Term Care Questionnaire is now open until Friday, October 28.  Providers that have not received an email containing login information and instructions should contact Thomas Gavrish at tgavrish@pa.gov.
  • DOH will offer free potassium iodide, or KI, tablets on Thursday, September 15 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants as part of routine preventive efforts in case of future emergencies.  Learn more from this department news release.

COVID-19:  By the Numbers

Monkeypox

  • DHS has published a Medical Assistance Bulletin to advise providers of the addition of procedure codes to use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of the monkeypox vaccines.  Find the bulletin here.
  • The CDC has posted an updated map showing the distribution of 19,465 confirmed cases of monkeypox in the U.S. as of September 1, up from 16,926 cases on August 25.  561 of those cases were in Pennsylvania, up from 465 a week ago.
  • As of August 29, 327 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Mental and Behavioral Health Considerations for Long-Term Care – September 8

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on mental and behavioral health considerations for long-term care on Thursday, September 8 at 2:00.  This presentation will explore the most common behavioral health diagnoses seen among residents living in nursing facilities and will share approaches to managing appropriate use of psychotropic medication and best practices around deprescribing.  Learn more about the event and how to participate from this notice.

Pennsylvania Health Care Cost Containment Council – September 8

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, September 8 at 10:00.  Agendas will be available here 24 hours.  The public is invited to participate. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Patient Safety Authority – September 8

The Patient Safety Authority will meet virtually on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-02T18:45:52+00:00September 2nd, 2022|COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 2
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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