Pennsylvania Medicaid laws and regulations Archives - Page 4 of 10

PA Health Policy Update for the Week of September 6

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

General Assembly

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

Department of Health

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

Department of Human Services

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

Pennsylvania Rural Health Model

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

COVID-19: By the Numbers

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

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

Around the State

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

Independent Regulatory Review Commission

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

Stakeholder Events

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

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

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

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

The Wolf Administration

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

General Assembly

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

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

Department of Health

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

Department of Human Services

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

COVID-19: By the Number

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

Around the State

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

Stakeholder Event

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

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

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

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

General Assembly

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

Department of Health

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

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

Department of Human Services

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

Department of Drug and Alcohol Programs

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

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

COVID-19: By the Numbers

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

Around the State

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

Stakeholder Events

Traumatic Brain Injury Advisory Board

August 6 at 9:00 a.m.

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

Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

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

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

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

COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logo The following is a summary of the major COVID-19-related developments in Pennsylvania today.

Telemedicine

The Office of Medical Assistance Programs has issued guidance for providers on the use of telemedicine services for Medicaid patients – those covered both by managed care plans and on a fee-for-service basis. Learn more from the newly posted telemedicine guidelines and a separate memo to the HealthChoices managed care plans from the state.

In addition, CMS issued a waiver for certain restrictions on the provision of telemedicine services under the Medicare program. The details of the wavier are described in a Fact Sheet and FAQ.

New Guidance From the State

Today the state published a number of COVID-19-related resources:

Letter from Department of Health Secretary

Attached to this memo, please find a letter and its attachment issued by the PA Department of Health providing additional hospital guidance on implementing your emergency preparedness plans.

PA Insurance Department Public Notice

You can find a preview copy of a pending public notice from the insurance department related to COVID-19 at this link.

PA General Assembly Update

Both the House and Senate are currently in recess with a 12-hour call of their respective chairs. Neither chamber is expected to be in Harrisburg through the remainder of this week and we will likely receive an update on next week’s session schedule over the weekend.

The House passed temporary rules during session yesterday to allow its members to work and vote remotely should the need arise in the coming weeks/months. This temporary rule still requires majority and minority leadership to be at the Capitol for bill movement and to tally votes. The same is required of Committee Chairs should they call voting meetings during this time away from Harrisburg.

Daily State Briefing

Department of Health Secretary Levine reported that the state is now receiving more COVID-19 test results from commercial and hospital laboratories, which are now doing most of the testing. As that number rises, the ability of officials to trace the origin of the disease is expected to decrease.
Mass testing sites for Philadelphia and Montgomery County are still being explored. They would perform drive-through testing and would only be for people showing symptoms.
With state liquor stores about to close, state officials are planning to meet later today to discuss possible resources for alcohol-dependent individuals who suffer withdrawal problems.
The state will be providing guidance to dentists, who are considered very high risk, later this week.
No hospitals are reporting to the state that they are overtaxed by COVID-19 patients at this time.

Secretary Miller’s Briefing

DHS Secretary Teresa Miller is holding an invitation-only briefing later today. If anything urgent arises we will let you know immediately. Otherwise, we will report on it tomorrow.

Resources to Consult

Pennsylvania Department of Human Services

Pennsylvania Department of Health

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 Admin2020-03-18T16:53:47+00:00March 18th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Wolf Administration Proposes New Human Services Initiatives for FY 2021

New human services efforts to support vulnerable populations are a major part of Governor Tom Wolf’s proposed $36.06 billion FY 2021 budget for Pennsylvania.

The proposed budget, presented to the state legislature earlier this week, includes the following new initiatives:

creating pathways to success in the workforce for low-income Pennsylvanians
increasing the minimum wage to $15
increasing Department of Human Services staffing to support licensing and oversight
supporting adults in long-term-care facilities
legal services for vulnerable populations
direct care worker comprehensive training
commitment to performance-based metrics, accountability, and transparency in services and licensing
supporting vulnerable populations through home- and community-based services and reducing waiting lists
prevention services to support at-risk families
improving food security while supporting agriculture

Go here to see DHS’s presentation of these initiatives.

In addition, the Safety-Net Association of Pennsylvania has prepared a detailed memo describing the proposed FY 2021 budget’s implications for Pennsylvania safety-net hospitals and the state’s Medicaid program. For a copy of this memo, use the “contact us” link in the upper right-hand corner of this page.

PA Safety Net Admin2020-02-07T06:00:38+00:00February 7th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2021 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

MA Bulletin Presents New PDL

Pennsylvania’s new Medicaid preferred drug list is presented in an October 10, 2019 state Medical Assistance Bulletin.

Bookshelf with law books The Department of Human Services bulletin outlines the purpose of the new PDL, provides background information, and describes how the PDL was developed and will work. In addition, it lists the past Medical Assistance Bulletins rendered obsolete by the new bulletin and describes the prior authorization procedures that will be employed when the new program takes effect on January 1, 2020.

Finally, the bulletin includes a comprehensive list of the prescription drugs on the new PDL.

See the October 10 PDL Medical Assistance Bulletin here.

PA Safety Net Admin2019-10-15T09:59:07+00:00October 15th, 2019|Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its September 2019 newsletter.

Included in this month’s edition are articles about:

changes in federal “public charge” regulations and their implications for immigrants who are currently enrolled in Medicaid or considering applying to participate in the program;
the right of participants in programs sponsored by the state’s Department of Drug and Alcohol Programs to continue receiving services while they appeal denials of services or reductions of services;
changes in the application process for state-paid home and community-based services; and
the continued implementation of the Community HealthChoices program of managed long-term services and supports for low-income seniors.

Go here for articles about these and other subjects.

PA Safety Net Admin2019-10-10T06:00:31+00:00October 10th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Senate to Take Up Medicaid Work Requirement

Undeterred by past defeats, members of PA’s state senate are again attempting to advance Medicaid work requirement legislation.

This time, the proposal to impose a Medicaid work requirement will add new flexibility to such a requirement, offering exemptions for individuals deemed “medically frail” and enabling individuals who do volunteer work, attend college, or who are actively looking for work to continue qualifying for Medicaid benefits.

Harrisburg, PA capital building The proposal will be considered by the Senate Health and Human Services Committee.

The legislature has passed two Medicaid work requirement bills in the past but Governor Tom Wolf has vetoed them.

Learn more about this latest effort to establish a Medicaid work requirement in Pennsylvania in the PA Post article “Wolf, Republicans resume tug-of-war over Medicaid work requirements.”

PA Safety Net Admin2019-09-17T06:00:13+00:00September 17th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

The Pennsylvania Department of Human Services has issued a new Medical Assistance Bulletin titled “Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans.”
According to the document,

The purpose of this Medical Assistance (MA) Bulletin is to remind hospitals of the requirements for the Hospital Uncompensated Care Program (Program) and reinforce the responsibility of hospitals to actively engage patients when determining eligibility for the Program.

See the entire Bulletin here.