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PA Health Policy Update for March 7

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

General AssemblyHarrisburg, PA capital building

  • The state House of Representatives and Senate concluded their hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.
  • The Department of Human Services (DHS) appeared before the House Appropriations Committee on Tuesday, March 4. A recording of that hearing is viewable here and here.
  • DHS also appeared before the Senate Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here and here.
  • The Pennsylvania Insurance Department and PENNIE appeared before the House Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here. 
  • The House Health Committee held an informational meeting on Monday, March 3 to examine the practice of community health workers. A recording of the meeting is viewable here.
  • The House Human Services Committee held a voting meeting on Wednesday, March 5 and favorably reported the bills below. A recording of the hearing is viewable here. 
  • House Bill 269, which requires the Department of Health, in consultation with the Department of Drug & Alcohol Programs, to develop opioid overdose public education materials. 
  • House Bill 640, which updates the annual reporting requirements for the Department of Drug & Alcohol Programs.
  • House Bill 749, which requires the Department of Human Services to conduct a study of Pennsylvania’s SNAP payment distribution. 
  • The Senate Democratic Policy Committee will hold a meeting on Monday, March 10 at 2:00 p.m. to discuss “health care accessibility and the impacts of hospital closures.” The meeting will be held at Neumann University in Aston, PA and virtually. Find additional details here. 
  • The House and Sente are currently recessed until Monday, March 17 and Monday, March 24, respectively, 

Department of Health 

  • The Department of Health (DOH) has announced the 2024-25 Patient Safety Surcharge (MCARE) letter and invoices for hospitals, ambulatory surgery centers, abortion facilities, and birthing centers have been emailed. Payment is due by June 1, 2025. If you have any questions, please call the Division of Acute and Ambulatory Care (DAAC) at 717-783-8980 or email RA-DAAC@pa.gov.
  • DOH has announced the Event Reporting System (ERS) has been updated with a new Flu A and separate Flu B, as well as RSV reporting enhancement to streamline the reporting of these event types. DOH has shared a Quick Start Guide (opens as a separate Microsoft Word document) for the new enhancement. This enhancement will function in the same manner as the COVID-19 enhancement initiated in March of 2021.

Department of Human Services

The Department of Human Services (DHS) has shared the following presentations utilized at the Medical Assistance Advisory Committee (MAAC) meeting on February 27.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in February, which was $44.0 million, or 1.6 percent, more than anticipated. Fiscal year-to-date General Fund collections total $27.0 billion, which is $104.3 million, or 0.4 percent, below estimate. 

Around the State  

WHYY has published an article about Prospect Medical Holdings’ plan to file a preliminary request to begin closing its remaining Delaware County hospitals. 

The Patriot-News has reported about potential for significant Medicaid cuts in Washington, D.C. and the concern that has raised in Pennsylvania with medical professionals and state legislators. 

Stakeholder Meetings

DOH – Health Policy Board – March 21

The Health Policy Board of the Department of Health will meet on Friday, March 21 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 25

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Tuesday, March 25 from 10:00 a.m. until 12:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2025-03-07T22:13:24+00:00March 7th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for March 7
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PA Health Policy Update for February 21

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

 General Assembly

The state House of Representatives and Senate began hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.

  • The Department of Health appeared before the Senate Appropriations Committee on Wednesday, February 19. A recording of that hearing is viewable here.
  • The Department of Health and the Department of Drug & Alcohol Programs appeared before the House Appropriations Committee on Friday, February 21. A recording of that hearing is viewable here.  

The House of Representatives and Senate will continue budget hearings next week. The only health-related agency scheduled to appear is the Department of Aging, which will be before the Senate Appropriations Committee on Tuesday, February 25 at 1:00 p.m. and the House Appropriations Committee on Thursday, February 27 at 1:00 p.m. The House Appropriations Committee’s full hearing schedule is viewable here and the Senate Appropriations Committee’s full hearing schedule is viewable here. 

Department of Human Services

The Department of Human Services (DHS) has released a rate and wage study for its long-term services and supports (LTSS) and home and community-based services (HCBS) programs. The study assessed rates paid to LTSS and HCBS providers in order to inform the commonwealth’s budget and rate setting process. The study is viewable here.

DHS has issued a Medical Assistance Bulletin to advise providers that effective February 18, the Medical Assistance (MA) program will cover Early and Periodic Screening, Diagnostic and Treatment (EPSDT) screening and diagnostic services to eligible juveniles in the 30 days prior to release, and targeted case management services, both physical and behavioral health, in the 30 days prior to and for at least 30 days following release from a carceral setting.  

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will hold a webinar on March 3 at 10:00 a.m. to discuss the changes to 42 CFR Part 8 (Medications for the Treatment of Opioid Use Disorders) and their practical implications in treatment settings. Find additional information and details on how to participate here. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of a special report on the finances of rural hospitals in Pennsylvania. Find the full report and data visualizations from the report here. 

Around the State  

The Philadelphia Inquirer’s Harold Brubaker has written an article about Sharon Regional Medical Center and Crozer Health and the financial support provided by the state to help keep them open and serving patients.

Governor Shapiro’s appointment by President Trump to serve a two-year term on the Council of Governors was covered by The Philadelphia Inquirer. Among other things, the council is tasked with improving state-federal partnerships and coordinating national security and disaster response efforts. 

Stakeholder Meetings

DHS – Consumer Sub-MAAC – February 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – February 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

Pennsylvania Health Care Cost Containment Council – Committee Meetings

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the schedule of various committee meetings for the first quarter of 2025. Find a detailed schedule and details on how to participate in this Pennsylvania Bulletin notice.

2025-02-21T21:58:30+00:00February 21st, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for February 21
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PA Health Policy Update for February 7

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

Fiscal Year 2025-26 Budget Proposal 

Governor Shapiro delivered his third annual budget address before the General Assembly this week. In total, the proposed FY 2025-26 budget spends $51.5 billion, a $3.6 billion or 7.5 percent increase over the current fiscal year. The governor’s speech included a mixture of accomplishments from his administration’s first two years in office and aspirational policy goals focused on economic competitiveness, education and workforce development, energy infrastructure, public safety, and health care access and affordability. The budget does not propose any broad-based tax increases, but it does rely on a significant amount of fund transfers and new revenue sources, including the elimination of the Delaware tax loophole, the legalization of recreational marijuana, and the taxing of skill games.

The following are budget-related documents released by the budget office, including a proposed line item appropriation spreadsheet.

Governor Shapiro 

Governor Shapiro signed Senate Bill 184, now known as Act 2 of 2025, into law this week following its passage in the Senate. Act 2 enables team physicians traveling internationally with their club or national team to treat their team players on site during games without requiring a Pennsylvania medical license. 

General Assembly

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

  • The House Aging & Older Adult Services Committee held an informational meeting on Monday, February 3 on the Area Agencies on Aging (AAAs). A recording of the hearing is viewable here. 
  • The Human Services Committee held an informational hearing on Wednesday, February 5 on treatment and support for traumatic brain injuries. A recording of the hearing is viewable here.   
  • The House Health Committee met on Wednesday, February 5, a recording of which is viewable here, and favorably reported the following bills from committee.
    • House Bill 60, which aligns Pennsylvania with federal policies to permit the electronic transfer of certain prescribed controlled substances between pharmacies.
    • House Bill 157, which establishes a rural health care grant program to provide financial incentives to health care providers to practice in rural areas.
    • House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. 

Department of Health 

The Department of Health (DOH) has updated its Event Reporting System (ERS) with new flu and RSV reporting enhancements to streamline the reporting of both event types. This is similar to the enhancements made during COVID-19 in March 2021. As a reminder, all flu and RSV events are to be reported to ERS within 24 hours of the facility becoming aware of the diagnosis. Find additional information on the enhancement in this Quick Start Guide (opens as a Word document). 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced it is conducting a medical professional liability insurance study to determine whether sufficient capacity exists to increase the basic coverage limits of insurance required by the Medical Care Availability and Reduction of Error (MCARE) Act. Find additional information and details on how to provide written comments to PID in this Pennsylvania Bulletin notice. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.9 billion in General Fund revenue in January, which was $51.3 million, or 1.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $24.1 billion, which is $148.3 million, or 0.6 percent, below estimate. 

Around the State  

  • The Philadelphia Inquirer has written an article about the bankruptcy proceedings of Crozer Health’s parent company, Prospect Medical Holding, and the judge’s recent approval of the appointment of a temporary manager, FTI Consulting, for 30 days. 
  • An article published by the Pennsylvania Capital-Star highlighted Governor Shapiro’s FY 2025-26 budget proposal and the response by Republican leaders in the General Assembly. 
  • The Pittsburgh Post-Gazette wrote an article about comments made by Governor’s Shapiro in his budget address about the need to remove private equity money from health care and implement a more stringent regulatory review process.
  • WHYY published an article about the health care issues receiving attention at the start of the 2025-2026 legislative session and in Governor Shapiro’s budget address.  

Stakeholder Meetings

Patient Safety Authority – February 18

The Patient Safety Authority will hold a meeting of the Authority’s board on Tuesday, February 18 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-02-07T21:45:49+00:00February 7th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for February 7
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PA Health Policy Update for January 31

The following is an update of selected state health policy developments in Pennsylvania January 27 – 31.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro will deliver his Fiscal Year (FY) 2025-2026 budget address to a joint session of the Pennsylvania General Assembly on Tuesday, February 4. 

General AssemblyHarrisburg, PA capital building

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

  • The Senate Health & Human Services Committee met on Monday, January 27 and favorably reported Senate Bills 155, 156, and 157, which are part of a package of bills aimed at eliminating waste, fraud, and abuse in public assistance programs.
  • The House Aging & Older Adult Services Committee convened for an informational meeting on direct care workers and the homecare industry. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, January 28 and favorably reported, among other bills, House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile.  A recording of the meeting is viewable here.
  • The House Human Services and Insurance Committees jointly convened on Wednesday, January 29 for an informational hearing on traumatic brain injury care needs and coverage options. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, January 29 and favorably reported House Bill 27, which requires health care facilities to adopt and implement policies to mitigate exposure to surgical smoke through the use of a smoke evacuation system for each procedure that generates surgical smoke, and House Bill 33, which implements greater oversight of medical marijuana labs and product testing. A recording of the hearing is viewable here.
  • The House Professional Licensure Committee met on Wednesday, January 29 and favorably reported House Bill 309, which enables team physicians traveling internationally with their club or national team to treat their team players on site during games without requiring a Pennsylvania medical license. A recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for session in Harrisburg again next week. The chambers will hold a joint session on Tuesday, February 4 for Governor Shapiro’s FY 2025-2026 budget address. 

Department of Human Services 

The Department of Human Services (DHS) has issued an updated PA Promise™ Provider Handbook for providers who submit claims via the 837 Professional format or the CMS-1500 Claim Form.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on January 23.

Health Department  

The Shapiro administration, including the Department of Health (DOH) and the Department of Drug & Alcohol Programs (DDAP), highlighted its $3.6 million investment to develop regional maternal health coalitions. Find more information in this press release. 

Around the State

  • The Philadelphia Inquirer has published an article about Governor Shapiro’s plan to again propose the legalization of recreational marijuana in his budget address next week as a strategy to address the state’s growing budget shortfall.  
  • WESA has reported about the potential for a significant increase in premiums for Pennsylvanians enrolled in Pennie, the state’s health insurance marketplace, if federal tax credits are allowed to expire in 2026. The average premium increase would be 81 percent.
  • Democratic lawmakers in Harrisburg introduced a package of bills this week seeking to codify protections provided by the Affordable Care Act (ACA) in Pennsylvania state law, as reported by the Pittsburgh Post-Gazette. 

Stakeholder Meetings

DOH – Organ Donation Advisory Committee – February 6

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 6 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – WIC State Advisory Board – February 11

The WIC State Advisory Board will hold its next regular meeting on February 11 from 11:00 a.m. to 12:00 p.m. This is a rescheduling of the board’s January 14 meeting, which was cancelled due to technical challenges. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – February 13

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, February 13 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – February 18

The Patient Safety Authority will hold a meeting of the Authority’s board on Tuesday, February 18 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-01-31T22:45:42+00:00January 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 31
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PA Health Policy Update for January 24

The following is an update of selected state health policy developments in Pennsylvania January 20 – 24.  (Some of the language used below is taken directly from state documents). 

Pennsylvania Row Offices 

Pennsylvania’s three row officers – Attorney General Dave Sunday, Auditory General Tim DeFoor, and Treasurer Stacy Garrity – were sworn into office on Tuesday, January 21. This marks the first time all three row offices are held by Republicans. 

General Assembly

Following the unfortunate passing of Rep. Matt Gergely (D-Allegheny), Speaker McClinton has scheduled a special election for the 35th Legislative District to occur on Tuesday, March 25.

The state House of Representatives and Senate are scheduled to return to session on Monday, January 27, 2025. The following is a selection of health care-related legislative activity currently scheduled for next week. 

  • The Senate Health & Human Services Committee is scheduled to meet “off the floor” on Monday, January 27 to consider Senate Bills 155, 156, and 157, which are part of a package of bills aimed at eliminating waste, fraud, and abuse in public assistance programs.
  • The House Aging & Older Adult Services Committee will convene on Tuesday, January 28 at 9:30 a.m. for an informational meeting on direct care workers and the homecare industry. The meeting will be held in Room G-50 of the Irvis Office Building.
  • The House Insurance Committee is scheduled to meet on Tuesday, January 28 “at the call of the chair” to consider, among other bills, House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile.  The meeting will be held in Room B-31 of the Main Capitol.
  • The House Human Services Committee will convene on Wednesday, January 29 at 9:00 a.m. for an informational hearing on traumatic brain injury care needs and coverage options. The hearing will be held in Room G-50 of the Irvis Office Building.
  • The House Health Committee will convene on Wednesday, January 29 at 10:00 a.m. in Room G-50 of the Irvis Office Building to consider the following bills.
    • House Bill 27, which requires health care facilities to adopt and implement policies to mitigate exposure to surgical smoke through the use of a smoke evacuation system for each procedure that generates surgical smoke.
    • House Bill 33, which implements greater oversight of medical marijuana labs and product testing.
    • House Bill 79, which establishes a medical debt relief program in the commonwealth. 

Department of Human Services 

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of December.

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

Department of Health  

The Department of Health (DOH) and the Patient Safety Authority have released draft recommendations to all hospitals and birthing centers to mitigate the risk of harm related to shoulder dystocia. Find the draft recommendations and instructions on how to comment in this Pennsylvania Bulletin notice.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs’ (DDAP) State Epidemiological Outcomes Workgroup (SEOW), in partnership with Drexel University’s Department of Community Health and Prevention, has released two new reports.

State Board of Nursing  

The State Board of Nursing has issued proposed rulemaking that would amend regulations related to professional, practical, and certified registered nurse practitioner education programs. The proposed amendments also codify current board practice and update requirements to meet national standards. Find the proposed rulemaking in this Pennsylvania Bulletin notice. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has released new county-level utilization data and condition-specific reports, which provide greater insight into ambulatory/outpatient utilization and hospitalization rates for high interest conditions. Find the full reports here. 

Around the State  

  • Pennsylvania anticipates it will receive $212 million over 15 years from a multi-state opioid settlement recently reached with the Sackler family and Purdue Pharma. Read the Pennsylvania Capital-Star’s coverage here. 
  • The Philadelphia Inquirer has published an article about the challenges confronting Governor Shapiro, who is mid-way through his first term, including an anticipated $4.5 billion budget deficit.
  • The Patriot-News has written an article about Pennsylvania’s continued downward trajectory of vaccination rates among children.
  • Spotlight PA has published a detailed article about Bucktail Medical Center and its recent receipt of $1 million from the state in an effort to prevent its closure.

 Stakeholder Meetings

Council on Aging – 2025 Meeting Dates

The Pennsylvania Council on Aging, an independent advisory board under the Office of the Governor and supported by the Department of Aging, has released its meeting schedule for 2025. Find the full schedule and details on how to participate in this Pennsylvania Bulletin notice.

2025-01-24T20:07:55+00:00January 24th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 24
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PA Health Policy Update for January 17

The following is an update of selected state health policy developments in Pennsylvania January 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The state House of Representatives and Senate are scheduled to return to session on Monday, January 27, 2025. 

Department of Human Services

  • The Department of Human Services (DHS) has issued final-form regulations regarding Psychiatric Rehabilitation Services (PRS). The regulations, which are effective upon publication in the Pennsylvania Bulletin incorporate several updates, including lowering the minimum age to 14 years old for PRS eligibility, the inclusion of individuals with posttraumatic stress disorder, bipolar disorder, major depressive disorder, and anxiety disorders without requiring an exception process, and the implementation of a weekly file note requirement. Find additional information in this Pennsylvania Bulletin notice. 
  • DHS has provided final notice of the FY 2024-2025 nursing facility assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities subject to the assessment. Find those details in this Pennsylvania Bulletin notice.  
  • DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the top 15 non-English languages used by Medicaid beneficiaries and to remind providers of their responsibility to provide interpretation and translation services free of charge to all individuals who have limited English proficiency, vision limitations, and/or auditory limitations. 

Health Department

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 782) to share information with health care professionals about exposure to environmental contaminants, including a list of trainings and resources from academic and governmental organizations that can help providers assess environmental exposures and respond to patient concerns.
  • DOH has shared an announcement from the Federal Office of Rural Health Policy regarding new funding available for the Rural Residency Planning and Development (PRPD) program.

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced it took an important step toward fully implementing the commonwealth’s new Pharmacy Benefit Manager (PBM) reform law. PID established a new process for pharmacies to challenge a health benefit plan’s designation of a specialty drug, as provided by Act 77 of 2024. PBMs and pharmacies looking for more information about Act 77, including a schedule that outlines the Act’s full implementation dates, can visit PID’s website here. 

Pennsylvania Supreme Court 

The Pennsylvania Supreme Court and the Administrative Office of Pennsylvania Courts (AOPC) have announced their efforts to combat the behavioral health crisis, including the establishment of an Office of Behavioral Health.  

Around the State  

  • The Pennsylvania Capital-Star has published an article highlighting laws enacted by the General Assembly in 2024 that will take effect this year, including bills that improve access by mandating insurance coverage of biomarker testing and telemedicine. 
  • Prospect Medical Holding’s, the parent company of Crozer Health in Delaware County, decision to file for bankruptcy was covered by Harold Brubaker for The Philadelphia Inquirer in this article. 
  • WPSU has reported that Bucktail Medical Center in Clinton County has received a $1 million state grant from the Department of Community and Economic Development’s (DCED) Hospital and Healthsystem Emergency Relief fund. 

Stakeholder Meetings

DOH – Achieving Better Care by Monitoring All Prescriptions Board – 2025 Meeting(s)

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board, established under the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) has set its calendar for 2025. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

2025-01-17T22:38:55+00:00January 17th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 17
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PA Health Policy Update for January 10

The following is an update of selected state health policy developments in Pennsylvania January 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The General Assembly convened on Tuesday, January 7 to officially commence the 2025-2026 legislation session. Members of the state House of Representatives and Senate who were newly elected or re-elected were sworn in. In addition, the two chambers elected their respective presiding officers, adopted rules, and established standing committees.

At the conclusion of Tuesday’s legislative business, the House and Senate recessed until Monday, January 27. Following are their respective 2025 session calendars.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has approved the remainder of the commonwealth’s request for a five-year section 1115 demonstration – Bridges to Success: Keystones of Health for Pennsylvania. You will recall Pennsylvania received approval from CMS back in November to implement multi-year continuous eligibility for Medicaid-eligible children through age six and one year of continuous coverage for Medicaid-eligible citizens returning from a state correctional facility. The Department of Human Services (DHS) has stated it, “will work through the state budget process to determine next steps for potential implementation.” Find CMS’ approval letter to DHS here. 

Department of Human Services 

  • DHS has issued updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Anticonvulsants submitted for prior authorization. Find additional information in this Medical Assistance Bulletin.
  • DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the Admissions Notice Packet (MA 401) form due to an increase in the personal needs allowance (PNA) deduction amount. This bulletin applies to nursing facilities, intermediate care facilities, and long-term care facilities enrolled in the Medical Assistance program. 

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that 259 Pennsylvanians successfully appealed denied health service claims through PID’s new Independent External Review process. Of the total health service denials submitted for review in 2024, 50.1 percent were overturned.

PID has also shared information related to its efforts to increase health insurance transparency through several reports available to the public, including its annual Transparency in Coverage Report for ACA Health Plans, which outlines data on claims, denials, and appeal information, and its inaugural ACA and Qualified Health Plans (QHP) Summary. Find additional information in this press release.

Around the State

  • WHYY has written about the Pennsylvania Insurance Department’s external review program which received 517 health service denial appeals in 2024. 259 of those denials were overturned. 
  • City & State Pennsylvania has published an article about the General Assembly’s first session day of 2025. 
  • The Pittsburgh Post-Gazette has written an article about a study released by Pennsylvania Partnerships for Children that kids largely stayed insured despite uncertainties during the Medicaid eligibly redetermination process following the conclusion of the COVID-19 public health emergency. 

Stakeholder Meetings

DOH – WIC Advisory Board – January 14

The WIC State Advisory Board will hold a meeting on January 14 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Special Pharmaceutical Benefits Advisory Council – January 30

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, January 30 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-01-10T20:27:58+00:00January 10th, 2025|Federal Medicaid issues, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 10
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PA Health Policy Update for November 15

The following is an update of selected state health policy developments in Pennsylvania November 4 – 15.  (Some of the language used below is taken directly from state documents). 

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it approved an amendment to Pennsylvania’s section 1115 Medicaid demonstration waiver to provide continuous Medicaid eligibility for children until the age of six, and 12 months of continuous eligibility for individuals aged 19 through 64 leaving incarceration, who meet certain high-risk criteria. Find additional information about Pennsylvania’s section 1115 demonstration amendment approval here. 

General Assembly

The state House of Representatives and Senate briefly convened for voting session this week to conclude legislative business for the 2023-2024 session and elect caucus leadership for the upcoming 2025-2026 legislative session. Following is the comprehensive list of each caucus’ leadership team.

* Denotes majority party.  

Department of Human Services

  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it released an updated Psychiatric Outpatient Clinic Regulatory Compliance Guide (RCG). The changes made were primarily to language and updates based on comments received from stakeholders on the original document issued in 2021. OMHSAS has been working on developing RCGs for each licensed level of care. The RCG is designed to be a tool for providers, OMHSAS staff, and the public to better understand pertinent regulations. The guide is a companion piece to 55 Pa. Code Chapter 5200.
  • DHS has issued several Medical Assistance bulletins with updated handbook pages that include the requirements for prior authorization for various pharmacy services. Following is a comprehensive list of prior authorization bulletins recently issued by DHS.

Department of Health 

The Department of Health (DOH) has published notice of the Secretary of Health’s decision not to effectuate the recommendation of the Medical Marijuana Advisory Board that certified registered nurse practitioners (CRNPs) and podiatrists be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana. Find the notice regarding CRNPs here and podiatrists here. 

Insurance Department

The Pennsylvania Insurance Department (PID) has released a comprehensive study of the accuracy of health insurer provider directories. The report highlights persistent inaccuracies in health insurer provider directories that can delay care, hinder scheduling, or result in surprise out-of-network charges. PID is planning to initiate stakeholder outreach to gather input and develop solutions that reduce inaccuracies in provider directories. Find additional information in this press release. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) has released its Economic and Budget Outlooks for FYs 2024-2025 to 2029-2030. This annual fiscal outlook report, which includes projections of state revenues and expenditures, also considers economic and demographic trends that will impact tax revenues and expenditures over the next five fiscal years. Find the IFO’s presentation here and its full report here. 

Office of Administration 

The Office of Administration has recently announced the launch of a new resource page on PA.gov that makes it easier for residents, businesses, non-profits, and local government entities to find and apply to various grant programs from state agencies. Find additional information in this press release. 

Around the State  

  • The Hill has published an article about Governor Shapiro’s national political prospects following the 2024 election. 
  • WHYY has written an article about this year’s open enrollment for health insurance coverage in 2025.  The Pittsburgh Post-Gazette has also written about open enrollment and the potential for premiums to increase. 
  • An article published by the Patriot-News highlights the continued partisan split in Harrisburg for the upcoming 2025-2026 legislative session.  The Pennsylvania Capital-Star also wrote about this dynamic but noted House Democrats’ hope for greater cooperation with the Republican Senate. 

Stakeholder Events 

DOH – Newborn Screening Advisory Committee – November 21

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 21 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual conference. Find additional information in this Pennsylvania Bulletin notice.

2024-11-15T20:57:21+00:00November 15th, 2024|Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for November 15
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PA Health Policy Update for October 11

The following is an update of selected state health policy developments in Pennsylvania October 7 – 11.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The Commonwealth of Pennsylvania is taking steps to address the state’s high maternal mortality rate through the development of a statewide “Maternal Health Strategic Plan.” The Shapiro administration is asking stakeholders to complete a survey through November 4 to help inform the development of the strategic plan. Along with the governor’s office, the health agencies involved include the departments of Health, Human Services, Drug and Alcohol Programs, and Insurance. Find the survey here. 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate unanimously voted to concur with House amendments to Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill will now be presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill was subsequently received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee for consideration.
  • The Senate unanimously passed House Bill 2381, which allows a licensing board or commission under the Department of State’s Bureau of Professional and Occupational Affairs to promulgate temporary regulations necessary for the implementation of each interstate licensure compact enacted by the General Assembly. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed House Bill 2268, which provides coverage for speech therapy for stuttering. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate passed House Bill 2084, which establishes a license for prescription drug virtual manufacturers. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously voted to concur with the House amendments to Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources. The House subsequently voted to concur with the Senate’s amendments and the bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 155, which removes the requirement that direct care workers be interviewed in-person for a position. The bill was subsequently presented to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2562, which prohibits health insurance companies from imposing annual and lifetime limits to the dollar value of core benefits provided under the policy to the enrollee. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2563, which provides for health insurance coverage of dependent children up to age twenty-six by a parent’s health insurance policy. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2564, which prohibits health insurance companies from imposing any rules for initial or continued eligibility for individuals having a preexisting condition. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate Health & Human Services Committee met on Monday, October 7 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the hearing is viewable here.
  • The House Labor & Industry Committee met on Wednesday, October 9 for an informational hearing on the Federated Insurance Company v. Summit Pharmacy court case. A recording of the hearing is viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers are scheduled to return to Harrisburg on Monday, October 21. 

Department of Human Services

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced that the proposed Psychiatric Residential Treatment Facilities (PRTF) regulations have been posted for public comment. OMHSAS’ proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

The Department of Human Services (DHS) has published proposed rulemaking to amend a data element in DHS’ case-mix payment system for non-public and county nursing facilities to utilize the patient driven payment model (PDPM) in place of the Resource Utilization Groups, Version III (RUG-III) classification system in setting Medical Assistance (MA) payment rates for nursing facilities. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 773) with information about the first Marburg Virus Disease (MVD) outbreak in the Republic of Rwanda, including information about patient assessment and monitoring of U.S. health care workers who may have been in Rwanda within the last 21 days.

DOH has issued a notice to physicians renewing their licenses in Pennsylvania to ensure their practice information is up to date. 

Insurance Department  

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its intent to submit an application to extend the 1332 State Innovation Waiver Reinsurance Program (PA-Re) for another five years. The state reinsurance program helps moderate premiums in the state’s individual health insurance marketplace. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

PID has announced Pennsylvania’s 2025 Affordable Care Act (ACA) health insurance rates. The enrollment period for Pennie, Pennsylvania’s health insurance marketplace, will begin November 1 and go through December 15 for coverage that starts on January 1, 2025.

Around the State  

  • WHYY has published an article about the worsening shortage of IV fluids due to Hurricane Helene which damaged a factory in North Carolina that produces more than half the country’s supply of IV fluids. 
  • The New York Times has written an article about the consequential role Pennsylvania is currently playing in this year’s U.S. Presidential election and the amount of time and money the candidates are spending in Pennsylvania.
  • Health care professionals from across Pennsylvania rallied at the State Capitol on Tuesday along with gun violence awareness advocates. WGAL reports the rally is part of a new statewide coalition called PA Health Professionals to End Gun Violence. 

Stakeholder Events

DOH – WIC State Advisory Board – October 22

The WIC State Advisory Board will hold a meeting on October 22 from 1:00 – 2:00 p.m. The purpose of this meeting is to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-11T19:46:11+00:00October 11th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for October 11
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PA Health Policy Update for October 4

The following is an update of selected state health policy developments in Pennsylvania from September 30 – October 4.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The House of Representatives passed House Bill 2295 and House Bill 2294, which allow a physician assistant to work with either an allopathic or osteopathic physician without having to obtain a license from both medical boards. The bills were subsequently received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Labor & Industry Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2548, which requires employers to provide paid sick leave. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Monday, September 30 for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care. A recording of the hearing is viewable here.
  • The House Insurance Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. A recording of the hearing is viewable here. The Insurance Committee also met on Tuesday, October 1 for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes. A recording of the hearing is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, October 1 and favorably reported, among other bills, Senate Bill 1303, which lowers the influenza vaccine offering from age 65 and older, down to age 50 and older. A recording of the hearing is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, October 1 and favorably reported the following bills.
    • House Bill 155, which allows two-way video calls to satisfy the face-to-face requirement for job interviews for direct care workers.
    • House Bill 1608, which requires coverage of doula services in the Medical Assistance program.
    • House Bill 2084, which establishes a license for virtual prescription drug manufacturers.
    • House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with information about postpartum depression and counseling resources.

A recording of the Senate Health & Human Services Committee is viewable here.

  • The House Health Committee met on Wednesday, October 2 and favorably reported the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

A recording of the Health Committee meeting is viewable here.

    • The Human Services Committee met on Wednesday, October 2 for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee held a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. A recording of the meetings is viewable here.

The state House of Representatives and Senate will convene again for voting session Monday, October 7 through Wednesday, October 9. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced a Request for Applications (RFA) seeking managed care organizations to administer services for the Children’s Health Insurance Program (CHIP) program. 
  • DHS has announced its intent to increase rates paid in its Behavioral HealthChoices program, which provides access to mental health, substance use disorder, and other behavioral health services for Medicaid recipients. Once approved by CMS, the new rates to the Behavioral HealthChoices Managed Care Organizations (MCOs) will be retroactive to July 1, 2024 for their current 2024 contract agreements. 
  • DHS announced an increase in the assessment fee that managed care organizations (MCOs) will pay per member per month as a means to generate federal matching funds to support the capitation payments. The increase, which becomes effective in January, is expected to generate an additional $223.531 million in assessment revenue for FY 2024-2025. 
  • DHS has shared the following presentations from the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee meeting on September 25.
  • The Independent Regulatory Review Commission (IRRC) approved the DHS Psychiatric Rehabilitation Services regulations that were first proposed in 2022. With this revision, the regulations expand eligibility for psychiatric rehabilitation services to include individuals 14 years of age or older but under 18 years of age and expand the diagnoses that allow individuals to access PRS without going through the exception process. Find more information in this Pennsylvania Bulletin notice. 

Department of Health 

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 772) regarding health care and long-term care facility preparedness for the 2024-2025 respiratory virus season.
  • DOH has issued a Health Advisory (PA-HAN 771) with information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo and prevention strategies for U.S. travelers visiting countries with an outbreak.
  • DOH has issued a Health Advisory (PA-HAN 770) announcing that has received adequate supplies of Benzathine Penicillin G (Bicillin L-A®) and is now lifting the restrictions for the administration of Bicillin L-A® for individuals who are diagnosed with or suspected of having syphilis. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued a licensing alert regarding DDAP’s implementation of the updated federal regulations for the certification of Opioid Treatment Programs (OTPs).

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate. 

Stakeholder Events

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

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

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-07T15:57:14+00:00October 4th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 4
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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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