PA Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the April edition of Health Law PA News, its monthly newsletter.
Included in this edition are articles about the status of Pennsylvania’s latest Medicaid expansion effort; an explanation of state policy for calculating applicants’ income for the purpose of determining whether they are eligible for Medicaid; health insurance options for immigrants; and more.
Find the latest edition of Health Law PA News here.

2015-05-12T06:00:12+00:00May 12th, 2015|HealthChoices PA, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Releases Monthly Newsletter

PA Moves to Streamline Medicaid Provider Enrollment

In response to the challenges the state has encountered processing Medicaid provider enrollment applications, the Pennsylvania Department of Human Services (DHS) has unveiled what it believes will be an improved approach to tackling this problem.
The improvements include electronic enrollment, standardization of policies and procedures, and additional provider enrollment staffing.
At the heart of the backlog are Affordable Care Act requirements.
Go here to see a message from DHS acting secretary Theodore Dallas on this subject.

2015-04-23T06:00:08+00:00April 23rd, 2015|Affordable Care Act, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Moves to Streamline Medicaid Provider Enrollment

Healthy Pennsylvania Medicaid Benefits Posted

Bookshelf with law booksThe Pennsylvania Department of Human Services has published materials describing Medicaid benefits under the state’s Healthy Pennsylvania Medicaid expansion.
A Medical Assistance Bulletin (#99-15-02) describing the “Interim Healthy Benefit Plan” can be found here and tables comparing the benefits packages under the “Healthy” (low risk), “Healthy Plus” (high risk), and Private Coverage Option plans (PCO) can be found here.

2015-01-22T06:00:53+00:00January 22nd, 2015|Healthy PA, Meetings and notices, Pennsylvania Medicaid laws and regulations|Comments Off on Healthy Pennsylvania Medicaid Benefits Posted

PA Officially Ends Enhanced Medicaid Payments

The Affordable Care Act-mandated increase in Medicaid payments for primary care services ends on December 31.
Bookshelf with law booksWhile some states believe this increase improved access to care for their Medicaid population and will continue the increase using their own money, Pennsylvania will not, and a new Medical Assistance Bulletin informs primary care providers in the state that the fee-for-service rates they are paid will return to their previous level on January 1.
See the Medical Assistance Bulletin notice here.

2014-12-29T06:00:31+00:00December 29th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Officially Ends Enhanced Medicaid Payments

PA Issues Bulletin Detailing Healthy PA Benefits

The benefits offered through Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion program are detailed in a new Medical Assistance Bulletin issued by the state’s Department of Human Services.
In addition to describing both the benefits and the processes the state will employ for seeking exceptions to the established benefits, the Bulletin includes several attachments:  a benefit plan comparison chart; automatic benefit limit exceptions for APR-DRG; automatic benefit limit exceptions for radiology and imaging; automatic benefit limit exceptions for laboratory services; automatic benefit limit exceptions for durable medical equipment; and automatic benefit limit exceptions for medical supplies.
The program, the benefits, and the new guidelines take effect on January 1.
Find this Medical Assistance Bulletin here.

2014-12-22T06:00:27+00:00December 22nd, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Issues Bulletin Detailing Healthy PA Benefits

Medicaid Directors Weigh in On Managed Care Regulation

The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs.
In a paper entitled “Medicaid Managed Care Modernization:  Advancing Quality Improvement,” the National Association of Medicaid Directors urges the Centers for Medicare Services (CMS) to work with the states to develop quality reporting measures that are both useful and not overly burdensome.
Bookshelf with law booksThe association also asks CMS to leave decisions about accrediting requirements for state Medicaid managed care programs in state hands and not to establish a national quality rating system for Medicaid managed care plans.
The regulation of Medicaid managed care plans is especially important to Pennsylvania safety-net hospitals because they care for so many Medicaid patients and managed care has become the primary means through which the state’s Medicaid program serves those patients.
Learn more about Medicaid directors’ recommendations for improving and regulating state Medicaid managed care programs in this National Association of Medicaid Directors correspondence with the Center for Medicaid and CHIP Services.
 

2014-10-27T06:00:19+00:00October 27th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Medicaid Directors Weigh in On Managed Care Regulation

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its September newsletter.  Included in this edition is a story on federal approval of Pennsylvania’s Medicaid expansion proposal, an FAQ on how the approved plan will work, and a chart detailing key differences between what the state proposed and what the federal government ultimately approved.
Find the newsletter here.

2014-10-07T06:00:17+00:00October 7th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest newsletter.
Among the articles are stories about the preservation of the state’s Medical Assistance for Workers with Disabilities Program (MAWD); new funding for home- and community-based services for people with disabilities; a clarification of Children’s Health Insurance Program (CHIP) benefits; and more.
Find the newsletter here.

2014-08-18T06:00:24+00:00August 18th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on New Pennsylvania Health Law Project Newsletter

PA Reverses “MAWD” Elimination

The Corbett administration has reversed an earlier decision and decided to retain Pennsylvania’s Medical Assistance for Workers With Disabilities program, frequently referred to as “MAWD.”
Pennsylvania State MapMAWD provides low-cost health insurance to Pennsylvanians with disabilities who do not otherwise qualify for Medical Assistance because they work and have earnings.
The program, which serves about 34,000 people, costs the state $7 million a year.  A Department of Public Welfare spokesman said preserving the program is consistent with the Corbett administration’s Healthy Pennsylvania initiative.
Learn more about MAWD here and about the decision to retain it in this Insurance Net News article.

2014-07-29T06:00:28+00:00July 29th, 2014|Healthy PA, Pennsylvania Medicaid laws and regulations|Comments Off on PA Reverses “MAWD” Elimination

Providers Must Re-enroll to Serve PA Medicaid Population

All health care providers that serve Pennsylvania’s Medicaid population must re-enroll with the state if they wish to continue doing so.
Pennsylvania State MapThe requirement, established under the Affordable Care Act, applies to providers that participate in both the state’s Medicaid managed care and fee-for-service programs.
Additional information can be found about the requirement and how to re-enroll in this Medical Assistance Bulletin notice.

2014-03-14T06:00:34+00:00March 14th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Providers Must Re-enroll to Serve PA Medicaid Population
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