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to work closely with the relevant standing committees in the House to review which regulations should be permanently repealed or reformed.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.

 

 

COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logoThe 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.

 

 

 

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.

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 booksThe 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 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.

2019-10-10T06:00:31+00:00October 10th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter

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 buildingThe 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.”

 

2019-09-17T06:00:13+00:00September 17th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Senate to Take Up Medicaid Work Requirement

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.
 

2018-01-08T06:00:47+00:00January 8th, 2018|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

Wolf Vetoes Medicaid Work Requirement

Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work.

 Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.

2017-10-23T10:00:53+00:00October 23rd, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Wolf Vetoes Medicaid Work Requirement

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May newsletter.

 Included in this edition are articles on new criteria for Medicaid coverage of high-cost hepatitis C drugs and the release of a draft of the state’s proposed Medicaid quality strategy; an update on Community HealthChoices, Pennsylvania’s new program of Medicaid managed long-term services and supports; an overview of Medicaid-covered behavioral health services; a summary of recent federal proposals with implications for the state’s Medicaid program; and a report on the nomination of Teresa Miller to lead the new Department of Health and Human Services that Governor Wolf has proposed establishing.

 Find the newsletter here.

2017-06-02T06:00:28+00:00June 2nd, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2017 newsletter.
Included in this edition are stories about:

  • the potential implications of turning Medicaid into a block grant program
  • the governor’s proposed FY 2018 budget
  • a new federal requirement that hospitals must inform Medicare patients if they are designated as hospitalized under “observation status”
  • counseling services available through PA LINKs

Find the latest edition of PA Health Law News here.

2017-03-02T12:21:18+00:00March 2nd, 2017|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget|Comments Off on Pennsylvania Health Law Project Newsletter
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