Pennsylvania Medicaid laws and regulations Archives - Page 6 of 10

PA Officially Ends Enhanced Medicaid Payments

The Affordable Care Act-mandated increase in Medicaid payments for primary care services ends on December 31.
While 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.

PA Safety Net Admin2014-12-29T06:00:31+00:00December 29th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2014-12-22T06:00:27+00:00December 22nd, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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.
The 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.

PA Safety Net Admin2014-10-27T06:00:19+00:00October 27th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2014-10-07T06:00:17+00:00October 7th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2014-08-18T06:00:24+00:00August 18th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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.”
MAWD 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.

PA Safety Net Admin2014-07-29T06:00:28+00:00July 29th, 2014|Healthy PA, Pennsylvania Medicaid laws and regulations|Comments Off

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.
The 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.

PA Safety Net Admin2014-03-14T06:00:34+00:00March 14th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Changes in Medicaid Fee Schedule

The Pennsylvania Department of Public Welfare has announced changes in its Medical Assistance fee schedule. Those changes, published in the January 18 edition of the Pennsylvania Bulletin, can be found here.

PA Safety Net Admin2014-01-21T06:00:39+00:00January 21st, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Seeks Federal OK for Medicaid Expansion

The Corbett administration is asking the federal government to authorize the expansion of the state’s Medicaid program to serve another 500,000 people.
Healthy Pennsylvania, the reform plan unveiled by the Corbett administration in September, calls for expanding eligibility for Medicaid as envisioned in the federal Affordable Care Act but providing coverage to newly eligible individuals through private insurers
Under the plan, most newly eligible recipients would select state-subsidized insurance through the federal health insurance marketplace and receive the same benefits as regular commercial customers.
Healthy Pennsylvania also calls for streamlined benefits packages, enrollee premiums, and a work search requirement.
The formal unveiling of the plan is linked to the state’s application to the federal government for a waiver from selected federal Medicaid requirements. While states routinely request such waivers, each waiver is subject to individual scrutiny and negotiation between the state and federal governments after a period of public comment at the state level.
To learn more about the Healthy Pennsylvania proposal, see this Philadelphia Inquirer article. The administration also has published a description of its proposed application for the federal waiver, including information about how interested parties may comment on the proposal, in the Pennsylvania Bulletin; that notice can be found here. The complete draft waiver application can be found here.

PA Safety Net Admin2013-12-06T10:48:35+00:00December 6th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Uncategorized|Comments Off

SNAP Comments on Observation Rate Proposal

The Safety-Net Association of Pennsylvania has submitted a formal comment letter to the state’s Department of Public Welfare in response to the department’s expressed interest in establishing an observation rate in the state’s Medical Assistance fee-for-service program.
DPW expressed this interest in a June 29 Pennsylvania Bulletin notice.
SNAP supports the creation of an observation rate, and in its letter it outlines how it believes DPW should go about developing a rate that is fair to hospitals.
Safety-net hospitals have a special interest in this issue because observation rate candidates enter hospitals through their emergency rooms and safety-net hospitals typically have among the busiest emergency rooms in the communities they serve.
Read SNAP’s observation rate comment letter here .

PA Safety Net Admin2013-07-23T16:12:30+00:00July 23rd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

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