PA Health Policy Update for Friday, September 16

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

General Assembly

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

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

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

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

Department of Human Services

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

Behavioral Health Commission for Adult Mental Health

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

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

Department of Health

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

COVID-19:  By the Numbers

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

Monkeypox

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

Department of Drug and Alcohol Programs

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

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

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

DHS – Medical Assistance Advisory Committee – September 22

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

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

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

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

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

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

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

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

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

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

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

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

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

 

PA Health Policy Update for Friday, July 29

The following is an update of selected state health policy developments in Pennsylvania for the week of July 25-29, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has issued an executive order on reproductive health services that addresses the delivery of legal reproductive health services in Pennsylvania; investigations of reproductive health services initiated by or in other states regarding services that are legal in Pennsylvania; the protection of health care and other professionals involved in the provision of reproductive health services; communication about reproductive health services; and circumstances under which the governor will not approve interstate extradition for alleged violations of reproductive health laws in other states that are not violations of reproductive health laws in Pennsylvania.  Learn more from the governor’s executive order on reproductive health services.

Governor Wolf has filed a lawsuit against the General Assembly for what the Wolf administration calls its “…unconstitutional attempt to ban abortion in Pennsylvania” through an amendment of the state’s constitution.  The governor’s suit also cites what he believes to be procedural flaws in the manner in which the legislature adopted the proposed amendment.  Learn more from this news release from the governor’s office.

Bookshelf with law booksExecutive Branch Regulatory Agenda

Pennsylvania Executive Order 1996-1 requires all agencies under the jurisdiction of the governor to submit for semi-annual publication an agenda of regulations under development or consideration.  These agendas are compiled to give the regulated community advance notice of regulatory activity.  This week’s Pennsylvania Bulletin includes the latest such publication of regulations under development and consideration.  They include:

  • Department of Aging – matters involving older adult living centers and the Pennsylvania Community Adult Respite Program.
  • Department of Health – matters involving long-term-care facilities.
  • Department of Human Services – matters involving psychiatric rehabilitation services, Medical Assistance manual changes, the Office of Developmental Programs, county children’s and youth social programs, child residential and day treatment facilities, medical marijuana in facilities, adult protective services, crisis regulations, children with intellectual disabilities and autism, child care regulations, the county mental health and intellectual disabilities fiscal manual, and psychiatric residential treatment facilities.

Learn more about what these agencies are contemplating and find contact information for seeking additional information from this Pennsylvania Bulletin notice.

Department of Human Services

The Department of Human Services has extended its calendar of remittance advice (RA) delivery dates, mailing of checks, and electronic transfers of funds into early September.  Find the updated schedule here.

Department of Health

The Wolf administration has expanded the Department of Health’s naloxone standing order to combat the rise of opioid overdoses to include ZIMHI, an intra-muscular version of naloxone in the form of an injection device that comes as a single-dose pre-filled syringe or a carton containing two cases of the pre-filled syringes.  Pennsylvanians can present a copy of the standing order at pharmacies to obtain naloxone and can obtain the standing order here.  Learn more from this news release.

COVID-19:  By the Numbers

Monkeypox

The CDC has posted an updated map showing the distribution of 4639 confirmed cases of monkeypox in the U.S. as of July 27 – more than twice as many as a week ago.  114 of those cases were in Pennsylvania.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued its latest legislatively mandated report on the financial impact of COVID-19 on the state’s hospitals; the report covers the first quarter of the 2022 calendar year.  Hospitals that submitted data to PHC4 (71 percent of the state’s hospitals and health systems) reported $418.8 million in COVID-19-related costs – a combination of COVID-related expenses and revenue losses – during that period and a collective COVID-related revenue loss of $95.7 million.  The figures do not reflect COVID-related emergency funding from either the state or federal government.  Learn more from this PHC4 news release and the report itself.

Stakeholder Events

Department of Health – State Child Death Review Team – August 10

The Department of Health’s State Child Death Review Team will hold a virtual public meeting on

Wednesday, August 10 at 1:00.  The state’s Child Death Review Program provides training and technical assistance to local child death review teams.  Learn more about the State Child Death Review Team and how to join the August 10 meeting from this Pennsylvania Bulletin notice.

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

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

 

2022-07-29T19:57:25+00:00July 29th, 2022|COVID-19, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for Friday, July 29

PA Health Policy Update for Friday, June 3

The following is an update of selected state health policy developments in Pennsylvania for the week of May 31 to June 3, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state House and Senate will return to Harrisburg for session the week of June 6.  The Senate will be in session on Monday (6/6), Tuesday (6/7), and Wednesday (6/8).  The House will be in session on Tuesday (6/7), Wednesday (6/8), and Thursday (6/9).
  • The House Health Committee will hold a joint hearing with the Environmental Resources & Energy Committee on “Oil and gas byproducts:  powering modern medicine and our healthcare system.”  The hearing will take place on Tuesday, June 7 at 10:00 a.m.
  • The House Insurance Committee will hold an informational meeting on Wednesday, June 8 at 10:00 a.m. to examine cybersecurity and insurance data security.
  • The Senate Health & Human Services Committee will meet on Tuesday, June 7 at 10:30 a.m. to consider the following bills.
    • Senate Bill 571, which establishes a uniform time-frame for distribution of SNAP benefits.
    • Senate Bill 1198, which seeks to promote and improve the availability of and access to assisted living residences.
    • Senate Bill 1202, which requires health insurers to cover the use of medically prescribed pasteurized donor human milk in inpatient and outpatient settings for children under the age of 12 months.
    • House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.

Revenue Collection Update

The Independent Fiscal Office (IFO) has released its Monthly Revenue Update for May. General Fund revenue collection exceeded estimate by $459.1 million for the month.  For the fiscal year to date Pennsylvania has received $5.5 billion more than projected.  The IFO reported that increased revenue collections continue to be driven by strong sales and use tax, personal income tax,  and corporate net income tax payments.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added a CPT code to the MA fee schedule for the administration of a third dose of the Pfizer pediatric COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes to the MA fee schedule for the administration of Pfizer’s ready-to-use novel COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • The managed care delivery system subcommittee of DHS’s Medical Assistance Advisory Committee has posted a draft file note summarizing its May 12 public meeting.  Find that draft here.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has released a new tool states can use to prepare for the eventual end of the COVID-19 public health emergency and return to normal Medicaid and CHIP eligibility and enrollment operations.  This tool highlights the ten fundamental actions states need to complete to prepare for unwinding when the Medicaid continuous enrollment requirement ends.  Find it here.

CMS has issued a letter to state Medicaid programs updating its 2022 SSI and spousal impoverishment standards.  These measures affect financial eligibility rules (the “spousal impoverishment rules”) that apply when married individuals seek coverage of certain long-term services and supports.  Find the letter and the new standards here.

Department of Health

The Department of Health is working with Philadelphia’s Department of Public Health to confirm and investigate what appears to be the first case of monkeypox in Pennsylvania and one of only 21 currently suspected in the U.S.  Learn more from this Philadelphia Department of Public Health news release.

The Department of Health’s Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities of modifications of the reporting process for skilled nursing facilities with ongoing outbreaks of COVID-19.  Find that notice here.

COVID-19:  By the Numbers

  • For the first time in more than two months daily COVID-19 case counts fell, declining from a seven-day average of 4238 on May 25 to 3552 on June 1.
  • The seven-day average of COVID-19-related deaths fell by more than half, from 36 to 15, over the same period of time.
  • Despite the decline in new cases, the number of Pennsylvanians hospitalized with COVID-19 rose, but only slightly (three percent) over the past week.
  • The number of these patients on ventilators and hospital intensive care units held steady over the past week.
  • Sixty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19; Juniata County was the exception, with a substantial rate of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded a grant of $1.4 million to continue the Pennsylvania Perinatal Quality Collaborative’s work in improving perinatal health outcomes.  Learn more about the grant, the program, and the grant recipient from this department news release.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has issued comments on proposed regulations governing long-term-care facilities that were published on March 19.  See these comments in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Care Delivery System Subcommittee – June 9

The Medical Assistance Advisory Committee’s managed care delivery system subcommittee will meet virtually on Thursday, June 9 at 10:00.  Go here for the meeting agenda and information about how to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 9

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special population webinar on polypharmacy challenges in nursing homes on Thursday, June 9 at 2:00.  The webinar is especially targeted for skilled nursing facility medical directors, directors of nursing, pharmacy staff, and recreational therapy.  To learn more about the virtual webinar and how to participate, go here.

Department of Aging – Pennsylvania Long-Term Care Council – June 9

The Department of Aging’s Pennsylvania Long-Term Care Council will meet in Harrisburg on Thursday, June 9 at 10:00; the meeting also will be available virtually.  For information on the location of the meeting and how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

PA Health Policy Update for the Week of April 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of April 18-22, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed House Bill 245, which reduces the graduate medical training required for international medical graduates from three years to two years; removes the limit on the number of affiliated facilities at which a doctor with an institutional license may practice or teach; and expands and clarifies the scope of practice of temporarily licensed physicians.

General Assembly

  • The state House will be in session next Monday (4/25), Tuesday (4/26), and Wednesday (4/27). The Senate is in recess.
  • The House Professional Licensure Committee will meet on Monday, April 25 at 10:00 a.m. to consider House Bill 1956, which creates a license for certified anesthesiologist assistants.
  • The House Health Committee will convene on Tuesday, April 26 at 9:30 a.m. to consider the following bills.
    • House Bill 398, which requires a non-custodial parent of a child to enroll their child in their own health insurance plan before seeking Medicaid coverage.
    • House Bill 2441, which gives legislative agencies access to records information for research purposes under the Vital Statistics Law.
    • Senate Bill 317, which provides for the authority to prescribe antibiotics to treat sexually transmitted infections without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy in the Management of Sexually Transmitted Diseases guidance issued by the CDC.
    • Senate Bill 818, which seeks to align procedures permitted in licensed ambulatory surgery centers with those of the federal Centers for Medicare & Medicaid Services (CMS).

Department of Human Services

  • Act 2 of 2022 appropriated $225 million to support the health care workforce needs of hospitals and behavioral health providers.  The law directed that the funding be used strictly for recruitment and retention payments to direct care staff.  Entities receiving payments under Act 2 must submit a report to the Department of Human Services (DHS) documenting staff retention payments by September 30, 2022 and a report on staff recruitment spending by December 31, 2022.  DHS has posted an FAQ describing how Act 2 works and has added to that FAQ a template for submitting the required reports.  Find the FAQ and the report template here.
  • DHS has updated its calendar for delivering Remittance Advice and corresponding checks to extend into early June.
  • DHS has issued a Medical Assistance Bulletin to announce the addition of new procedure codes to the Medical Assistance program fee schedule for the provision of personal care services that are provided through home health agencies to Medicaid beneficiaries under 21 years of age.  Find that bulletin here.
  • DHS has posted a notice to Medical Assistance fee-for-service providers reminding them of the recommended documentation needed to support the review of authorization requests for private duty/shift nursing and home health aide service hours provided to children under the age of 21.  Find that notice here.
  • DHS has shared the minutes of the February 23 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.
  • DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include March 2022 data.

Department of Health

  • Keara Klinepeter has resigned as Pennsylvania’s Acting Health Secretary.  She will be replaced by the state’s Physician General, Dr. Denise Johnson.  Learn more from this Wolf administration news release.
  • The Secretary of Health issued a letter to the hospital community clarifying that the intention of the recently issued innovative hospital guidance was to preserve access to care in rural communities in a financially sustainable way.  Find a copy of that letter here.
  • The Department of Health has updated its guidance to providers caring for adults and children with multisystem inflammatory syndrome.
  • The Department of Health has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Blair, Centre, and Clinton counties and at Edinboro University in Erie.  Learn more about the locations and hours of operation in this department news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the fourth consecutive week.  The state’s seven-day average of new cases rose 26 percent, from 1067 cases on April 14 to 1343 on April 21.
  • The seven-day average of COVID-19-related deaths, which has long been declining, rose during the past week from 10 on April 13 to 16 to April 21.
  • The rising number of COVID-19 cases in Pennsylvania has led to increases in some but not all measures of COVID-19-related hospital care.  In the past week the number of Pennsylvanians hospitalized with the virus rose 13 percent and has now risen 21 percent since the beginning of the month.  The number of COVID-19 patients in hospital ICUs rose 15 percent in the past week but remains modest.  The number of such patients being treated on ventilators, on the other hand, declined 22 percent and remains very low.
  • During the past week nine Pennsylvania counties, up from five last week, experienced high rates of community transmission of COVID-19; three counties, down from five last week, experienced a low rate of transmission; 20 counties, up from 15 last week, experienced a substantial rate of community transmission; and the remaining 35 counties experienced a moderate rate.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a fourth quarter 2021 report on the effect of COVID-19 on hospitals and health care facilities in Pennsylvania.  In the report, PHC4 aggregates data on fourth quarter of 2021 COVID-19 expenses and lost revenue as reported by hospitals and health systems to show the impact of the public health emergency on those institutions.  The data in the report reflects financial performance for fewer than half of the hospitals in the state and does not include emergency funding the providers received from the federal or state government.  Learn more from this PHC4 news release and the agency’s “COVID-19 Disaster Emergency Report.”

Stakeholder Events

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

The Department of Human Services’ Office of Long-Term Living, Office of Mental Health and Substance Abuse Services (OMHSAS), the HealthChoices behavioral health managed care organizations, and the Community HealthChoices managed care organizations will host a joint webinar on the importance of providing behavioral health services in nursing facilities and making sure nursing facilities know how to gain access to these services.  The webinar will be held two more times and the material presented will be the same at each session.  The webinars will be recorded.  The session on Tuesday, April 26 will be held at 2:00; go here for more information and to register to participate.  The session on Tuesday, May 3 also will be held at 2:00; go here for more information and to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

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

Special Pharmaceutical Benefits Program Advisory Council – April 28

The Department of Human Services’ Special Pharmaceutical Benefits Program Advisory Council will meet by teleconference on Thursday, April 28 at 10:00.  Join the meeting at 866-588-4789 and use conference ID code 211 418 005#.

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m.  For information about how to participate see this Pennsylvania Bulletin notice.

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

The following is an update of selected state health policy developments in Pennsylvania for the week of April 11-15, 2022.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • The state House and Senate convened for session in Harrisburg this week.
  • The House concurred with the Senate’s amendment to House Bill 245 and sent it to the governor’s desk.  House Bill 245 reduces the clinical residency requirement from three years to two years for an applicant who has graduated from an international medical college to receive licensure in Pennsylvania.
  • The House passed on third and final consideration House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses, and House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.  These bills will now be sent to the Senate for consideration.
  • The Senate passed on third and final consideration Senate Bill 1172, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.  The bill was received in the House and referred to the Health Committee.
  • The House Health Committee held an informational meeting on Tuesday, April 12 regarding “Opioids in the Commonwealth:  Lessons learned and next steps.”  A recording of the meeting may be viewed here.
  • The House Veterans Affairs and Emergency Preparedness Committee favorably reported House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.
  • The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 12 to examine long-term-care facility workforce challenges.  A recording of the meeting may be viewed here.
  • The Senate Health & Human Services Committee met on Tuesday, April 12 and favorably reported the following bills.
    • Senate Bill 749, which seeks to provide clarity for employees and employers regarding current ambiguity in the state’s medical marijuana law concerning the use of medical marijuana in the workplace.
    • Senate Bill 1121, which requires the Department of Human Services (DHS) to verify wage records from employers and the Department of Revenue for Medicaid and SNAP beneficiaries.
    • Senate Bill 1124, which requires DHS to check death certificates at the Bureau of Vital Statistics against Medicaid and SNAP beneficiaries.
    • Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.

A recording of the hearing may be viewed here.

Department of Human Services

The Department of Human Services (DHS) has posted a file note summarizing the March 10 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

DHS has announced the addition of two procedure codes to the Medical Assistance fee schedule for the provision of personal care services by home health agencies to beneficiaries under 21 years of age, effective with dates of service on and after May 1, 2022.  Find those procedure codes in this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its guidance for reporting on point-of-care COVID-19 test results to bring Pennsylvania into compliance with revised federal requirements.  See the new guidance here.
  • DOH has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Centre, and Clinton counties and at Edinboro University in Erie.  Learn more about the locations and hours of operation in this department news release.
  • DOH has posted new online resources for providers and the public to learn about and support

Pennsylvanians who may be experiencing symptoms of Alzheimer’s disease and related disorders.  The new information comes in response to a law passed by the legislature earlier this year and signed by Governor Wolf requiring the administration to provide such information.  Go here to find the resources for providers and here to view resources for the public.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the third consecutive week.  The state’s seven-day average of new cases rose nearly 24 percent, from 797 cases on April 5 to 986 on April 13.
  • On the other hand, the number of new COVID-19-related deaths continues to decline, from a seven-day average of 17 on April 5 to just 10 on April 13.
  • The rising number of COVID-19 cases in Pennsylvania has not led to increases in hospital care for COVID-19 patients:  during the past week the number of residents in hospital ICUs because of the virus and being treated with ventilators has remained steady while the number admitted to hospitals has risen only seven percent since the beginning of the month.
  • During the past week five Pennsylvania counties – up from two last week – experienced  high rates of transmission of COVID-19 (Potter, Bradford, Susquehanna, Columbia, and Pike); five counties – the same number as last week – experienced a low rate of community transmission (Bedford, Fulton, Juniata, Elk, and Sullivan); and 15 counties experienced a substantial rate of community transmission while another 42 experienced a moderate rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued a news release describing its recent talks with state Attorney General Shapiro and other officials about how Pennsylvania might use its share of the national opioid settlement – as much as $1.07 billion – to address substance use challenges in the state.  Learn more here.

Insurance Department

The Insurance Department has published a policy statement that will permit insurers to ask applicants to voluntarily provide race and ethnicity data on insurance applications in an effort to promote equity initiatives.  The new statement of policy ends enforcement of a prohibition on such data collection published in 1969.  Learn more about this policy change in this department news release and see the policy statement in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

The Department of Human Services’ Office of Long-Term Living, Office of Mental Health and Substance Abuse Services (OMHSAS), the HealthChoices behavioral health managed care organizations, and the Community HealthChoices managed care organizations will host a joint webinar on the importance of providing behavioral health services in nursing facilities and making sure nursing facilities know how to gain access to these services.  The webinar will be held two more times and the material presented will be the same at each session.  The webinars will be recorded.  The session on Tuesday, April 26 will be held at 2:00; go here for more information and to register to participate.  The session on Tuesday, May 3 also will be held at 2:00; go here for more information and to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

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

Special Pharmaceutical Benefits Program Advisory Council – April 28

The Department of Human Services’ Special Pharmaceutical Benefits Program Advisory Council will meet by teleconference on Thursday, April 28 at 10:00.  Join the meeting at 866-588-4789 and use conference ID code 211 418 005#.

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m.  For information about how to participate see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board – May 6

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, May 6 at 10:00 at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive in Harrisburg, in the Dauphin Conference Room.  To learn more about the meeting, and for information about how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00.  To register to participate, go here.

PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023.  Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds.  Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds.  Proposed spending increases include:

  • rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
  • increased Supplemental Nutrition Assistance Program benefits
  • increased supplemental payments to personal care homes
  • increased county mental health funding
  • reducing the waiting list for intellectual disability services
  • expanding court-appointed child special advocates
  • expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced.  The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate.  Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease.  It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate.  Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies.  A press release issued by the governor’s office can be viewed here.

General Assembly

  • The state House and Senate convened for voting session this week.  The following is a selection of health-related bills that received consideration.
    • House Bill 1440 passed on third and final consideration by a vote of 132 to 67.  This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals.  It will now be sent to the Senate.
    • House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66.  The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.
  • The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
  • The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
  • The House Appropriations Committee will begin budget hearings next Tuesday, February 15.  The Senate Appropriations Committee will begin budget hearings the following week, on February 22.  The hearing schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program.  The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system.  Find the bulletin here.
  • DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19.  Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action.  Such comments are due within 30 days.
  • DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting.  Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic.  The update reflects a recent revision in the CDC’s guidance.  Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state.  Learn more in this DOH news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
  • To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
  • The number of new COVID-19-related deaths also remains very high but declined slightly over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
  • To date, more than 42,000 Pennsylvanians have died from COVID-19.
  • The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
  • The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

 

PA Health Policy Update for the Week of January 31-February 4

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

Governor Wolf

As part of a preview of the budget proposal Governor Wolf will deliver to the legislature on Tuesday, February 8, his office has issued a news release  announcing “…his $1.7 billion plan to help Pennsylvania fully recover from the pandemic and pave the way for a successful future with support for families and workers, small businesses, the healthcare system, and statewide community revitalization through the American Rescue Plan​ Act (ARPA).”  Included in that news release is the following:

Support for Pennsylvania’s Healthcare System, $325 million

This investment would recognize healthcare workers for their heroic dedication and hard work throughout the pandemic and give healthcare providers resources to recruit and retain a skilled workforce​:

    • $250 million for long-term care recruitment and retention incentives and workforce development initiatives to grow the critical healthcare workforce​;
    • $40 million for the behavioral health workforce to expand county mental health programs; and 
    • $35 million to expand the student loan forgiveness program at PHEAA to include additional critical healthcare workers.

Redistricting Update

This afternoon the Legislative Reapportionment Commission voted 4-1 to approve new state House and Senate legislative district maps.  The final maps can be viewed here.  Pennsylvanians who are “aggrieved” by the approved maps have one month to appeal them to the Supreme Court, which has the authority to send the maps back to the commission.  Earlier this week the state Supreme Court assumed responsibility for drawing the state’s congressional district map.

House Chamber of the State HouseGeneral Assembly

  • The General Assembly will be in session next Monday (2/7), Tuesday (2/8), and Wednesday (2/9).
  • The state House and Senate will convene for a joint session on Tuesday (2/8) for Governor Wolf’s final budget address.
  • The House of Representatives is planning to consider the following health-related bills on second and third consideration next week.  Please note that this list is subject to change.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 19, which creates professional licensure for behavior analysts.
    • Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The House Health Committee will convene on Monday, February 7 to consider House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat coronavirus infections, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that the Medical Assistance program will pay for FDA-authorized over-the-counter COVID-19 tests provided to Medical Assistance beneficiaries, effective with dates of service on and after August 30, 2021.  This bulletin applies to Medical Assistance-enrolled pharmacies that serve Medical Assistance beneficiaries.  Providers serving Medical Assistance beneficiaries in physical health HealthChoices or Community HealthChoices should address any billing and payment questions with the applicable managed care organization.  Learn more from this Medical Assistance Bulletin.
  • DHS has published notice of its final $255.556 million funding allocation for various FY 2022 disproportionate share hospital (DSH) payments.  DHS is not otherwise changing the qualifying criteria or payment methodology for any of these payments.  Learn more in this Pennsylvania Bulletin notice.
  • Thirty Pennsylvania counties have received nearly $28 million in federal funding to enhance their behavioral health programs.  Administered through DHS, this one-time funding consists of money granted to states through the federal Consolidated Appropriations Act of 2021 combined with funds from Pennsylvania’s annual Community Mental Health Services Block Grant award.  The grants will target specific state priorities, including mobile crisis mental health services, telehealth, student assistance programs, start-up funding for residential treatment services and assisted outpatient treatment, and additional crisis services projects.  These projects include walk-in and remote crisis supports, expanding crisis, respite, and residential care capacity, and enhanced collaboration with law enforcement to assist with crisis response.  Learn more about the services this funding will support and which counties received grants from this news release.
  • DHS has circulated a briefing document on pharmacy prior authorization for sedative hypnotics when prescribed for Medical Assistance beneficiaries and has invited stakeholder comment.  Comments are due by February 8 and should be sent in MS Word to c-bstarr@pa.gov.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its final annual case-mix per diem payment rates for FY 2022 for non-public and county nursing facilities that participate in the Medical Assistance program.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report,” which updates the report to include January 2022 enrollment data.

Department of Health

  • Leaders of the Pennsylvania Department of Health (DOH), Department of Military and Veterans Affairs, and Pennsylvania Emergency Management Agency (PEMA) announced that they would establish four long-term care regional support sites to relieve pressure on hospitals and skilled nursing facilities due to a high number of patients with COVID-19.  Each facility will receive clinical and non-clinical support staff to open up to 30 beds to allow for more rapid discharge of patients from hospitals, when clinically safe to do so, freeing additional acute care space to meet COVID-19 demands.  A staffing firm will provide clinical staff, including RNs, LPNs and CNAs; the Pennsylvania National Guard will provide non-clinical staffing to support the facilities’ existing staff; and PEMA will assist with coordination.  The four regional support sites will open at the following skilled nursing facilities:  Vincentian Home in Pittsburgh; Lutheran Home in Hollidaysburg, Blair County; Springs at the Watermark in Philadelphia; and Clarview Nursing Home and Rehabilitation in Sligo, Clarion County.  Learn more from this news release.
  • DOH this week established new COVID-19 testing sites in Clearfield, Fayette, Monroe, Somerset, and Venango counties, joining previous sites it opened in Berks, Blair, Centre, and Clinton counties.  Learn more about individual clinic locations and hours in this DOH news release.
  • DOH has posted information about two options for DHS-certified child care facilities to report positive COVID-19 cases.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 8512 cases day; a week ago (January 27) its seven-day average was 14,025 cases a day.
  • The number of new COVID-19-related deaths also remains very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 135 deaths a day; a week ago (January 27) its seven-day average was 166 deaths a day.
  • The Department of Health reports that the percent of available adult and pediatric ICU beds in the state rose to 18.9 percent and 14.4 percent, respectively; that in approximately 22.1 percent of all staffed adult ICU beds are COVID-19 patients; and that 30.6 percent of all ventilators state-wide are in use.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 25 percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators fell 21 percent over the past week and the number in ICUs fell 25 percent.

Stakeholder Events

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

PA Health Policy Update for the Week of January 24-28

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

General Assembly

  • The General Assembly enacted House Bill 253 (Act 2), providing $225 million in federal American Rescue Plan funding to support health care professionals on the frontlines of the COVID-19 pandemic in hospitals and behavioral health care facilities.  The breakdown of the funding is as follows:
    • $100 million for one-time payments to hospitals for making retention and recruitment payments to qualified staff.
    • $110 million for one-time payments to behavioral health providers, critical access hospitals, and high Medical Assistance hospitals for making retention and recruitment payments to qualified staff.
    • $15 million to be used by the Pennsylvania Higher Education Assistance Agency (PHEAA) to fund the Pennsylvania Student Loan Relief for Nurses Program.

A press release issued by Republican leaders of the General Assembly that quotes several health systems can be found here.  A press released issued by Governor Wolf can be found here.

  • The Senate passed Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.  The bill was received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee.
  • The Senate Health and Human Services Committee convened this week and favorably reported the following bills.
    • Senate Bill 152, which provides direction to the Department of Human Services on how to distribute funding intended for women’s health and family planning services.
    • Senate Bill 956, a constitutional amendment that clarifies that there is not a right to an abortion or abortion funding in the state constitution.
    • House Bill 1420, which directs the Department of Human Services to establish a public awareness campaign to provide information about the programs and services available for first responders, health care workers, and other frontline workers suffering from mental health issues related to the COVID-19 pandemic.
  • The Senate Aging and Youth Committee favorably reported the following bills this week.
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances.
    • House Bill 996, which requires the departments of Human Services and Health to establish protocols to permit residents of long-term-care facilities to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.
  • The House Professional Licensure Committee convened and favorably reported the following bills this week.
    • House Bill 19, which establishes professional licensure for behavioral analysts.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 1862, which preserves the COVID-19 regulatory waiver that authorizes physicians with an institutional license in a teaching hospital to serve patients at more than just two facilities in a health system.

Department of Human Services

  • The Department of Human Services (DHS) has mailed letters to hospitals potentially eligible for FY 2021-22 OB/NICU DSH payments requesting verification of their current licensure status.  Courtesy electronic notification also was sent to contacts on file on January 26.  To verify that they meet the criteria for inclusion in the payment program, hospitals must sign and return the attestation form to RA-pwdshpymt@pa.gov by Friday, 2/25/22.  Any Pennsylvania hospitals that are currently licensed to provide obstetric or neonatal services and did not receive a notification should contact DHS at RA-pwdshpymt@pa.gov.
  • DHS has issued a Medical Assistance Bulletin to inform pharmacies of the addition of procedure code S5001 to the Medical Assistance Program fee schedule for dispensing oral antiviral treatments with FDA emergency use authorization for the treatment of COVID-19
    and providing instructions for pharmacies on how to submit claims for dispensing these treatments.  Learn more in this Medical Assistance Bulletin.
  • DHS has announced that it will add Aduhelm (aducanumab) and complement inhibitors to the Medical Assistance Program’s list of services and items requiring prior authorization.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report.”  The new report includes the first look at October 2021 Medicaid managed care enrollment data.

Department of Health

  • The Department of Health (DOH) has posted a notice on its message board that it will provide direct access to COVID-19 therapeutics to residents of long-term-care facilities. With the recent approval of oral antiviral medications for COVID-19 (Pfizer’s Paxlovid and Merck’s molnupiravir), DOH is holding product in strategic reserve for residents of long-term-care facilities and others in congregate care settings.  Paxlovid and molnupiravir are authorized for use in individuals who test positive for COVID-19 and are at high-risk for severe disease progression.  Upon receipt of a request for medication, supply permitting, DOH will ship the product the same day or the next day to the requesting facility.  Due to the nature of the medications, this product is only appropriate for residents within five days of the onset of symptoms.  Go here to request these oral antiviral medications from DOH.
  • DOH has issued an update of its recommendations for return to work for health care workers with confirmed or suspected COVID-19.
  • DOH has updated its guidance on work restrictions for health care workers who have been exposed to COVID-19.
  • DOH has announced changes to hospitalization data reporting on its Corvena platform to align with federal reporting requirements.  The new data fields must be completed beginning February 2 and daily thereafter.  Click here to download a Word file announcing these changes and download the Corvena data dictionary here (Excel).
  • DOH has deployed the first state-directed health care strike team to Grand View Health in Bucks County.  The team includes 10 registered nurses provided through GHR Healthcare under a contract with the Department of Health.  Learn more about the strike team concept and how it works and what this group will do at Grand View Health in this Department of Health news release.
  • DOH has introduced two new resources to help skilled nursing facilities encourage their residents and staff to receive COVID-19 vaccines and boosters:  a document on best practices and a vaccine and booster fact sheet.
  • DOH has adopted the new federal CDC standard for blood lead reference value (BLRV) from 5 μg/dL to 3.5 μg/dL.  The department explains why it adopted this new standard and what it means in this health advisory notice.

COVID-19:  By the Numbers

Stakeholder Events

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m.  The purpose of this meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the acting secretary on matters relating to the administration of this fund.  Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                      Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

Traumatic Brain Injury Advisory Board – February 4

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, February 4 at 10:00 a.m.  For information about the board, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

PA Health Policy Update for the Week of December 13-17

The following is an update of selected state health policy developments in Pennsylvania for the week of December 13-17, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration requested support from the Federal Emergency Management Agency (FEMA) for Pennsylvania’s health care system in its continued battle against COVID-19.  In particular, it has asked for staffing support for clinical and non-clinical professionals and continued pandemic response support.  Learn more from this Wolf administration news release.

General Assembly

  • The Senate unanimously passed House Bill 1260, which expands eligibility for the PACENET prescription program from $27,500 to $33,500 for single individuals and from $35,500 to $41,500 for married couples.  The bill has been sent to the governor.
  • The House Health Committee held an informational hearing on Monday to discuss the various COVID-19 treatment options available.  House Bill 1741, which provides for prescribing and dispensing to treat COVID-19 off-label drugs approved by the FDA for other purposes, received a considerable amount of attention during the hearing.  Chairman Kathy Rapp indicated the committee may move the bill in early 2022.  You can view a recording of the hearing here.
  • The Senate Health & Human Services Committee convened on Tuesday and favorably reported the following bills:
    • Senate Bill 200, which expands early intervention services for infants and mothers;
    • 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;
    • 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; and,
    • House Bill 118, which establishes requirements for the final disposition of fetal remains.

You can view the committee’s agenda and a video recording here.

  • The House Human Services Committee held an informational hearing on House Bill 1644 on Thursday.  The bill 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 held an informational hearing on community participation supports during COVID-19 pandemic.  You can view a recording of the hearing here.
  • The state House and Senate appropriations committees released their FY 2023 budget hearing schedules.  The schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has updated its schedule for Remittance Advices, adding January dates and pay dates that go into early February.  Find it here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its intention to allocate funds in FY 2021-2022 for several classes of Medicaid inpatient disproportionate share hospital (Medicaid DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  The department does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  The allocations include:
    • $1.057 million in total funds for DSH payments to qualifying acute-care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue, and are located in an area of the state with a disproportionate need for Medicaid services
    • $1.585 million for DSH payments to qualifying acute-care general hospitals to promote access to acute-care services for Medicaid-eligible persons in less urban areas
    • $18.293 million for DSH payments to Medicaid-enrolled acute-care general hospitals that qualify as a trauma center
    • $111.585 million for DSH payments to qualifying Medicaid-enrolled acute-care hospitals that promote access to comprehensive inpatient services for Medicaid-eligible persons by providing an adequate supply of health care professionals who have been trained in high-volume Medicaid-enrolled hospital settings
    • $9.377 million for DSH payments to qualifying acute-care general hospital burn centers
    • $14.119 million for DSH payments to qualifying acute-care general hospitals providing obstetrical and neonatal services
    • $0.500 million for DSH payments to qualifying teaching hospitals that provide psychiatric services to Medicaid beneficiaries
    • $34.356 million for DSH payments to critical access and qualifying rural hospitals
    • $0.695 million for DSH payments to qualifying acute-care general hospitals that provide surgical services to patients with cleft palate and craniofacial abnormalities
    • $0.737 million for DSH payments made to qualifying Medicaid-enrolled acute-care general hospitals that provide a high volume of inpatient services to Medicaid-eligible and low-income populations
    • $4.333 million for DSH payments to qualifying acute-care general hospitals that qualify as academic medical centers
    • $23.946 million for DSH payments to qualifying acute-care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals
    • $7.397 million for DSH payments to qualifying acute-care general hospitals that participate in an academic medical program
    • $5.290 million for supplemental payments to qualifying acute-care general hospitals that provide medical and surgical ocular services to Medicaid beneficiaries
    • $0.900 million for supplemental payments to qualifying acute-care general hospitals that provide a substantial portion of their inpatient services to Medicaid beneficiaries

Learn more from this Pennsylvania Bulletin notice.

  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization.  Find the bulletin here.

Department of Health

  • Department of Health (DOH) acting secretary Alison Beam will leave that job at the end of the year.  She will be replaced by department deputy secretary Keara Klinepeter.  Learn more from this Wolf administration news release.
  • DOH announced that the state is opening free outdoor drive-up COVID-19 testing sites in Berks, Blair, Centre, Clinton, Jefferson, Luzerne and McKean counties.  For locations and hours, see this department news release (and this separate notice for the site in Blair County).
  • DOH has introduced a new “post-vaccination data” web page on which it will provide data on so-called breakthrough cases of COVID-19:  cases, hospitalizations, and deaths.  The web page reports that from January 1 through December 6, 2021, 85 percent of reported COVID-19 cases in Pennsylvania were in unvaccinated or not fully vaccinated people; 87 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 86 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.  For additional information and a more detailed breakdown of these and other numbers, see the department’s new post-vaccination data web page.
  • DOH has posted a notice on its message board about the transition from the Regional Congregate Care Teams to a new program that will support response operations at long-term-care facilities that experience COVID-19 outbreaks.  Find that message here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments on DOH’s proposed amendments of regulations governing long-term-care facilities.  In addition to specific comments, the IRRC stated its agreement with many others in the regulated community that have urged DOH to reevaluate its approach of promulgating several packages of proposed regulations and instead consider submitting a comprehensive regulatory update regarding long-term care.  Find the IRRC comments in this Pennsylvania Bulletin notice.
  • DOH has issued its monthly report detailing its nursing home inspection and sanction activities.  Learn more from this department news release and the department’s November report.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at 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 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 has risen 18 percent since December 1; the number in hospital ICUs because of COVID-19 has risen 13 percent; and the number on ventilators because of the virus has risen 16 percent since the start of the month.
  • This situation is reflected in the high rate of occupancy in the state’s hospitals.  There currently are only 484 unoccupied adult ICU beds – 13.7 percent of the total of such beds in the state; 2106 unoccupied medical/surgical beds – 10.5 percent of such beds in the state; 34 pediatric ICU beds (9.0 percent); 191 pediatric beds (16.8 percent); and 938 airborne isolation beds (29.6).
  • Media reports confirm the challenges some communities and hospitals are facing, including this story in the Philadelphia Inquirer; a situation that the director of the 911 call center in Westmoreland County calls “desperate;” and reported capacity and hospital discharge problems in western and rural Pennsylvania.
  • DOH reports that 6.8 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 186,000 boosters have been administered to city residents since August 13.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published Hospital Performance Report – 2020 Data, which presents volume and outcome information about a variety of medical conditions and surgical procedures performed by the state’s  general acute-care hospitals.  Learn more from the following resources:

 

PA Health Policy Update for the Week of September 20-24

The following is an update of selected state health policy developments in Pennsylvania for the week of September 20-24, 2021.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • House Republican leadership held a press conference on Monday to discuss their legislative agenda for the fall.  In addition to addressing the Wolf administration’s mask mandate for K-12 schools, they plan to work on legislation to address the opioid and addiction crises and COVID-19 regulatory waivers and flexibilities.  View the news conference here.
  • The House of Representatives sent House Bill 1861 to the Senate, where it was referred to the Health & Human Services Committee.  This bill will likely serve as the legislative vehicle for an extension of the health-related COVID-19 regulatory waivers and flexibilities set to expire on September 30, 2021.
  • The House of Representatives unanimously approved House Bill 1774, which amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP).  Specifically, the bill extends the sunset date to December 31, 2028 and grants the Department of Labor & Industry access to the prescription monitoring program.
  • Senate Bill 397 and Senate Bill 398 were reported as amended by the House Professional Licensure Committee on Monday.  These two bills would modernize Pennsylvania law on physician assistants and their oversight.
  • The House and Senate will be in session again next week on Monday (9/27), Tuesday (9/28), and Wednesday (9/29).  The following health care-related committee meetings have been scheduled:
    • The House State Government Committee will convene on Monday (9/27) to consider, among other bills, House Bill 1893, which amends the Disease Control and Prevention Act of 1955 to make disease information under this act subject to the Right-to-Know Law.  The committee also will consider Senate Bill 533, which prohibits certain regulatory and administrative actions during a disaster emergency.
    • The Senate Health & Human Services Committee will convene on Monday, September 27 at 12:00 p.m. to consider House Bill 1861 (COVID-19 regulatory waiver and flexibility extension); House Bill 1774 (Achieving Better Care by Monitoring All Prescriptions Program); Senate Bill 782 (payment for FDA-approved anti-obesity drugs); Senate Bill 815 (pelvic exam consent requirement); and Senate Bill 818 (allowable ambulatory surgical center procedures).

Department of Human Services

Department of Health

  • The Department of Health has updated its interim infection prevention and control recommendations for health care settings to add new options for fully vaccinated individuals working in facilities in counties with low to moderate rates of community transmission of COVID-19.
  • The Department of Health, Department of Drug and Alcohol Programs, and the Pennsylvania Commission on Crime and Delinquency have written to Pennsylvania hospital officials advising them on how they can secure a supply of Narcan to support hospital- and community-based naloxone distribution efforts to help in the fight against overdose-related deaths.  See their letter here.
  • Acting Secretary of Health Alison Beam has signed an order to ensure that vaccine providers are prepared to start COVID-19 booster shots as soon as the CDC issues federal guidance to do so.  The order requires vaccine providers, as possible, to provide online scheduling for vaccination appointments; provide a telephone number to assist with scheduling appointments; offer walk-in appointments; and work with local Area Agencies on Aging and Medicaid managed care plans to help schedule appointments for eligible adults and people who cannot leave their homes to get vaccinated.  Learn more from the Department of Health’s announcement about the order and the order itself.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week.  Today the number of Pennsylvanians who have contracted COVID-19 surpassed 1.4 million.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is 12.2 times greater this year than in 2020.  Between September 15 and September 21, 2020 there were a total of 650 COVID-19 cases in school-aged kids compared to 7,928 cases in the same age group during the same week in 2021.
  • According to Pennsylvania’s COVID-19 dashboard, only 41 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
  • The number of new COVID-19-related deaths also remains high.  Yesterday the number of Pennsylvanians who have died from COVID-19 rose past 29,000.
  • For the third consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
  • The number of Pennsylvanians hospitalized because of COVID-19 rose 13 percent in the past week and has risen 44 percent since the first of the month; the number on ventilators has risen 14 percent in the past week and 38 percent since the first of the month; and the number in hospital intensive care units has risen 12 percent in the past week and 37 percent since the beginning of September.
  • 68.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.1 million people – up from 67.5 percent last week.  10,000 Philadelphians and 74,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; some of the 74,000 were added to the ranks of the vaccinated as the result of a Department of Health adjustment of its vaccination data.

Around the State

  • “Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again,” reports Spotlight PA, which takes a closer look at some of the waivers that have been in place in Pennsylvania, what they do, and what the stakes might be if they are not renewed.
  • Emergency department volume at Children’s Hospital of Pittsburgh and Excel Health Frick Hospital has risen so much that the hospitals have erected tents to help them handle growing numbers of patients, according to the Pittsburgh Tribune-Review.
  • Mobile clinics operated by the organization Latino Connection are making a special effort to provide COVID-19 vaccines to Hispanic communities around the state, the Allentown Morning Call reports.
  • Black Doctors COVID-19 Consortium, a group launched to ensure access to COVID-19 vaccines for Philadelphia’s African-American community, will extend its scope of endeavor and open a primary care clinic to help address health disparities and inequities.  The Philadelphia Inquirer explains the group’s evolution.
  • “A new study from Penn State shows Pennsylvania could avoid billions of dollars in health damages by joining a regional cap and trade program targeting power plant emissions… The team at Penn State used four types of damage estimates to find that the commonwealth could reduce health impacts caused by power plant pollution by between $18 and 40 billion dollars over the next nine years by joining the Regional Greenhouse Gas Initiative (RGGI).”  StateImpact Pennsylvania explains.
  • Spotlight PA has posted an update on its reporting on what it calls the “…growing dementia care crisis in one of the nation’s most rapidly aging states…”  Read it here.
  • “Mental health agencies in Bucks, Dauphin, Carbon, Monroe and Pike counties are using new grant funding to test out a program designed to help people who live with serious mental illness and are at risk of ending up in jail.”  Learn more from this WITF story.
  • An EMS organization serving parts of Lancaster County is encountering funding problems – a situation found in other parts of the state as well, according to the Pennsylvania Capital-Star.

 

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