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 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.
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
.
Primary Docs Can Get Medicaid Pay Raise
The Affordable Care Act calls for selected primary care providers to receive an increase in their Medicaid fees during calendar years 2013 and 2014.
The pay raise, which seeks to bring Medicaid fees to the same level as Medicare rates, is intended to induce more primary care providers to serve Medicaid patients in anticipation of the increase in Medicaid enrollment expected when the Affordable Care Act takes full effect.
Eligible providers must complete a form attesting to their eligibility for the pay raise and the Pennsylvania Department of Public Welfare has issued the form and instructions for completing it. Find both the form and the instructions here
.
DPW Announces Revisions of Medicaid Fee Schedule
The Pennsylvania Department of Public Welfare (DPW) has published a notice of its intention to implement changes in the Medicaid fee schedule and to update selected prior authorization requirements.
Those notices are published here, in the June 22 edition of the Pennsylvania Bulletin, and the changes took effect on June 24.
DPW also published a Medical Assistance Bulletin on the procedure code updates and a table showing the updates. Find the bulletin here and the table here.
PA Announces Plans for Increased Medicaid Fees
The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014. The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act.
A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here.
The revised fee schedule with the new, higher fees can be found here.
DPW Establishes Exceptions to Monthly Prescription Limit
Since January of last year, Pennsylvania’s Medical Assistance program has limited categorically needy adult recipients over the age of 21 to six prescriptions a month.
While Medical Assistance has established a process for seeking exceptions to this limit, the Department of Public Welfare has now published a new MA Bulletin that lists exceptions that will automatically be granted.
Find that list in this
MA Bulletin.
Medicaid Expansion Would Boost PA’s Economy and Save Money, New Report Says
Expanding Medicaid eligibility as envisioned in the Affordable Care Act would boost the state’s economy and save state government money, according to a new study.
In the report “Economic and Fiscal Impact of Medicaid Expansion in Pennsylvania,” the Pennsylvania Economy League and the PA Health Funders Collaborative concluded that Medicaid expansion in the state would generate $4.4 billion in state government savings, bring $32 billion of new federal government money into the state’s economy, support as many as 40,000 new jobs and $3.6 billion in new tax revenue, and have a positive fiscal impact of more than $5 billion.
The Safety-Net Association of Pennsylvania supports Medicaid expansion in the state.
Read the entire report here, on the web site of the Pennsylvania Economy League.
DPW Updates Fee Schedule
The Pennsylvania Department of Public Welfare (DPW) has updated its Medical Assistance fee-for-service fee schedule for a variety of physician services, podiatrist services, surgical services, and more.
See a complete list of changes here, in the Pennsylvania Bulletin.
DPW Publishes DSH Notice
The Pennsylvania Department of Public Welfare has published a notice detailing its final allocations for FY 2013 for Medicaid disproportionate share hospital payments (Medicaid DSH) for OB/neonatal intensive care services, trauma services, burn centers, academic medical centers, critical access hospitals, and selected other limited groups of providers.
Read the Pennsylvania Bulletin notice here.