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PA Health Policy Update for the Week of December 6-10

The following is an update of selected state health policy developments in Pennsylvania for the week of December 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate Democratic Policy Committee held an informational hearing this week on substance use disorder treatment facilities. The hearing was co-hosted by senators Schwank, Tartaglione, and Muth. Panelists included individuals affected by the addiction crisis, treatment providers, and the Department of Drug and Alcohol Programs. Testimony offered at the hearing and a video recording may be found here.

The state House and Senate will return to session next week. The following are the relevant health committee hearings currently scheduled.

The House Health Committee has scheduled a hearing on Monday, December 13 at 9:00 a.m. to discuss COVID-19 treatment options. Chairman Kathy Rapp has indicated the committee will examine House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat COVID-19.
The Senate Health & Human Services Committee is scheduled to convene on Tuesday, December 14 at 11:00 a.m. to consider, among other bills, 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; Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning; Senate Bill 848, which creates a chief nursing officer position in the Department of Health; Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board; and Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception. The committee also will consider House Bill 118, which establishes requirements for the final disposition of fetal remains.
The House Human Services Committee has scheduled an information hearing on House Bill 1644 for next Thursday, December 16 at 9:30 a.m. House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner. The Human Services Committee also has scheduled an 11:00 a.m. hearing to examine community participation supports during COVID-19 pandemic.

Department of Human Services

The Department of Human Services (DHS) has updated its list of regulations that have been suspended to facilitate the state’s response to the COVID-19 emergency. Find the updated list here.
The federal Centers for Medicare & Medicaid Services (CMS) has written to state Medicaid directors to encourage them to take advantage of a provision in the American Rescue Plan that authorizes their programs, beginning on April 1, 2022, to provide 12 months of postpartum Medicaid coverage to pregnant women enrolled in either their Medicaid or CHIP programs. Learn more from the CMS letter to state Medicaid directors. Pennsylvania announced in August that it would extend this coverage.
CMS has sent a letter to state Medicaid directors to help them understand provisions in the Consolidated Appropriations Act of 2021 that include new reporting requirements for non-disproportionate share hospitals (DSH) supplemental payments and a change in the methodology for calculating hospital-specific DSH limits. See that letter here.
DHS has issued a news release elaborating on Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act. This funding will support Medicaid’s home and community-based services system throughout the state. Learn more from this DHS news release.

Department of Health

The Department of Health (DOH) has issued a seasonal influenza update urging providers to encourage their patients to receive flu vaccines, offering treatment recommendations, and reminding providers that they are required to report flu cases to the state. Learn more in this department influenza update and reminder health alert.
DOH has updated two health alerts, PA-HAN-609 and PA-HAN-610, to clarify that the visitation guidance from the department applies only to skilled nursing facilities and that other types of facilities, such as personal care homes, assisted living facilities, and intermediate-care facilities, should seek guidance from their licensing agencies when it comes to COVID-19 visitation policies.
DOH has distributed communication that it received from the Centers for Medicare & Medicaid Services informing states that the federal government will not be enforcing the health care provider vaccination mandate while federal litigation is pending.

COVID-19: By the Numbers

Daily COVID-19 case counts remain near their highest levels since the beginning of the pandemic. To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths also remains high.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus all rose sharply in the past week.
These numbers reflect the growing rate of occupancy in the state’s hospitals. There currently are only 481 unoccupied adult ICU beds – 13.5 percent of the total of such beds in the state; 2019 unoccupied medical/surgical beds – 10 percent of such beds in the state; 29 pediatric ICU beds (7.7 percent); 234 pediatric beds (20.8 percent); and 919 airborne isolation beds (29.1).
Media reports confirm the challenges some communities and hospitals are facing, including this report on the situation at the nine hospitals that constitute Geisinger Health; this report on the situation in Allegheny County; this report on the situation in the Erie area; and this report on the situation throughout Pennsylvania.
The Department of Health reports that 6.7 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters. Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that nearly 170,000 boosters have been administered to city residents since August 13.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has established minimum qualifications for the positions of project director, facility director, clinical supervisor, counselor, and counselor assistant but these regulations permit persons to meet those qualifications with a degree in an “other related field.” In Licensing Alert 03-2021 the department lists “other related fields” that meet qualifications and notes that this list is not necessarily all-inclusive and that the department will review those degrees on a case-by-case basis. Find the licensing alert here.

The Department of Drug and Alcohol Programs has published its long-delayed, much discussed final standards for drug and alcohol recovery house licensure. Find them in this Pennsylvania Bulletin notice.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published its annual report on the financial performance of the state’s non-general acute-care hospitals, including rehabilitation hospitals, psychiatric hospitals, long-term acute-care hospitals, and specialty hospitals. Learn more from this PHC4 news release and the report itself. PHC4 also offers download data from the report in Excel format.

jsteinbock2021-12-10T21:44:43+00:00December 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

PA Health Policy Update for the Week of November 29-December 3

The following is an update of selected state health policy developments in Pennsylvania for the week of November 29 to December 3, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced a plan to spend approximately $1.2 billion in American Rescue Plan Act federal funding to support Medicaid’s home and community-based services (HCBS) system, giving more Pennsylvanians access to critical services in their communities. This temporary funding enhancement will be directed toward Medicaid-funded essential care services to seniors, adults with intellectual and physical disabilities, adults with behavioral health needs such as substance use disorder or mental illness, and children with chronic complex medical needs. The American Rescue Plan Act provides states with a temporary, one-year, 10 percent increase in the rate at which the federal government matches state spending for certain Medicaid-covered home and community-based services. To learn more about how Pennsylvania plans to spend this money, see this Wolf administration news release. For more on Pennsylvania’s plan, go here. A week after this announcement, the federal government approved the state’s plan for using this money, as the Department of Human Services reported to stakeholders.

General Assembly

The House Republican Policy Committee held a hearing this week examining the health care staffing crisis. Representatives from the Hospital & Healthsystem Association of Pennsylvania (HAP), Penn State Health, Geisinger, the Pennsylvania Health Care Association (PHCA), SEIU Healthcare, and the Pennsylvania State Nurses Association testified. Hearing testimony and a video recording may be viewed here.

Two members of the General Assembly – House majority leader Kerry Benninghoff (R-Mifflin) and Representative Mark Gillen (R-Berks) – have tested positive for COVID-19.

State Revenue Update

Revenue collections continue to exceed estimates. The Department of Revenue reported this week that Pennsylvania collected $6.6 billion in General Fund revenue in November, which was $217.9 million, or 3.4 percent, more than anticipated. For the year to date Pennsylvania has collected $18.7 billion in General Fund revenue, which is $1.0 billion, or 5.7 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin explaining that it intends to allocate $106.130 million in total funds for disproportionate share hospital payments (Medicaid DSH payments) to qualifying acute-care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the state and $88.994 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms. Go here to see the Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin updating its dental fee schedule. The update is effective as of August 23, 2021.

Department of Health

The state Supreme Court has temporarily restored the Department of Health’s (DOH) order requiring students, teachers, and staff to wear masks in Pennsylvania school districts. Read the court’s ruling here. The ruling only put a hold on Commonwealth Court’s decision to issue a stay of the order; the Supreme Court will still need to consider the governor’s appeal of the Commonwealth Court decision.

DOH has established new walk-in COVID-19 testing sites in Berks, Centre, Clinton, Crawford, Jefferson, and Susquehanna counties. Learn more from this news release.

COVID-19: By the Numbers

Daily COVID-19 case counts are on the rise in Pennsylvania. Wednesday’s 7606 new cases and Thursday’s 9143 new cases are the highest single-day totals in the state since the second week of January. To date, more than 1.75 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths remains high. To date, more than 33,000 Pennsylvanians have died from COVID-19.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which declined during the first two weeks of November, rose significantly during the last two weeks of the month. As the month came to a close, COVID-19 related hospitalizations were up 43 percent over the beginning of the month, ventilator cases were up 32 percent, and COVID-19 patients in hospital ICUs also were up 32 percent.
231,000 Pennsylvanians were recorded as completing a vaccine regimen during the month of November.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs released Policy Bulletin 21-05, which documents modifications to the Standard General Terms & Conditions, Fiscal and Operations Manual, and Substance Abuse Prevention and Treatment Block Grant (SAPTBG) provisions.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, December 8 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m. Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m. Go here for information about registering and participating.

jsteinbock2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of November 15-19

The following is an update of selected state health policy developments in Pennsylvania for the week of November 15-19, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf, the Department of Human Services, and the Department of Community and Economic Development announced a plan to spend nearly $300,000 on the state’s Pre-Apprentice and Apprenticeship Program to expand its nurse residency apprenticeship program. Go here to read the announcement and here to learn more about the state’s apprenticeship programs.

General Assembly

The House of Representatives passed House Bill 1995 by a vote of 115-85 this week. This legislation clarifies the Department of Drug and Alcohol Programs’ authority to promulgate regulations that affect licensed drug and alcohol treatment providers and subjects those regulations to the formal regulatory review process, including publication, notice, and comment.
The House Health Committee met on Tuesday, November 16 and favorably reported the following bills:
- House Bill 1005 adds information to the prescription drug monitoring program (ABC-MAP) when Narcan/Naloxone is used to combat an overdose by emergency responders or medical professionals.
- House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.
- House Bill 1959 authorizes the clinical study of the efficacy and cost/benefit optimization of psilocybin-assisted therapy in the treatment of post-traumatic stress disorder, traumatic brain injury, and various mental health conditions.
- House Bill 2013 adds language to the state constitution establishing an individual’s right to refuse any medical procedure, treatment, injection, or vaccine.
- House Bill 2033 extends the reporting requirement on the status of COVID-19 testing at the state laboratory until December 31, 2022.
- House Bill 2077 creates certain exceptions to the COVID-19 vaccine requirement.

The House Human Services Committee held an informational hearing on reimbursement rates for drug and alcohol, mental health, and intellectual disability treatment. A recording of the hearing may be viewed here.

Department of Human Services

The Department of Human Services (DHS) has added December to its list of delivery dates for Remittance Advices and corresponding checks. Go here to see the updated list.
DHS has issued a Medical Assistance Bulletin to inform providers about updates to the state-wide preferred drug list (PDL) to take effect on January 3, 2022.
DHS has issued updated requirements on the information needed to evaluate prior authorization requests for certain medications:

Department of Health

The Department of Health shared updated guidance from the Centers for Medicare & Medicaid Services about visitation in nursing homes during the pandemic.
The Department of Health has produced a neonatal abstinence syndrome family guide toolkit in partnership with the Northwestern Pennsylvania Neonatal Abstinence Syndrome Coalition and the Ohio Perinatal Quality Collaborative to help educate families on the symptoms of neonatal abstinence syndrome and treatment resources.
The Department of Health has posted a notice on its message board explaining that its Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities that they are not required to call 1-877-PA-HEALTH or email Bureau of Epidemiology staff with each new case of COVID-19 identified in staff and residents. Facilities should continue to call 1-877-PA-HEALTH only to report new outbreaks within their building. Bureau of Epidemiology staff may request line lists or updates about the status of an outbreak during specific situations. Facilities should continue to follow all other reporting mandates, including reporting to ERS, CMS, NHSN, or PA-NEDSS.

COVID-19: By the Numbers

The general downward trend in new daily COVID-19 cases in Pennsylvania has ended. The new case totals for Wednesday, November 16 and Thursday, November 17 were the highest the state has experienced since mid-April.
The number of new COVID-19-related deaths remains high.
“About nine in ten COVID-19 hospitalizations and deaths in Pennsylvania have involved people who are less than fully vaccinated against the virus, according to new data from the state health department,” PennLive reports.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which had declined during the first two week of November, are now higher than they were on the first of the month.
73.3 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people. 49,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $10 million in grant funding for stabilization payments to substance use disorder treatment providers to assist with pandemic-related expenses. Learn more about the program and how to apply for funding in this department news release. The deadline for funding applications is noon on December 8,

The Department of Drug and Alcohol Programs is in the process of implementing the ATLAS® (Addiction Treatment Locator, Analysis, and Standards) platform in Pennsylvania in the coming months. Affected providers previously were asked to complete a survey for this purpose. Find that survey here. The following resources are available for those seeking assistance completing the survey:

ATLAS Survey FAQs
a virtual walkthrough of the ATLAS survey
the ATLAS Help Desk
ATLAS office hours. Use this form to request a 30-minute meeting discuss the ATLAS survey
email questions to ATLAS@shatterproof.org
December ATLAS Provider Roundtable – Wednesday, December 15 – 2 pm – 3 pm
January ATLAS Provider Roundtable – Wednesday, January 5^th – 2 pm – 3 pm

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume two of its annual ambulatory surgery centers financial analysis for 2020. Its analysis found that the average total margin for ambulatory surgery centers decreased 1.66 percentage points, from 25.04 percent in FY 2019 to 23.38 percent in FY 2020, with the state-wide average operating margin decreasing 2.88 percentage points, from 25.13 percent in FY 2019 to 22.25 percent in FY 2020. Go here (under “Ambulatory Surgery Centers Volume Two”) for the agency’s news release about the report, the report itself, and a link to downloadable data from the report.

Pennsylvania Higher Education Assistance Agency (PHEAA)

“Pennsylvania-licensed nurses could soon have some of their student loan debt paid off for them,” reports PennLive, explaining that “A one-time student loan forgiveness program will provide up to $7,500 in debt reduction under a program that the Pennsylvania Higher Education Assistance Agency’s board authorized on Thursday.” Learn more about the PHEAA board action here and about the PA Student Loan Relief for Nurses Program here.

Stakeholder Events

Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee Meeting – December 2

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will hold a virtual public meeting on Thursday, December 2 at 10:00 a.m. To register to participate, go here.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m. Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m. Go here for information about registering and participating.

jsteinbock2021-11-19T22:17:34+00:00November 19th, 2021|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

Group Looks at Health Care for Children in PA

Pennsylvania Partnerships for Children has released a report detailing various aspects of the health of children in Pennsylvania.

Among the subjects addressed in the group’s report 2021 State of Children’s Health Care in Pennsylvania: Health Insurance During the COVID-19 Pandemic are the increase in the number of insured children in the state as a result of the current public health emergency; the impact of the pandemic on children receiving their childhood immunizations; the major role Medicaid and the Children’s Health Insurance Program (CHIP) play in insuring children in the state; the implications of the end of the declared public health emergency; and more.

The report also looks at steps that could be taken to reduce health care disparities in Pennsylvania.

Learn more from this news release and Pennsylvania Partnerships for Children’s new report 2021 State of Children’s Health Care in Pennsylvania: Health Insurance During the COVID-19 Pandemic.

jsteinbock2021-11-10T16:17:47+00:00November 9th, 2021|COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off

PA Health Policy Update for the Week of October 11-15

The following is an update of selected state health policy developments in Pennsylvania for the week of October 11-15, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced a new grant program to support community organizations conducting outreach on COVID-19 vaccines. The $5 million COVID-19 Vaccine Outreach Grant Program is available to eligible organizations, including non-profits, child care, and educational institutions. The program will provide grants from $10,000 up to $100,000 to support targeted outreach efforts such as sponsorship of vaccine-related community events, equipment rental to assist with setting vaccine appointments, local media buys, creation of outreach and training materials, and more. Learn more about the program from this news release from the governor’s office and the program’s web page, which includes a link to application guidelines. The deadline for the first round of grant applications is November 1.

General Assembly

The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Saving Community Hospitals: Keeping Care Close.” The informational hearing, held in Downingtown, focused heavily on Tower Health’s recent decision to sell Chestnut Hill Hospital and close Jennersville Hospital. Labor issues, including clinical staffing levels, also were discussed. Panelists included representatives from SEIU Healthcare, the Pennsylvania State Association of Staff Nurses and Allied Professionals (PASNAP), and first responders. A press release issued following the hearing can be found here. The same committee will hold another hearing in Stroudsburg on Monday, October 18 at 1:00 p.m. focused on consolidation in the health care sector.

Department of Human Services

The Department of Human Services (DHS) issued Medical Assistance bulletin 99-16-15, “Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder” on August 17, 2016 to remind providers of the requirements of Act 62 of 2008 and to issue a list of procedure codes that are subject to the MA cost avoidance process described in the bulletin. Effective August 23, 2021, the list of procedure codes subject to the MA cost avoidance process under Act 62 will be updated as a result of the implementation of the 2021. Learn about the update here.
DHS has added two new documents to its “Hospital Assessment Initiative” web page under the heading of “Potentially Avoidable Admissions:”
- Hospital Quality Incentive Program Webinar
- Hospital Quality Incentive Program (HQIP) Measurement – Potentially Avoidable Admission (PAA)
DHS has updated its Pennsylvania PROMISe Provider Handbook: 837 Professional/CMS-1500 Claim Form. DHS also has updated its “CMS-1500 Billing Guide for PROMISe^TMHealthy Beginnings Plus (HBP) Providers.”

Department of Health

The departments of Human Services and Health have announced that the Regional Congregate Care Assistance Teams (RCAT) will continue to provide COVID-19 prevention, preparation, and response support to long-term-care facilities from October 1, 2021 through December 31, 2021. More information, including contact information for each regional lead, can be found here.

The Department of Health has developed a series of new vaccine hesitancy materials to assist long-term-care facilities with their vaccine outreach efforts. These materials include:

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) will propose changes to modernize the confidentiality of substance use records in the state, the department informed stakeholders in a message delivered through its listserv. Another message to stakeholders elaborates on the department’s intentions.

In preparation for this undertaking, DDAP surveyed stakeholders on the state’s substance use confidentiality policies and has posted the appendices to its summary report.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained very high this week and today it passed the 1.5 million mark since the pandemic began. Approximately 31,780 of these cases have been among health care workers.
The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly six times greater this year than in 2020. Between October 6 and October 12, 2020 there were 1101 COVID-19 cases in school-aged kids compared to 6433 cases in the same age group during the same week this year.
The number of new COVID-19-related deaths continues to rise slightly. This week Pennsylvania passed 30,000 deaths from the disease since the pandemic began.
Every county in Pennsylvania continues to experience a high level of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
70.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – nearly 6.4 million people. 3000 Philadelphians and 77,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; the latter number represents a much larger weekly total than in recent months.

Stakeholder Events

Independent Regulatory Review Commission – Consideration of Department of Drug and Alcohol Regulation – October 21

Pennsylvania’s Independent Regulatory Review Commission will consider final-omitted rulemaking Standards for Drug and Alcohol Recovery House Licensure (#74-4). The commission will be considering a revised version of a proposed regulation it rejected in July. To review a history of the regulation and its latest version, go here. To register to view the meeting virtually or offer testimony, send an email to irrchelp@irrc.state.pa.us.

Infant Hearing Screening Advisory Committee- October 21

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, October 21, 2021 at 1:00. Go here for information on how to participate.

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – October 28

The Medical Assistance Advisory Committee will meet on Thursday, October 28 at 10:00 a.m. Go here to register to participate virtually.

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m. To participate:

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m. To participate virtually or by phone, go here for further information.

jsteinbock2021-10-15T21:19:47+00:00October 15th, 2021|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

PA Health Policy Update for the Week of September 27-October 1

The following is an update of selected state health policy developments in Pennsylvania for the week of September 27-October 1, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Tom Wolf announced that the state’s open data portal now includes COVID-19 vaccination rates by legislative district. The vaccination data by legislative district excludes districts fully or partially located in Philadelphia County, which is a separate CDC-designated vaccine jurisdiction. The legislative district dashboard will be updated monthly. Find the data here.

General Assembly

House Bill 1861 (Act 73) was unanimously passed by the House and Senate and signed by Governor Wolf. This legislation extends the COVID-19 regulatory waivers and flexibilities issued by the Department of Health, Department of Human Services, and the Bureau of Professional and Occupational Affairs at the Department of State until March 31, 2022. The bill also extends certain waivers issued by the Department of Drug and Alcohol Programs. These waivers were previously set to expire on September 30, 2021. In addition to the extension, Act 73 requires state agencies to publicly issue a report on their respective suspended regulations by May 1, 2022. Similar to Act 21 (House Bill 854), which extended the waivers to September 30, 2021, state agencies retain the authority to terminate a suspension before March 31, 2022. If an agency does so, it must notify the General Assembly.
House Bill 1774 (Act 72) was passed by the House and Senate and signed by the governor. The bill amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP), extending the sunset date to December 31, 2028 and granting the Department of Labor & Industry access to the prescription drug monitoring program.
Senate Bill 397 and Senate Bill 398, which modernize Pennsylvania laws governing physician assistants and their oversight, were passed by the House and Senate and sent to the governor on Wednesday, September 29.
The House will be in session next week on Monday (10/4), Tuesday (10/5), and Wednesday (10/6). The Senate is currently in recess until October 18. As of Friday afternoon the following relevant committee meetings have been scheduled for next week:
- The House Professional Licensure Committee will convene for a voting meeting on Monday, October 4 at 10:00 a.m. to consider, among other bills, House Resolution 142, which requires the Joint State Government Commission to conduct a review of the State Board of Nursing, including the “Authorization to Test” process. The committee also will meet on Wednesday, October 6 for an informational meeting on House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.

Department of Human Services

The Department of Human Services (DHS) has published a Medical Assistance Bulletin notifying providers of its intent to permanently expand access to telemedicine and establish guidelines for services rendered via telemedicine. The bulletin applies to providers enrolled in the Medical Assistance program who deliver physical health services to Medical Assistance fee-for-service beneficiaries. Highlights of the Bulletin include:
- DHS will permit providers to use audio-only telecommunication when the beneficiary does not have access to video capability or for an urgent medical situation.
- Services rendered via telemedicine to Medical Assistance fee-for-service beneficiaries will be reimbursed at the same rate as if the services were rendered in person.
- This bulletin only applies to Medical Assistance fee-for-service. Medical Assistance managed care plans “may, but are not required to” permit the use of telemedicine services. They also may negotiate reimbursement for services rendered via telemedicine.
- Out-of-state licensed practitioners who render services via telemedicine to Medical Assistance fee-for-service beneficiaries in Pennsylvania must meet licensing requirements established by the Department of State and be enrolled in the Medical Assistance program.

This new policy takes effect on September 30, 2021. See the Medical Assistance Bulletin establishing this new policy here.

DHS has updated its list of regulations suspended due to the COVID-19 pandemic. Go here to find a more comprehensive list that encompasses all of state government.
DHS has published a Medical Assistance Bulletin updating the family planning services program fee schedule effective August 23.
DHS announced plans to distribute $655 million in funding from the American Rescue Plan Act to licensed child care agencies. Providers are invited to submit applications for one-time grant funding that can be used to cover expenses and provide stabilization. Learn more about the available funding and find links to information about the application process and an FAQ in this DHS news release.
DHS has posted a “provider quick tip” explaining procedure code/modifier combinations to be used when requesting home accessibility durable medical equipment in the Medicaid fee-for-service delivery system. Find it here.

Department of Health

The Department of Health (DOH) has updated its guidance on hospitals’ responses to COVID-19.
DOH and Department of Community and Economic Development have announced a new $5 million grant program to help grassroots organizations encourage vaccine-hesitant populations to get the COVID-19 vaccine. The COVID-19 Vaccine Outreach Grant Program will provide grants up to $100,000 to non-profit organizations and child care and educational institutions. These grants will support grassroots outreach efforts including local media buys, creation of outreach and training materials, sponsorship of vaccine-related community events, equipment rental to assist with scheduling vaccine appointments, and more. Learn more about the program and how to apply for grant funding from the departments’ joint announcement of this initiative and this program overview and accompanying guidelines on the Department of Community and Economic Development’s web site.
Based on recommendations from the CDC, DOH has updated its guidance on the use of antibody testing in determining quarantine status. Find that updated guidance here.
DOH has published a health advisory echoing a CDC message that pregnant people should receive COVID-19 vaccines to prevent serious illness, deaths, and adverse pregnancy outcomes from COVID-19. Find that advisory here.
DOH issued a message to long-term-care facilities regarding staff vaccination and testing requirements. Read that notice here.
DOH updated its guidance for long-term-care facilities responding to an outbreak of COVID-19 among residents, including removing recommendations for quarantine of fully-vaccinated personnel in most circumstances.
DOH has updated infection control and prevention strategies for long-term-care facilities that supplement general guidance for all health care facilities that was issued last month. Key changes include removal of the sections on source control, eye protection, and physical distancing measures recommended for vaccinated and unvaccinated health care personnel and residents.
DOH has awarded $1 million in grants to six recipients focused on spinal cord injury research. Learn about the research the money will support and the recipients of the grant funding in this department news release.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs sent out guidance on June 14, 2021 about three temporary regulatory suspensions granted through the governor’s declaration of a disaster emergency due to the COVID-19 pandemic. House Bill 1861, which was signed into law this week by Governor Wolf, further extends those regulatory suspensions from September 30, 2021 until March 31, 2022 unless terminated sooner. These three regulatory suspensions and an additional relevant suspension by the Department of State that also is extended until March 31, 2022 are summarized in this chart.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained very high this week.
The number of new COVID-19-related deaths also remains high. Yesterday’s total of 97 deaths was the highest single-day figure since mid-February.
For the fourth consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
According to Pennsylvania’s COVID-19 dashboard, only 44 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
The number of Pennsylvanians hospitalized because of COVID-19 rose seven percent in the past week and rose 53 percent during the month of September; the number on ventilators rose 19 percent in the past week and 63 percent since September 1; and the number in hospital intensive care units rose five percent in the past week and 44 percent during September.
68.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.2 million people – up from 68.2 percent last week. 7000 Philadelphians and 32,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Independent Fiscal Office

Pennsylvania’s Independent Fiscal Office has released a research brief that uses preliminary data for 2020 and 2021 (through September) to compute excess deaths above pre-COVID-19 historical trends in the state for those two years. After accounting for a notable increase in homicides and overdoses, the analysis finds 20,700 excess deaths in 2020 and projects 6,700 excess deaths for 2021. For 2020 the analysis finds that decedents age 65 or older comprised 86 percent of excess deaths. Find that report here.

Around the State

“Beginning in October 2021, the Pennsylvania Department of Human Services (DHS) will begin terminating state-funded Medicaid coverage for individuals who are found ineligible for the program. This is true despite the ongoing federal Public Health Emergency (PHE), which prevents Medicaid terminations for the majority of Medicaid recipients,” the Pennsylvania Health Law Project reports.
With Pennsylvania hospitals serving so many COVID-19 patients, some are transferring behavioral health patients and diverting incoming patients with behavioral health issues elsewhere, according to WITF.
Pennsylvania reportedly will allocate $6.5 million in federal funds to support and retain nurses, the Pennsylvania Capital-Star reports.
Central Pennsylvania is facing a blood supply shortage. Lancaster Online offers the details.
A lack of clarity about the state’s response to federal rules about the use of medical marijuana to treat addiction had led to confusion in Pennsylvania, Spotlight PA suggests in a recent report.
Pennsylvania is one of six states in which the proportion of children with elevated levels of lead in their blood (5.0 percent) is more than twice the national average (1.9 percent), according to the Philadelphia Inquirer.
Two new hospitals opened this week: Penn State Health’s Hampden Medical Center and AHN Wexford.
“Sharon Regional Medical Center announced Monday that it will discontinue its maternity and obstetrics services Wednesday, weeks before hospital officials had originally scheduled the department’s closure,” the Sharon Herald reported.
Centre County officials are considering funding a feasibility study to evaluate whether they should establish a county health department, the Centre Daily Times reports.

Stakeholder Events

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 from 10:00 a.m.–12:00 p.m. to participate:

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Stakeholder Events Materials

On September 23 the Medical Assistance Advisory Committee (MAAC) met virtually. Among the materials presented during that meeting were:

jsteinbock2021-10-01T20:33:49+00:00October 1st, 2021|Coronavirus, COVID-19, long-term care, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off

PA Health Policy Update for the Week of September 6

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The House of Representatives announced it will return to session a week early to address the Wolf administration’s implementation of a mask mandate for K-12 schools and child care facilities. The House, which was originally scheduled to return on September 27, has added September 20, 21, and 22 as voting session days.

Department of Health

The Department of Health has issued a health alert updating guidance about tuberculin skin testing for tuberculosis for individuals who have been vaccinated against COVID-19. The department no longer recommends waiting four weeks from the final COVID-19 vaccination for immune-based TB testing.
The Department of Health has published notices in the Pennsylvania Bulletin authorizing expanded scope of practice for various professionals functioning as part of an emergency medical services agency that has been licensed as a critical care transport ambulance service.
The Department of Health will offer free potassium iodide, or KI, tablets on Thursday, September 16 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants. Learn more from this department news release.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin announcing the addition of CPT codes 0003A and 0013A to the Medical Assistance Program Fee Schedule for the administration of a third dose of the Pfizer and Moderna COVID-19 vaccines. See the notice here.
The Department of Human Services has posted a notice announcing FY 2022 rates for selected services provided by the state’s Office of Mental Health and Substance Abuse Services (OMHSAS).
The Department of Human Services has announced that it will allocate $255.556 million in total funds in FY 2022 for inpatient disproportionate share hospital (Medicaid DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals, outpatient supplemental payments to qualifying inpatient acute-care general hospitals, and direct medical education payments to qualifying inpatient acute-care general hospitals. The department is not changing the state plan provisions addressing the qualifying criteria or payment methodology for these payments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has announced its intention to make COVID-19-related Medicaid DSH payments to qualified hospitals and how much it will pay hospitals based on their Medical Assistance days and their degree of Medicaid dependence. See the Pennsylvania Bulletin notice here.
The Department of Human Services is adding and end-dating procedure codes as a result of implementing the 2021 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The department also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance Program Fee Schedule, including fee adjustments. Learn more from this Pennsylvania Bulletin notice.
The Department of Human Services has published its latest monthly physical health managed care enrollment report. Find it here.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first report on the performance of its Pennsylvania Rural Health Model. Find that report here and go here for further information about the program.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained high this week, including the first day (today) with more than 5000 new cases since mid-April.
The number of new COVID-19-related deaths increased over the past week.
For the week ending September 9 in Pennsylvania, every county in the state is experiencing a high level of COVID-19 transmission. The CDC classifies transmission as follows:
- Low: 0-10 new cases per 100,000 residents over the past week or 0-5% positivity rate
- Moderate: 15-50 new cases per 100,000 residents over the past week or 5-8% positivity rate
- Substantial: 50-100 new cases per 100,000 residents over the past week or 8-10% positivity rate
- High: 100+ new cases per 100,000 residents over the past week or 10%+ positivity rate

The number of Pennsylvanians hospitalized because of COVID-19 has risen 17 percent since the beginning of the month, the number on ventilators has risen 14 percent, and the number in hospital intensive care units has risen 11 percent.
According to the state’s revised figures, 66.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.0 million people – up from 66.0 percent last week. Only 11,000 Philadelphians and 65,000 other Pennsylvanians (fewer than last week) completed a vaccine regimen in the past week.

Around the State

The Delaware County Board of Health is now hiring people to staff the county’s new health department, which is scheduled to begin operations in January, the Delaware County Times reports.
The city of Reading has been awarded $3.3 million by the federal government to remove lead paint from homes, according to the Reading Eagle.
The mayor of Scranton will propose legislation to the city’s council to decriminalize possession of fentanyl test strips, which are currently considered drug paraphernalia under state law. The Scranton Times-Tribune explains why.
Children ages 12 and under constituted 12 percent of Allegheny County’s COVID-19 cases in August, the county’s health director told the Pittsburgh Tribune-Review.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has rejected regulations proposed by the state’s Department of Drug and Alcohol Programs for the licensure or certification of drug and alcohol recovery houses that receive funds or referrals from the department or a federal, state, or other county agency to ensure that a drug and alcohol recovery house provides a safe environment for residents. See the commission’s explanation of its decision in this Pennsylvania Bulletin notice.

Stakeholder Events

The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm. Go here to register to participate remotely.
The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am. Go here to register to participate remotely.
The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

jsteinbock2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of August 16-20

The following is an update of selected state health policy developments in Pennsylvania for the week of August 16-20, 2021. (Some of the language used below is taken directly from state documents.)

The Wolf Administration

The Wolf administration has directed vaccine providers to support COVID-19 vaccination clinics and has introduced a free COVID-19 testing program for schools across the state. Learn more from this news release and from a Department of Health order in support of the governor’s directive.

General Assembly

The Senate Aging & Youth Committee held a hearing this week to examine proposed revisions of the state’s Child Protective Services Law. Testimony presented to the committee and a video transcript may be found here.

Next week the Senate Health & Human Services and Aging & Youth committees will hold a joint hearing with the House Aging & Older Adult Services and Human Services committees to “discuss the Department of Human Services’ intent to contract with Maximus as its independent enrollment broker (IEB) and the impact this will have on seniors and adults with disabilities.” The hearing will take place on Monday, August 23 at 12:30 p.m. Livestream the hearing here.

Department of Health

Effective August 18, the Department of Health’s order regarding daily hospital data reporting through the Corvena system is amended to add new data fields related to the vaccination status of hospital patients. View details in the amended order here.
The Department of Health has issued an advisory to health care facilities and providers caring for people whose immune systems are moderately to severely compromised about the CDC’s recommendation that such individuals may benefit from an additional dose of mRNA COVID-19 vaccine to ensure they have enough protection against COVID-19. Find the advisory here.
The Department of Health has informed health care facilities and providers of the CDC’s recommendation that pregnant people should be vaccinated against COVID-19. Learn more from a department health advisory.
In July the Department of Health’s nursing home surveyors conducted 466 inspections, including 289 complaint investigations, of 329 separate nursing homes. Of these inspections, 30 were COVID-19-specific investigations. There were five new sanctions finalized against nursing care facilities in the past month resulting in a total of $40,150 in fines. Learn more from this department news release.

Department of Human Services

DHS has added September dates to its calendar of MA remittance advice delivery dates. Find the updated list here.
DHS has published a Medical Assistance Bulletin announcing changes in the Medical Assistance program fee schedule, including changes resulting from the implementation of the 2021 Healthcare Common Procedure Coding System procedure codes updates. In addition, DHS also is adding other procedure codes and making changes to procedure codes currently in the MA program fee schedule, including fee adjustments, as well as setting limitations and prior authorization requirements. These changes are effective for dates of service on and after August 23, 2021. Find this Medical Assistance Bulletin here.
Officials from DHS and the Department of Health have introduced the PA Health Equity Analysis Tool (HEAT), an interactive map that synthesizes Medical Assistance and population health data to show opportunities for intervention to promote better health and promote health equity. PA HEAT provides state, county, zip code, and census track-level data on a number of population health measures and social determinants of health and how they affect local communities and Pennsylvania as a whole. Results can also be displayed according to environmental justice areas, which are calculated based on concentrations of people living at or below the federal poverty line, based on resident demographics. Learn more about PA HEAT from this DHS announcement and from the PA HEAT web site.
DHS has released quarterly licensing and enforcement activity data for its five licensing offices that oversee providers of long-term care, child care, behavioral health care, day activity programs, and residential care for individuals with intellectual disabilities and autism. Find a summary of the report in this DHS announcement.
A notice in the Pennsylvania Bulletin announces that documents are now available on DHS’s web site about proposed annual case-mix per diem rates for state fiscal year 2021-2022 for non-public and county nursing facilities and the budget adjustment factor that will be applied to non-public and county nursing facilities. Find the Pennsylvania Bulletin notice here and the DHS web site with the nursing facility rates here.

COVID-19: By the Number

The daily number of new COVID-19 cases continued to rise during the past week. The 3451 new cases reported on Thursday was the highest single-day total since April 30.
The number of deaths, while slightly higher during the past week, remains far lower than when comparable numbers of new cases were being reported in the spring.
For the week of August 6-12 the state’s overall COVID-19 test positivity rate was 6.0 percent, up from 5.4 percent last week and the fifth consecutive week with an increase.
In Pennsylvania, only Sullivan County is classified as having a low rate of COVID-19 transmission this week; three counties – Forest, Tioga, and Warren – have a moderate rate of transmission; 25 counties are currently experiencing a substantial rate of transmission; and 38 currently show a high rate of transmission, including nine of the ten most populous counties in the state: Philadelphia, Allegheny, Delaware, Bucks, Montgomery, York, Lehigh, Berks, and Lancaster.
The number of Pennsylvanians hospitalized because of COVID-19 has more than doubled since the beginning of the month; the number on ventilators because of the virus is two-and-half times greater than it was at the beginning of the month; and the number in hospital intensive care units has more than tripled since the beginning of the month.
According to the state’s COVID-19 Dashboard, only 57 pediatric ICU beds in the state are not currently occupied. That figure represents 14.7 percent of the total of such beds in Pennsylvania.
According to the state’s revised figures, 64.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 5.86 million people – up from 62.8 percent last week. Only 54,000 Pennsylvanians completed a vaccine regimen in the past week and only 134,000 have done so since the beginning of August.

Around the State

Governor Wolf is “…reinstating a mask mandate for all state employees and contracted staff working under his jurisdiction regardless of their vaccination status, starting on Monday,” PennLive reports.
A shortage of nurses in the Philadelphia area has led hospitals to offer signing and retention bonuses of as much as $20,000 to experienced nurses. The Philadelphia Inquirer offers the details.
“Overburdened health care systems from Texas to Florida are pleading with Western Pennsylvania hospitals to take on transfer patients at record-high rates as beds and ventilators reach capacity in covid-19 hot spots across the country,” the Pittsburgh Tribune-Review reports.
“While nearly a third of deer tested in Pennsylvania carried antibodies indicating they were exposed to COVID-19, the Pennsylvania Game Commission noted there is no evidence that deer can transmit the virus to humans and advised hunters to ‘take usual precautions when handling their harvests.’” The Bradford Era explains what this means.
WTAE TV in Pittsburgh has published on its web site an interactive map showing the COVID-19 transmission rate for every county in the state. Find the map here (scroll down to see it).
The Wolf administration plans to engage at least 100 people to perform COVID-19 contact tracing, Spotlight PA reports.

Stakeholder Event

The Department of Health’s Health Research Advisory Committee will hold a public meeting on Monday, August 23, from 10:00 a.m. to 11:30 a.m. The meeting will be held virtually via Microsoft Teams at +1 267-332-8737 with Conference ID: 545 844 262#. The purpose of the meeting is to review the work of the committee and plan future health research priorities. Find the meeting agenda here.

jsteinbock2021-08-20T21:33:37+00:00August 20th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, social determinants of health|Comments Off

PA Health Policy Update for the Week of July 26-30

The following is an update of selected state health policy developments in Pennsylvania for the week of July 26-30, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

House majority leader Kerry Benninghoff announced this week that he sent letters to state agencies notifying them that they should be prepared to have the nearly 500 waived and suspended regulations that were in place under the COVID-19 emergency disaster declaration reinstated on September 30, 2021. He also encouraged agencies to work closely with the relevant standing committees in the House to review which regulations should be permanently repealed or reformed. The letter noted the need to work expeditiously given the limited number of legislative session days scheduled between now and September 30. Benninghoff also highlighted in a letter to the Department of Health that “…nothing in current law prohibits tele-health services from being provided at pre-pandemic levels.” See Benninghoff’s letter to the Office of Administration here and his letter to the Department of Health here.

Department of Health

The Department of Health has invited applications for the approval of up to two additional academic clinical research centers as part of its medical marijuana program. Applications will be available beginning on August 3 on the Department of Health’s web site and applications are due September 2. Learn more from the department’s notice published in the Pennsylvania Bulletin.

The Department of Health plans to pursue a series of changes in the manner in which long-term-care facilities are regulated. It intends to do so in five separate parts and has published one of those parts, with explanations, in the Pennsylvania Bulletin.

Department of Human Services

DHS has issued a Medical Assistance Bulletin to inform providers that it is expanding the scope of Medicaid-enrolled providers that may bill the program for administration of COVID-19 vaccines and monoclonal antibody therapy. The new policy applies to physicians, certified registered nurse practitioners, certified nurse midwives, outpatient hospital clinics, independent medical/surgical clinics, home health agencies, renal dialysis centers, psychiatric outpatient clinics, drug and alcohol outpatient clinics, partial psychiatric hospitals, ambulance providers and licensed pharmacies. The policy is retroactive to April 1. Find the bulletin here.
DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will make an enhanced payment for the administration of COVID-19 vaccines to Medicaid beneficiaries who are homebound and has added a CPT code for the billing of this service. The policy is retroactive to April 1. Learn more in the bulletin notice.
DHS and the Department of Aging are seeking presenters for their 2021-2022 protective services virtual conference, to be held on October 6 and October 7. This year’s conference is about getting back to basics and mastering the core competencies of protective services: opening and conducting investigations. Learn more about the conference and opportunities to make presentations during it from this conference notice. The deadline for applying to make a presentation is August 6.
DHS has updated its Pennsylvania Medicaid Managed Care Directory with key contacts for both the physical health and behavioral health HealthChoices programs.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has published a policy bulletin to announce changes in its prevention, fiscal, operations and case management, and clinical services manuals. Go here to find the revised manuals.

The state’s Independent Regulatory Review Commission has disapproved a proposed regulation submitted by the Department of Drug and Alcohol Programs seeking to “…establish regulations for recovery houses that receive public funds or referrals. Recovery houses provide support to individuals receiving outpatient treatment for substance use disorder who may benefit from supportive housing, a substance-free environment and peer camaraderie.” The commission has not yet issued an explanation for the rejection. The department now has three options: it may withdraw the regulation, resubmit the regulation with revisions within 40 days of receipt of the commission’s disapproval order, or submit the regulation without revision to the General Assembly.

COVID-19: By the Numbers

The daily number of new COVID-19 cases rose considerably again over the past week. Thursday marked the first time since May 28 that the state registered more than 1000 new cases in a single day. Even these numbers, however, are less than half of what they were in mid-May.
The number of deaths, however, remains very low.
For the week from July 16 through July 22 the state’s overall COVID-19 test positivity rate was 2.6 percent, up from 1.7 percent last week and the third consecutive week with an increase after more than two months of declining rates. As a frame of reference, however, that rate was 9.5 percent just three months ago.
Since the beginning of July the number of Pennsylvanians hospitalized with COVID-19 has risen 53 percent; the number in hospital ICUs has risen 71 percent; and the number on ventilators has risen 37 percent.
According to the state’s revised figures, 62.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated, up from 62.2 percent last week. Only 56,000 Pennsylvanians completed a vaccine regimen in the past week and only 300,000 have done so since July 1. In Philadelphia, only 17,000 people reached full vaccination status in the past week and 46,000 have done so since July 1.

Around the State

Spotlight PA has identified all of the emergency procurement spending the state has done since the start of the COVID-19 pandemic and highlighted those that were pandemic-related. Find its report here.
A Department of Drug and Alcohol Programs web site that enabled visitors to obtain information about drug abuse treatment facilities’ violations of state guidelines identified during state inspections had inaccurate information and has been taken down. Learn more from two Allentown Morning Call reports: the article about the inaccurate information and a separate story about the state’s decision to take down the site while it reviews the inaccurate data.
Shortly after the federal Centers for Disease Control and Prevention recommended that school teachers, staff, and students wear face masks in areas with high rates of COVID-19 transmission, a spokesperson for Governor Wolf said that the governor did not intend to mandate such a policy although he would urge local school districts to follow the new federal guidance. PennLive tells the story.
Shortly after the CDC recommended that even vaccinated people wear face masks indoors and under certain circumstances in areas of high transmission of COVID-19, Pittsburgh’s WTAE television published an interactive map showing community transmission rates throughout Pennsylvania.
PennLive was even more specific: it listed the seven Pennsylvania counties where the COVID-19 transmission rates meet the criteria for vaccinated people to wear masks indoors. They are Cameron and Crawford counties (high rates of community transmission) and Adams, Lawrence, Monroe, Northampton, and Wyoming counties (substantial rate of community transmission).
Scranton’s city council has voted to accept a three-year, $360,000 grant from the Moses Taylor Foundation to fund a health coordinator position for the city, according to the Scranton Times-Tribune.
“Drexel University College of Medicine at Tower Health is ready to welcome its inaugural class of first-year medical students next week,” the Reading Eagle reports.

Stakeholder Events

Traumatic Brain Injury Advisory Board

August 6 at 9:00 a.m.

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, August 6, 2021. For information about the board’s mission, meeting materials, and how to participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

August 11-12 at 9:00 a.m.

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, August 11, 2021, and Thursday, August 12, 2021 from 9 a.m. to 4:30 p.m. To see the agenda and find information about where the meeting will be held and how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

jsteinbock2021-08-16T15:10:18+00:00July 30th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations|Comments Off

Pennsylvania Health Policy Update for the Week of June 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of June 7-11, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has outlined guidelines for unvaccinated children under the age of 12 and for their families to stay safe from COVID-19. Those recommendations include parents of young children getting vaccinated themselves; children between the ages of two and 12 wearing masks in public settings, at events and gatherings, and any time they are indoors and around people from outside their own household; engaging in social distancing; and engaging in low-risk endeavors such as outdoor activities and small gatherings. Learn more from this Wolf administration news release.

The Wolf administration and the United Way of Pennsylvania have launched the Local Innovations in Vaccine Equity in Pennsylvania project (LIVE PA) to administer $4 million in mini-grants to local organizations seeking to reduce vaccine hesitancy and ensure equitable vaccine distribution throughout the state. LIVE PA is a collaboration between the Wolf administration’s Office of Advocacy and Reform and the departments of Health and Human Services, working with the United Way of Pennsylvania, to fund local, grassroots non-profit organizations to partner with certified vaccine providers to help the populations they serve overcome barriers to vaccination. The pilot phase of LIVE PA will target the zip codes and census tracts with the highest levels of health disparities, poverty, and vaccine inequity in Pennsylvania. Learn more from this Wolf administration news release.

Pennsylvania’s COVID-19 Disaster Declaration

The General Assembly invoked its new constitutional power on Thursday and voted to terminate the governor’s COVID-19 disaster declaration. House Resolution 106, which passed by a mostly party-line vote in both chambers, ends Governor Wolf’s recently renewed COVID-19 disaster declaration effective immediately. House Resolution 106 does not have to be signed by the governor.

The General Assembly also approved House Bill 854 to sustain all of the waivers and regulatory flexibilities that were still in effect under the declaration. Governor Wolf signed this bill on Friday. House Bill 854 extends the waivers and flexibilities until September 30, 2021 but agencies and authorities have the discretion to terminate their respective waivers earlier. If they choose to do so they must notify General Assembly leadership and the standing committees that have oversight authority. Some agencies have already begun terminating certain waivers. DHS published a Medical Assistance Bulletin in late April announcing its intention to reinstate prior authorization requirements that were in place pre-pandemic beginning on July 1.

Legislative Update

The following are health care bills that received third and final consideration in the state House and/or Senate during the week of June 7. We are tracking other health care bills as they move through the legislative process as well.

House Bill 854, which was amended to extend all of the waivers and regulatory flexibilities tied to the COVID-19 disaster declaration until September 30, 2021, as described above, also requires executive agencies to preserve all records relating to the orders of a declaration of disaster emergency issued by the governor relating to COVID-19. Governor Wolf signed the bill on Friday, June 11.
House Bill 118 requires a health care facility that possesses fetal remains to provide for the final disposition of those remains to be buried, in accordance with Pennsylvania Code, or cremated. The House passed the bill 118-83 and sent it to the Senate for consideration.
House Bill 253 establishes a task force to examine the opioid epidemic’s impact on infants and children. The House unanimously passed the bill on Monday and sent it to the Senate for consideration.
House Bill 1012 provides for a $130 per diem payment for ventilator or tracheostomy care provided by qualified skilled nursing facilities that meet certain criteria based on the volume and proportion of Medicaid patients to whom they provide these services. The House unanimously passed the bill on Tuesday and sent it the Senate for consideration.
House Bill 1024 makes numerous revisions to the state’s Medical Marijuana Act, including caregiver, dispensing, and criminal background check provisions. The House passed the bill 164-38 on Monday and sent it to the Senate for consideration.
House Bill 1033 permits health care practitioners to order diagnostic tests and prescribe, administer, or dispense antibiotic therapy for the duration the health care practitioner determines appropriate for patients with a clinical diagnosis of Lyme disease or a related tick-borne illness. The bill also imposes certain insurance coverage requirements. The House passed the bill 136-66 on Monday and sent it to the Senate for consideration.
House Bill 1500 prohibits an abortion if it is sought solely due to the sex of the fetus or if the fetus receives a prenatal diagnosis of Down syndrome. The House passed the bill 120-83 on Wednesday and sent it to the Senate for consideration.
Senate Bill 618 prohibits the state, as well as counties, municipalities, school districts, and colleges that are subsidized with state funds, from requiring proof of vaccination or vaccine passports. The bill also prohibits the Secretary of the Department of Health from requiring face masks, travel restrictions, social distancing, sheltering in place, and closures of privately owned businesses and also prohibits institutions of higher education that receive state subsidies from requiring their students, faculty, and staff to be vaccinated. Following final passage in the Senate the bill was sent to the House and referred to its Health Committee. It is scheduled to be considered “off the floor” on June 14.

Department of Health

The Department of Health has issued an update on its work to permit temporary nurse aides to become permanent nurse aides following the end of the public health emergency. The department has stopped accepting and processing temporary nurse aide applications while it reviews federal guidance on the training required to secure permanent status.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline and has been in three digits for 14 days in a row. With 297 new COVID-19 cases reported, Monday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths is now declining significantly.
For the week from May 28 through June 4 the state’s overall COVID-19 test positivity rate was 2.9 percent, down from 3.8 percent last week and 4.5 percent the week before.
Fifty-five counties had a positivity rate lower than five percent, up from 28 last week, and no counties had a positivity rate greater than 20 percent for the sixth consecutive week.
Thirteen counties are currently experiencing low levels of community transmission of COVID-19, up from ten last week; 53 counties are experiencing moderate levels of community transmission; and only one county (McKean) is currently experiencing a substantial level of community transmission, the same number as last week.
In just 11 days since June 1, the number of Pennsylvanians hospitalized with COVID-19 has fallen 40 percent; the number on a ventilator has fallen 27 percent; and the number in hospital intensive care units has fallen 32 percent.
Five million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past two weeks. Another 656,000 have been vaccinated in Philadelphia. According to the state, 56.6 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 60.1 percent of the entire population has now received at least the first dose of a vaccine.

Department of Human Services

DHS has released the latest issue of its Positive Approaches Journal, which aims to provide the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities to live an everyday life. Go here for information about the latest edition and a link to the publication itself.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs announced that Pennsylvania is one of four new states partnering with Shatterproof, a national non-profit organization dedicated to ending addiction, to develop and implement the Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS). During a 12-month implementation period the Department of Drug and Alcohol Programs will work with Shatterproof to customize and align ATLAS with ongoing initiatives in Pennsylvania. This project is part of the department’s 2020-2022 strategic plan goal to strengthen treatment systems by ensuring that care is delivered using evidence-based best practices. See the announcement and learn more about the expected program here.

Around the State

While the outdoor mask mandate is now history, some Philadelphians are having trouble letting go. WHYY shares their story.
They will have more changes to get used to as well: as of Friday, the Philadelphia Inquirer reports, Philadelphia’s mask mandates have been lifted.
Faced with declining numbers of residents willing to get COVID-19 vaccines, Philadelphia is joining the big money incentives movement, planning three drawings that will give away two top prizes of $50,000 and other four-figure sums as well, according to the Philadelphia Inquirer.
Lycoming County’s plan to develop a county health care center to provide preventive services to county employees took its latest step when the county awarded a contract for design and engineering services for the planned facility. The Williamsport Sun-Gazette offers the details.
Monongahela Valley Hospital will become part of Penn Highlands Healthcare later this year, according to the Pittsburgh Post-Gazette.
Erie County is taking its COVID-19 vaccination program on the road with a mobile clinic that will visit events, celebrations, workplaces, and more. GoErie explains how and why.
The federal Centers for Disease Control and Prevention has awarded Pennsylvania $36 million to address health disparities in rural and minority communities. PennLive has the story.
After two years on the market, Valley Forge Medical Center, an 88-bed addiction treatment center in Montgomery County, has been sold to Avenues Recovery Center, the Philadelphia Business Journal reports.
With 83 percent of its residents ages 12 and older at least partially vaccinated against COVID-19 and 92 percent of those 18 and older at least partially vaccinated, Chester County is easing some of its mask requirements, according to the Daily Local News.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Stakeholder Events Documents

The Medical Assistance Advisory Committee met on May 27, 2021. The following documents from that meeting are now available:

jsteinbock2021-06-11T20:19:16+00:00June 11th, 2021|Coronavirus, COVID-19, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

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