Pennsylvania Medicaid coronavirus Archives - Page 3 of 3 - Safety-Net Association of Pennsylvania

Medicaid Enrollment in PA Continues to Rise – But Not as Much as Elsewhere

Medicaid enrollment in Pennsylvania rose 14.7 percent from February 2020 to March 2021.

That’s a lot, but Medicaid enrollment in 36 states examined as part of a recent analysis rose 17.7 percent from February 2020 to March 2021. Leading the way were two Medicaid expansion states, Utah and Nebraska, which saw their Medicaid enrollment increase 37.6 percent and 30.9 percent, respectively.

Other states with major increases in Medicaid enrollment were Missouri (26.5 percent), Illinois (26.3 percent), and Indiana (25.7 percent). The increases appear to have been driven by pandemic-related job losses and the accompanying economic downturn.

Learn more about where and why Medicaid enrollment is rising and where Pennsylvania fits among them from the article “What is Happening With Medicaid Enrollment in Q1 of 2021?” on the web site of the Georgetown University Health Policy Institute.

jsteinbock2021-06-07T17:20:52+00:00June 8th, 2021|Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off

PA Health Policy Update for the Week of June 1

Beginning today, SNAP is expanding its regular COVID-19 updates to encompass a broader scope of Pennsylvania state health policy endeavors. As efforts to address COVID-19 prove more effective and the state moves from focusing almost exclusively on the public health emergency back to its usual, much broader array of health policy concerns, we hope this update will be a useful resource on matters of importance to the hospital community. Please feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is an update of selected state health policy developments in Pennsylvania for the week of June 1-4, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has issued a reminder to Pennsylvanians that all businesses, events, and venues can return to 100 percent capacity with the lifting of COVID-19 mitigation orders starting Monday, May 31 at 12:01 a.m. The current order requiring masks for unvaccinated and partially vaccinated individuals will remain in place until June 28 or when 70 percent of Pennsylvanians age 18 and older get their second dose of Pfizer or Moderna vaccine or the single-dose Johnson & Johnson vaccine, whichever comes first. Individuals are still required to wear masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs, such as airports and stations. Individuals should still follow guidance at workplaces, local businesses, long-term-care facilities, hospitals, prisons, and homeless shelters. See the reminder here.

State Finances

The Department of Revenue announced that state General Fund collections for May totaled $3.9 billion, which was $1.6 billion, or 65.4 percent, more than projected. This significant increase is attributed to the one-month delay for personal income tax collections. Personal income tax revenue in May was $1 billion above estimate. So far this year the state has collected $2.9 billion, or 8.5 percent, more than anticipated.
Last week the state Independent Fiscal Office (IFO) released its updated FY 2021-2022 revenue estimate. In contrast to FY 2020-2021, which is ending on a strong note, the IFO projects that FY 2021-2022 will be more challenging once all of the COVID-19 federal funds are exhausted. The IFO projects that the state’s economy and revenues generated from various sources will revert to the path they were on prior to COVID-19. The IFO forecast estimates that Pennsylvania will collect $37.96 billion, a decline of $2.152 billion from FY 2020-2021. Learn more from the presentation given by Matthew Knittel, the IFO’s director.

In the Legislature

A bill already passed by the state Senate and currently before the House would give parents the option of having their children repeat their current grade in school because of the challenges children have faced learning remotely. The Johnstown Tribune-Democrat tells the story.
A bill has been introduced in the Senate that would permit young people 14 years of age and older to receive COVID-19 vaccines without the consent of their parents. KDKA provides further information.
For a comprehensive summary of health care legislation currently under consideration in the Pennsylvania General Assembly, contact SNAP at info@pasafetynet.org.

Department of Health

The Department of Health has issued an advisory with information and reporting requirements about patients presenting with myocarditis and pericarditis after receiving Pfizer or Moderna COVID-19 vaccines.
The Department of Health circulated a reminder to long-term-care facilities with information on CMS’s requirement to report to the federal government on COVID-19 vaccinations and therapeutic treatments they provide. Facilities also are required to educate staff and residents on the importance of getting vaccinated.
The Department of Health issued a health advisory on COVID-19 treatment options that incorporates updated guidance from the FDA on monoclonal antibody treatments and combination therapies.
The Department of Health revised its order regarding skilled nursing facility data reporting requirements to require weekly rather than daily reporting. While facilities will be required to complete data surveys on a weekly basis, the data they submit will be cumulative. See the Department of Health announcement here and the full amended order here.
The Department of Health revised its interim guidance for skilled nursing facilities during COVID-19 to incorporate changes in data reporting requirements and other recently issued federal and state guidance.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline and has been in three digits for seven days in a row.
The number of COVID-19 deaths is declining but not as swiftly as the number of cases.
For the week from May 21 through May 27 the state’s overall COVID-19 test positivity rate was 3.8 percent, down from 4.5 percent last week and 5.5 percent the week before.
Twenty-eight counties had a positivity rate lower than five percent, up from 12 last week, and no counties had a positivity rate greater than 20 percent for the fifth consecutive week.
Ten counties (Cameron, Clarion, Elk, Forest, Fulton, Montour, Potter, Snyder, Sullivan, and Warren) are currently experiencing low levels of community transmission of COVID-19, up from four last week; 56 counties are experiencing moderate levels of community transmission, down from 58 last week and but up from 41 two weeks ago; and only one county (Wyoming) is currently experiencing a substantial level of community transmission, down from five counties last week and 22 the week before.
The numbers of Pennsylvanians hospitalized with COVID-19 fell 55 percent from May 1 to June 1; the number on a ventilator fell 47 percent from May 1 to June 1; and the number in hospital intensive care units fell 49 percent from May 1 to June 1.
4.8 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number slowed significantly over the past week. Another 709,000 have been vaccinated in Philadelphia. According to the state, 54.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 58.7 percent of the entire population has now received at least the first dose of a vaccine.
Governor Wolf has stated that Pennsylvania needs to reach 70 percent of adults vaccinated before he will lift the state’s remaining mask mandates.

Department of Human Services

On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal CARES Act to assist providers with COVID-19-related costs they incurred between March 1, 2020 and November 30, 2020. Providers that accepted Act 24 funding agreed to provide documentation to DHS and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021. With this in mind, DHS’s Office of Long-Term Living (OLTL) has asked providers to take the following actions:
- Review the list of providers. OLTL has compiled a list of providers that received Act 24 funding but for which it has no record of submission of a cost report or the return of funds. Organizations on this list should complete an Act 24 cost report and submit it to RA-PWOLTLCOVID-19@pa.gov no later than Friday, June 11, 2021. The applicable cost reports can be found here. Those that believe they submitted an Act 24 report yet are on this list should forward a screenshot of their submission to RA-PWOLTLCOVID-19@pa.gov.
- Return Unused Funding. Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating that the check is for the return of CARES Act 24 funding they did not use. Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg PA 17105-8025, Attn: Daniel Sharar. Providers should include their EIN on the memo line of the check to ensure that refunds are traceable to the correct provider.

Providers that fail to submit a cost report or return their funding by the deadline will be deemed to have no COVID-related expenses and the state will proceed to recoup the Act 24 funding that was distributed to them.

DHS’s Office of Medical Assistance Programs has issued a notice advising all county administrators, brokers, and all contracted Medical Assistance Transportation Program (MATP) agencies of updated guidance to ensure the safe provision of non-emergency medical transportation services to Medical Assistance beneficiaries during the COVID-19 public health emergency. The announcement directs the affected parties to federal CDC guidance for further information. See the DHS announcement here.
The Office of Medical Assistance Programs has posted a notice informing individuals who are eligible to participate in the Medical Assistance Transportation Program but who can provide or arrange for transportation assistance on their own that it has temporarily increased the mileage rate for the remainder of the COVID-19 pandemic. See the notice here.

Pennsylvania Health Care Cost Containment Council

PHC4 has published its annual report on the financial performance of the state’s acute-care hospitals. Among the highlights (taken directly from a PHC4 news release):

Uncompensated Care: The statewide percentage of uncompensated care to net patient revenue increased from 1.72% in FY19 to 1.73% in FY20. The foregone dollar value for statewide uncompensated care has decreased from $820 million in FY19 to $809 million in FY20.
Net Patient Revenue: The revenue hospitals received for patient care decreased 2.0% during FY20. Statewide net patient revenue was $46.8 billion during FY20, making up 91% of statewide hospital total operating revenue.
Operating Margin: Statewide operating income decreased from $2.8 billion in FY19 to $1.9 billion in FY20. As a result, the statewide average operating margin decreased from 5.61% in FY19 to 3.73% in FY20. Total operating revenue increased to $51.5 billion and operating expenses increased to $49.6 billion in FY20.
Total Margin: The statewide total margin realized by the hospitals decreased by 2.70 percentage points, from 6.63% in FY19 to 3.93% in FY20.

To learn more, go here for links to the PHC4 news release about the report, downloadable data, and the report itself.

Around the State

Philadelphia has added COVID-19 to its list of vaccines for which children do not need parental consent under a new Philadelphia Board of Health regulation.
In the face of declining COVID-19 cases, Philadelphia lifted most of its COVID-19 restrictions, including density limits, maximum capacity limits, and distancing rules, on Wednesday, June 2.
The city’s indoor mask mandate and 11 p.m. last call for dining orders will continue to be enforced until its Department of Public Health reviews the state of the pandemic and may drop those restrictions on Friday, June 11, according to a city news release. It was previously announced that the city would lift restrictions on Friday, June 11.
Berks County has the third highest rate in the state for children suffering from lead poisoning. It is particularly a problem in the city of Reading and in communities of color. Local officials and doctors are coming together to try to do something about it. WFMZ tells the story.
Penn State is offering incentives to students and staff to get vaccinated: cash prizes, book store gift certificates, and a football signed by coach James Franklin. The Centre County Times offers the details.
The Delaware County Council met in person for the first time in 14 months, the Delaware County Daily Times reports.
Erie’s city hall has reopened after a year, according to GoErie.
The number of flu cases in Pennsylvania fell 97 percent from last year. The AP offers the facts and figures.
Eighteen Pennsylvania colleges and universities (so far) are requiring students and staff to have COVID-19 vaccines for the fall semester. Scroll down this link to find the list.
Most hospitals, on the other hand, are holding off on imposing such requirements, PennLive reports.

Stakeholder Events

Medical Assistance Advisory Committee – Managed Care Delivery Systems Subcommittee Meeting

June 10 at 10:00 a.m.

Join Meeting

Meeting number (access code): 132 168 3592

Meeting password: Managed

Join by phone: +1-408-418-9388 United States (Toll)

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 2499From 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: Stakeholde

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

jsteinbock2021-06-04T20:20:09+00:00June 4th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Uncategorized|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2021 newsletter.

Included in this month’s edition are articles about:

The impact of the American Rescue Plan on health insurance eligibility.
The impact of the American Rescue Plan on “Pennie,” Pennsylvania’s health insurance marketplace.
Federal updates on nursing home visitation.
Medicare coverage of COVID-19 testing and vaccines.
Using the Medical Assistance Transportation program to get the COVID-19 vaccine.
Advancing maternal health care coverage in Pennsylvania.

Read about these subjects and more in the Pennsylvania Health Law Project’s April 2021 newsletter.

PA Safety Net Admin2021-05-06T11:13:13+00:00May 6th, 2021|Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

COVID Drives Major Increase in PA Medicaid Enrollment

Medicaid enrollment in Pennsylvania has risen nearly 14 percent in the past year as rising unemployment resulting from COVID-19 drives people to turn to the state for health insurance.

As a result, Pennsylvania has added nearly 400,000 people to its Medicaid rolls in the past year. Today, 3.2 million Pennsylvanians are enrolled in the state’s program, although among them are approximately 250,000 who would have been dropped from the program except for a federal requirement that the state not drop people from the program in exchange for a major increase in federal aid for the state’s program.

As a result of the increase, the state’s Department of Human Services, which runs its Medicaid program, has asked the legislature for nearly $1 billion in supplemental funding to help finance its services for this expanded enrollment through the rest of the state’s FY 2021 year.

Learn more about the past year’s increase in Medicaid enrollment, who the new enrollees are, and how the state is accommodating them in the Philadelphia Inquirer article “A huge spike in Medicaid enrollment in Pa. shows how devastating the coronavirus has been.”

PA Safety Net Admin2021-03-24T06:00:57+00:00March 24th, 2021|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency.

Or so reports the organization Families USA in a new study.

Pennsylvania State Map According to the study,

Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%.

But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss,

Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health Management Associates projects that up to 27 million people will lose their job-based insurance this year and that Medicaid will see an increase in enrollment of up to 18 million people by the end of 2020, depending on the severity of the economic downturn.

The effects of COVID-19 job loss and accompanying loss of insurance already appears to be visible in Pennsylvania, where Medicaid enrollment rose from 2.84 million in March of 2020 to 2.89 million in April, 2.94 million in May, and 2.977 million in June. Growing Medicaid enrollment poses a challenge for Pennsylvania’s safety-net hospitals because they care for so many low-income patients and payments from the state’s Medicaid program often do not cover the cost of the care they provide.

Learn more about the nation-wide trend in the Families USA report “Rapid Increases in Medicaid Enrollment: A Review of Data from Six Months.”

PA Safety Net Admin2020-09-16T06:00:58+00:00September 16th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals|Comments Off

COVID-19 Update: March 27, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 4:30 p.m. on March 27.

Pennsylvania Updates

Governor Wolf

Today Governor Wolf expanded his ‘Stay at Home’ order to include nine more counties to mitigate the spread of the virus: Berks, Butler, Lackawanna, Lancaster, Luzerne, Pike, Wayne, Westmoreland, and York counties. The governor’s amended order, the secretary of health’s amended order, and the stay at home guidance are available online. The order takes effect for these nine counties tonight at 8:00 p.m. and will continue for all of the affected counties until April 6.
Today Governor Wolf approved and signed several bills into law to provide emergency relief to schools (SB 751), unemployment compensation rules (HB 68), delaying the primary election (SB 422), and the $50 million in immediate funding for health care supplies via HB 1232. We do not yet know how this funding will be distributed but are monitoring it closely. According to the enabling legislation and a press release Governor Wolf issued yesterday, “The $50 million in funding will be deposited into a restricted account under the governor’s jurisdiction and funds will be used if there are insufficient funds available from the disaster proclamation ‘to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand. Health care entities include hospitals, nursing facilities and emergency medical services’.”

Department of Human Services

The Department of Human Services (DHS) has published a reminder that Governor Wolf has signed an executive order prohibiting elective medical and surgical procedures for the duration of the COVID-19 crisis.
Pennsylvania has been granted a section 1135 Medicaid waiver by the federal government. Key elements of the waiver address:
- Temporarily suspending Medicaid fee-for-service prior authorization requirements.
- Extending pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.
- Suspending Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days.
- State Fair Hearing Requests and Appeal Timelines.
- Provider Enrollment.
- Provision of Services in Alternative Settings.

These waivers will remain in effect until the current health crisis ends. See the letter from CMS to the state that explains all of these aspects of the waiver in greater detail.

DHS’s Office of Children’s Health Insurance Program has issued a CHIP policy clarification authorizing pharmacies to override early refill alerts for medications.
The same office has published an FAQ addressing CHIP coverage of COVID-19 testing and related services.

Department of Health

During her daily briefing today, Secretary Levine reported that the number of new COVID-19 cases in Pennsylvania yesterday declined slightly from the day before, although she dismissed this decline as “not statistically significant.” There are now COVID-19 cases in 50 of Pennsylvania’s 67 counties. While the number of hospitalizations, ICU cases, and patients put on ventilators remain low, she said those numbers remain in line with trends elsewhere in the country and her department’s own projections.
The department has revised its guidance prohibiting the provision of dental treatment except for urgent and emergency services.

Department of State

The Department of State requested, and Governor Wolf granted, an extension for 90 days of certain license renewal deadlines that fall between April 30, 2020, and June 30, 2020. Affected boards include the State Board of Medicine, State Board of Nursing, and State Board of Examiners of Nursing Home Administrators. Any associated regulations that establish these dates are temporarily suspended. While the department will provide guidance encouraging licensees to renew on time, if possible, this waiver ensures that if they miss the deadline their licenses will remain valid and they will have an additional 90 days to renew them.

Federal Updates

Congress

The House of Representatives passed the $2 trillion Coronavirus Aid, Relief, and Economic Security Act passed by the Senate late Wednesday. It now goes to the president for his signature and he has indicated he will sign it.

President Trump

President Trump sent a letter to governors thanking them for their efforts in fighting the COVID-19 emergency, outlining upcoming federal efforts, and expressing hope for the future.

Department of Health and Human Services

The Department of Health and Human Services has provided guidance to states asking them to take immediate action to waive restrictions on licensure, scope of practice, certification, and recertification/relicensure consistent with changes announced in federal programs. See that guidance here.
Secretary Azar sent a letter to governors requesting immediate action on a number of measures to help “extend the capacity of the health care workforce to address the pandemic.”
The department’s Office of Family Assistance Services has posted an FAQ about TANF (the Temporary Assistance for Needy Families) program and COVID-19.

Centers for Medicare & Medicaid Services

CMS has issued guidance for CLIA laboratories regarding the review of pathology slides, proficiency testing, alternate collection devices, and requirements for a CLIA certificate during the COVID-19 public health emergency.
CMS has released a notice announcing that it is delaying the release of its minimum data set (MDS – 3.0 v1.18.1) for nursing home and swing bed providers.

Centers for Disease Control and Prevention

An updated CDC FAQ on COVID-19.
CDC offers strategies for optimizing supplies of personal protective equipment.
The CDC has published guidance on self-quarantine for New York City transportation and delivery service workers.

Food and Drug Administration

The FDA established a process for companies that have interrupted or discontinued the manufacture of components of the medical product supply chain that could lead to disruptions or shortages of drug and biological products.
The FDA has published an FAQ for consumers on the use of hand sanitizer when fighting COVID-19.
The FDA has pulled together several of its COVID-19 FAQs in one space. Included are FAQs for:
- Laboratories and manufacturers offering testing for COVID-19.
- General FAQs.
- “What if I do not have…” (technical/clinical, mostly involving medical materials)
- Clinical laboratories
- Test kit manufacturers

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-03-27T17:25:53+00:00March 27th, 2020|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

COVID-19 Update: March 25, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 5:15 on March 25.

State Legislature

Today the Senate passed House Bill 1232, as amended, which includes up to $50 million of additional funding to be made available for the state’s COVID-19 response efforts. The legislation stipulates that funding shall only be used to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand. It also requires available federal funding and any funding made available through the governor’s disaster proclamation to be used before these funds. The authority to transfer funds expires on September 30, 2020.

Senate leadership noted that this is the first phase in its crisis response and recognizes that additional funds will likely be needed. The House is expected to pass the bill as amended today. The bill will then be signed in both chambers and sent to the governor for consideration and he is expected to sign it. It would take effect immediately.

The Administration

Governor Wolf

Today the governor added Lehigh and Northampton counties to his stay-at-home order.

Department of Health

Secretary Levine today issued an order requiring hospitals to make daily report of specified data regarding hospital facilities, beds, supplies, equipment, and staffing. Among the measures hospitals will be required to report daily are available beds, psychiatric beds, number of other beds in facilities, current emergency department capacity, number of COVID-19 patients, expected number of days remaining N-95 masks will last, expected number of days remaining until other personal protective equipment supplies will exhausted, supply of remaining NP specimen collection supplies in days, number of ventilators in facility and in use, and number of employees available for work. See the secretary’s order here.

Department of Human Services – Office of Medical Assistance Programs

The Office of Medical Assistance Programs has issued billing guidance to CHIP managed care organizations on the subject of alternative screening sites related to COVID-19. Find that two-page document here.
It issued another policy clarification to CHIP managed care organizations with directions to bypass the prior authorization requirements for chest CT scans for COVID-19 payments. See that policy clarification document here.

Another notice announces a new ICD-10 code for COVID-10 that takes effect on April 1. Find it here.

The Office of Medical Assistance Programs has posted an FAQ on Medicaid program coverage of COVID-19 testing and related services. It includes information about what Pennsylvania Medicaid will pay for COVID-19 testing, the services it will cover, and more. Find it here.

Department of Human Services – Office of Long Term Living

The Office of Long Term Living (OLTL) has published guidance on conducting pre-admission screening and resident reviews for applicants to and residents of Medicaid-certified nursing facilities. This includes an explanation of performing such screens by phone or video conference. See the guidance here.
OLTL also has sent a memo to nursing home transition coordination agencies about a new, COVID-19-motivated nursing home transition tenant-based rental assistance process. Find that memo here.
OLTL also communicated via its listserv that it is delaying the implementation deadline for electronic visit verification (EVV) until October 1, 2020.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has issued a document clarifying the state’s response to federal guidance on the disclosure of patients’ substance abuse disorder records during the telehealth process. See that policy clarification here.
DDAP has issued a policy bulletin addressing telehealth services for gambling treatment. Find that bulletin here.

Department of State

The Pennsylvania Department of State, which is responsible for licensing many health care providers, has announced new guidelines and processes for reactivating the licenses of retired health care professionals such as doctors, nurses, nurse practitioners, pharmacists, and others. This new policy supplements previous announcements the department has made on this subject. Find this updated information here.

Pennsylvania Health Centers Awarded Federal Funds

The federal Health Resources and Services Administration has awarded $100 million in grants to 1381 health centers across the country. Among them are 43 health centers in Pennsylvania that will share $12.9 million in federal funds. See a list of those grant recipients here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-03-26T06:00:31+00:00March 26th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

COVID-19 Update: March 24, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 4:45 today.

For your convenience, copies of our daily updates are also posted to the SNAP Blog available here.

State Updates

The State Legislature

House Chamber of the State House The legislature continues to deliberate on a number of measures to respond to the COVID-19 crisis. Among the issues being discussed between the administration and legislature are:

Declaring a public health emergency and providing funding to respond to the crisis.
Advancing telemedicine legislation.
Amending the rules of unemployment compensation during an emergency declaration such as easing work search requirements and extending the length of time that benefits are available.
Providing assistance to small businesses and non-profits through the Pennsylvania Industrial Development Authority.
Amending the state’s election code to move the primary election to June 2.
Amending the school code to protect employees and address various changes in state education requirements.

Department of Health Daily Briefing

Department of Health (DOH) Secretary Rachel Levine, M.D., provided her daily COVID-19 briefing. She reported that the number of cases in the state is doubling every two to three days and she expects the pandemic to spread to additional rural counties.

The state is sharing personal protective equipment and ventilators with providers as providers request them and its stock is being replenished by the federal government. Despite this, the state continues to seek to purchase more N-95 masks and ventilators.

Direct caregivers, she warned, cannot use homemade masks. They are not effective.

Turnaround time for COVID-19 testing in the state lab and most hospital labs is 24 hours. The major commercial testing companies are experiencing a backlog.

Health care personnel are being given priority for COVID-19 testing but only if they show symptoms.

While the state is discussing adapting facilities for post-acute care and other COVID-19-related purposes, Secretary Levine said she thinks it is unlikely the state would reopen Hahnemann Hospital.

People with chronic medical conditions such as lupus are starting to report trouble getting drugs like chloroquine and hydroxychloroquine because of unsubstantiated suggestions that they can help fight COVID-19. The Department of Health and Department of Human Services are talking to pharmacies about this and working to ensure access for patients who need these drugs for medically approved purposes.

The state is not prepared to consider easing its stay-in-place and non-essential business closure orders at this time.

Department of Human Services

The Department of Human Services (DHS), Office of Child Development and Early Learning has issued two documents. The first is titled “Infant Toddler Early Intervention Procedures during COVID-19 pandemic” and it describes how early intervention services can be delivered while face-to-face interactions are limited during the COVID-19 crisis. See the document here.

The second addresses child care program closures, waivers for child care programs to remain open, safety recommendations, and resources for workers who lose their jobs because of facility closures. Find that document here.

Home Care, Home Health, and Hospice Document Recirculated

On March 21, DOH published COVID-19 emergency response information for home care agencies, home health care agencies, and hospices. Today, in an effort to broaden the reach of that document, DHS shared it via its long-term care listservs.

Federal Updates

Centers for Medicare & Medicaid Services

CMS issued an FAQ explaining requirements for and distribution of the 6.2% enhanced FMAP stipulated in the Families First Coronavirus Response Act. States should expect to see their first payments no later than tomorrow. The document explains that the enhanced FMAP doesn’t apply to expansion population, though it does apply to DSH. It will flow through to the CHIP enhanced FMAP calculation but not in equal percentage point values for all states and the 100% cap on matching remains in effect. States will not need to submit a state plan amendment in order to receive the funding. The complete guidance document is available here.

Late yesterday the Centers for Medicare & Medicaid Services’ (CMS) Center for Clinical Standards and Quality/Quality Safety & Oversight Group issued a 28-page memo to state survey agency directors on the subject of prioritization of survey activities. During the three-week period following the March 13 declaration of a national emergency, state survey agencies are to have as their priorities complaint/facility-reported incident surveys, targeted infection control surveys, and self-assessments. They are not authorized to perform surveys on long-term-care facilities, hospitals, home health agencies, intermediate care facilities for individuals with intellectual disabilities, and hospices. See the CMS guidance letter.

CMS also has issued 11 more section 1135 Medicaid waivers. They are summarized in a CMS news release.

Health Resources and Services Administration

Today the Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) awarded $100 million in grants to 1381 health centers to address screening and testing needs, purchase medical supplies, and boost capacity in response to the COVID-19 crisis. See an HHS news release here.

National Institutes of Health

The NIH is launching training for health care workers who interact with COVID-19 patients. The worker-based program will include a web site with training resources. Learn more from an NIH news release that describes the new initiative.

Food and Drug Administration

The FDA has updated its FAQ on diagnostic testing with new information for providers having trouble obtaining viral transport media. Read it here.

The FDA also has issued a safety alert addressing the use of fecal microbiota for transplantation and additional safety protections involving COVID-19 and SARS-CoV-2. Find it here.

Centers for Disease Control and Prevention

The CDC has issued new guidance to state and local agencies and service providers on working with their homeless population. Find it here.

FEMA

The Federal Emergency Management Agency (FEMA) has updated its COVID-19 pandemic advisory. See the updated advisory here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-25T06:00:19+00:00March 25th, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020.

Pennsylvania Administration

Since yesterday, the Department of Human Services has issued the following four new guidance documents:

We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information.

Any business that would like to seek a waiver to the mandate to close can send a request to this email address: RA-dcexemption@pa.gov
In addition, questions about whether or not your specific business needs to close can be directed to: ra-dcedcs@pa.gov

At the Secretary of Health’s daily update she noted that the number of diagnosed COVID-19 cases in the state doubled in the past two days.

Federal

Administration

CMS approved Washington state’s 1135 waiver request. The approval letter can be found here.

In addition, CMS released two telehealth toolkits: one for general practitioners that is available here and another for end-stage renal disease providers available here.

Congress

Congress is preparing a combination bill to both combat the spread of the coronavirus and also provide economic stimulus to counteract the negative effects of the state of emergency. As Congress deliberates, SNAP weighed in today with Pennsylvania’s congressional delegation, asking for immediate financial support for hospitals, the elimination of the Affordable Care Act Medicaid DSH cuts, and a moratorium on new regulatory requirements on hospitals. Find a summary of the bill here and SNAP’s letter to the delegation here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-23T06:00:11+00:00March 23rd, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

COVID-19 Update: March 19, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania for March 19, 2020 as of 6:30 p.m.

Pennsylvania Administration

Governor’s Order Closing State Businesses

Early in the evening, Governor Tom Wolf announced that he was ordering the immediate closing of what he called “non-life-sustaining businesses in Pennsylvania.” See his news release on the order here, the order itself here, and a list of types of businesses and whether they are or are not “life-sustaining” here.

Pennsylvania Department of State Licensure Exceptions and Fast Track

The Pennsylvania Department of State Bureau of Professional and Occupational Affairs, in conjunction with Governor Wolf, issued a press release announcing that the governor had granted the department’s request for a suspension to permit licensed practitioners in other states to provide services to Pennsylvanians without obtaining a Pennsylvania license during the emergency. The announcement also makes clear that “no Pennsylvania law prohibits the practice of telemedicine.” Under the exception, out-of-state practitioners must:

Be licensed and in good standing in their home state, territory or country.
Provide the Pennsylvania board from which they would normally seek licensure with the following information prior to practicing telemedicine with Pennsylvanians:
their full name, home or work mailing address, telephone number, and email address; and
their license type, license number or other identifying information that is unique to that practitioner’s license, and the state or other governmental body that issued the license.

The full text of the document can be found here.

Pennsylvania Department of Drug and Alcohol Programs Authorizing Additional Take-home Opioid Treatment Medicine

On March 16, the federal Substance Abuse and Mental Health Services Administration provided additional guidance to Opioid Treatment Programs. Today, Pennsylvania’s Department of Drug and Alcohol Programs issued a licensing alert taking advantage of that guidance to suspend the prohibition on patients receiving a greater-than-two-week supply of medication to take home. The full text of the document can be found here.

Pennsylvania Department of Human Services Shares COVID Response Overview

On Tuesday, March 17 Pennsylvania’s Department of Human Services (DHS) hosted an invitation-only call to provider DHS stakeholders with an overview of its actions related to COVID-19. Last night DHS issued a summary of that presentation. Please find that summary attached.

Pennsylvania Department of Health Daily Update

The Secretary stated that the Department of Health (DOH) is working with hospitals to evaluate whether elective procedures are necessary and to delay them as appropriate.
DOH has directed hospitals to update their emergency plans to include COVID-19 and to implement those plans as of 11:59 tonight.
Although the number of diagnoses continues to rise, hospitalizations in Pennsylvania are on par with nationwide statistics at roughly 10 percent of the diagnosed population.
The Secretary is urging small businesses to comply with the social distancing protocols and called on small business owners to contact the Department of Community and Economic Development to identify financial resources to assist them through this period.
She reminded citizens that limiting individual exposure does not require a mask, stating that the limited personal protective equipment supplies are best used by frontline responders.

Pennsylvania Legislature

House Chamber of the State House The following summary of PA legislative actions was compiled by Cynthia Fernandez of Spotlight PA and Gillian McGoldrick of Lancaster Online.

Limiting Disaster Powers

When Gov. Tom Wolf declared a disaster emergency on March 6, he was able to claim expansive powers. Rep. Russ Diamond (R., Lebanon) plans to issue a resolution to terminate Wolf’s COVID-19 emergency declaration “if the need arises.”

Privacy

Sen. Doug Mastriano (R., Franklin) is drafting a resolution that would call on the federal government to suspend privacy regulations for people who have tested positive for COVID-19. There should be “full disclosure of anyone who came within immediate contact of any contaminated citizen,” Mastriano said in a statement, “until the COVID-19 crisis passes.”

Pa. Coronavirus Cases

As of March 18, 2020, the Pa. Department of Health reports that there are 133 positive cases of COVID-19 in Pennsylvania.

Total cases/Deaths

VIEW THE INTERACTIVE MAP HERE: https://www.pennlive.com/news/2020/03/evictions-student-loans-pssas-and-more-what-pa-lawmakers-are-proposing-in-response-to-the-coronavirus.html

Rent

Lawmakers are drafting a bill to limit landlords’ right to evict tenants when a governor declares a state of emergency. The measure, from Rep. Mary Isaacson (D., Philadelphia) and Rep. Summer Lee (D., Allegheny), would “provide an exemption from eviction for workers who are unemployed, separated from their employment, or unable to find employment.”

Schools

Sen. Andy Dinniman (D., Chester) and Sen. Scott Martin (R., Lancaster) are drafting a bill that would cancel the state PSSA and Keystone exams for the remainder of this school year. The measure would also require the state Department of Education to waive federal testing requirements.

Dinniman is also drafting a measure that would give school districts authority to deliver online instruction until the end of the academic year.

Martin has proposed a bill that would require colleges and universities closed because of COVID-19 to refund all fees paid in advance, including room and board. The prorated refund would only apply from the date the institution shuttered through the end of the semester.

Sick Leave

Rep. Joe Hohenstein (D., Philadelphia) and Sen. Larry Farnese (D., Philadelphia) want to require paid sick leave for any workers left out by a federal bill on its way to President Donald Trump’s desk, which is limited to workers who need to care for their children. The legislation could leave 19.3 million workers without any sick pay, the Washington Post reported.

The state legislation would also require employers to reinstate workers when they return from leave.

Small Businesses

To lessen the impact on small businesses, Sen. Tom Killion (R., Chester) plans to introduce legislation that would direct table game revenue to the Department of Community and Economic Development to create zero-interest loans.

Reps. Valerie Gaydos (R., Allegheny) and Jared Solomon (D., Philadelphia) also plan to introduce legislation to create low-to-no interest loans to help small businesses survive. The bill will outline two types of loans: one will be short-term funding to meet payroll and overhead expenses; the other will be for “long-term resiliency” to help businesses recover over time.

Student Loans

A measure by Rep. Malcolm Kenyatta (D., Philadelphia) would allow a 60-day grace period for repayment of student loans issued by the Pennsylvania Higher Education Assistance Agency.

READ MORE: U.S. courthouse in Harrisburg closed after agent assigned there tests positive for coronavirus

Taxes and Filing

Rep. David Rowe (R., Union) and Rep. Frank Ryan (R., Lebanon) are writing a measure that would suspend sales and personal income tax collection until the disaster declaration is lifted.

The IRS will keep its tax-filing deadline as April 15, but the U.S. Treasury announced Tuesday it will waive interest and penalties for 90 days after that date. Rep. Joe Ciresi (D., Montgomery) plans to introduce legislation that would apply a 60-day extension for Pennsylvanians to file state income taxes when the state is under a disaster declaration.

Voting

All Pennsylvanians are now eligible to vote by mail. Rep. Kevin Boyle (D., Philadelphia) wants to encourage that by mailing all voters that kind of ballot ahead of the April 28 primary.

Rep. Dan Williams (D., Chester) plans to introduce legislation to allow elections officials to open votes submitted by mail before the polls close. House Majority Leader Bryan Cutler (R., Lancaster) previously said this is a part of discussions with Gov. Tom Wolf to “clean-up” a comprehensive voting reform bill passed last year.

Workers’ Rights

A proposed state Senate bill would support workers while quarantined or in isolation during a public health emergency. Sen. Steve Santarsiero (D., Bucks) said in a memo to his colleagues that Pennsylvania does not have a law that addresses whether an employer can fire a worker under these conditions during a state of emergency.

A measure by Rep. Ed Neilson (D., Philadelphia) would provide unemployment compensation for people who have been ordered to quarantine or isolate because of the coronavirus. His bill would not offer extended benefits to people who used paid time off or paid sick days during quarantine or isolation.

Federal

CMS Catastrophic Plan Coverage Guidance

Catastrophic coverage plans are generally prohibited from covering essential health benefits until a covered individual has met its deductible. The U.S. Department of Health and Human Services has issued a notice informing plans that it will not enforce this provision as it relates to insurers amending their plans to provide pre-deductible coverage for services related to the diagnosis and treatment of COVID-19. The full notice is available here.

CMS Medicaid and CHIP FAQ Released

The guidance describes the authority states have generally to respond to emergencies but has also been updated as of March 18 to include additional guidance specific to the response to COVID-19. The updates generally provide additional clarity around telehealth.

There are also new sections on managed care flexibilities and 1115 waiver flexibilities, again generally focused on limiting the spread of person-to-person contact through the use of telehealth, remote monitoring, etc. It is worth mentioning that this is federal guidance for state Medicaid programs so it describes what is possible but does not describe the actual conditions in any particular state.

The FAQ document is available here.

CMS Elective Surgery Guidance

CMS released guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures, in an effort to conserve critical resources such as ventilators and Personal Protective Equipment (PPE). Decisions remain the responsibility of local health care delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients. To help with that decision-making, CMS offered a tiered framework of procedures that should be considered for postponement, taking into account the location (outpatient department, ambulatory surgery center, or hospital), the hospital’s COVID-19 patient census, the patient’s acuity, and more. Click here to read the full guidance. Click here to read the CMS press release.

HRSA Data Collection Activities

The Health Resources and Services Administration (HRSA) will not be going through notice and comment periods for data collection activities for the remainder of the emergency. Under this authority, HRSA launched an information collection effort to support the Trump administration’s response to the COVID-19 pandemic, surveying HRSA-funded health centers on their involvement in the COVID-19 response, including whether they are offering diagnostic tests. The agency will have to comply with relevant provisions within 30 days of the end of the emergency declaration. The announcement is available here.

CDC Alters Timeline to Implement New ICD-10 Code for Coronavirus (see attached)

The Centers for Disease Prevention and Control (CDC) is taking the unprecedented step of invoking the National Emergencies Act to supersede the schedule for updating the ICD coding set defined within HIPAA. Under this authority, CDC is establishing an effective date of April 1, 2020 for the new code as opposed October 1 date that would have been required under the normal statutory update schedule. The full text of the announcement is available here.