The Pennsylvania Department of Public Welfare has released changes in the state’s Medical Assistance fee-for-service fee schedule.
The changes, which took effect September 1, can be found in this Medical Assistance Bulletin notice
.
Medicaid improves access to care and saves lives and deserves to be expanded in the manner envisioned in the Affordable Care Act, according to a new blog entry on the web site of the health care-focused Commonwealth Fund.
According to the blog commentary, Medicaid “fulfills the two main purposes of health insurance – ensuring access to needed care and providing adequate financial protection from burdensome medical expenses.” It also cites research that “confirms that expanding Medicaid not only improves access to care and financial protection of vulnerable individuals and families, but actually saves lives.”
In addition, the blog suggests that Medicaid recipients have only slightly greater cost-related access-to-care problems than individuals with private insurance.
The Safety-Net Association of Pennsylvania (SNAP) and the state’s private safety-net hospitals have eagerly anticipated the expansion of Medicaid eligibility mandated by the Affordable Care Act. In the wake of the Supreme Court decision ruling the expansion mandate unconstitutional, these safety-net hospitals now await for Governor Corbett’s decision on whether Pennsylvania will move ahead with that Medicaid expansion.
The title of this commentary is “Medicaid Works: Public Program Continues to Provide Access to Care and Financial Protection for Society’s Most Vulnerable,” and it can be found here
, on the Commonwealth Fund’s web site.
The Department of Public Welfare (DPW) has issued a number of new bulletins governing Pennsylvania’s Medical Assistance program.
These new regulations include an amendment to the state’s Medicaid plan for children with disabilities; the process for prior authorization of pituitary suppressive drugs; the process for prior authorization of erythropoiesis stimulating protein; the process for prior authorization of benign prostatic hyperplasia treatments; the process for prior authorization of antibiotics (GI); and the process for the prior authorization of platelet aggregation inhibitors.
In addition, DPW formally announced the expansion of HealthChoices
to 13 counties in western Pennsylvania and the termination of ACCESS Plus in those counties effective October 1 and its intention to publish in the near future a new bulletin adding growth factors to the Medical Assistance program’s list of items requiring prior authorization.
The Pennsylvania Department of Public Welfare (DPW) has released its annual list of inpatient hospitals that qualify for Medical Assistance disproportionate share (DSH) payments, including the DSH percentages for acute-care general hospitals, psychiatric units of inpatient hospitals, drug and alcohol units of inpatient hospitals, medical rehab units of inpatient hospitals, freestanding rehab hospitals, private psychiatric hospitals, and private drug and alcohol hospitals.
Find the list and the corresponding DSH percentages in this Pennsylvania Bulletin notice.
The Pennsylvania Department of Public Welfare (DPW) has issued a new Medical Assistance Bulletin updating its procedures for seeking prior authorization for opiate dependence treatment.
The new bulletin, which can be found here, applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services through the Medical Assistance fee-for-service program.
An update of the Medical Assistance handbook for prior authorization of these services can be found here
.
The new policy takes effect on September 10.
The Pennsylvania Department of Public Welfare has issued a new Medical Assistance Bulletin updating the state’s preferred drug list. This bulletin applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services in the fee-for-service delivery system. The new bulletin can be found here.
Another document, an update of the Medical Assistance prior authorization handbook for pharmaceutical services, can be found here.
The new policies take effect August 13.
Pennsylvania has reduced its Medicaid dental benefits to basic services – mostly, cleanings, fillings, and extractions.
It has eliminated root canal and periodontal procedures and limits dentures. The changes are expected to save $42 million this year.
Most states do not pay for any dental care.
Read more about the changes in Pennsylvania’s Medicaid dental benefits and their impact on beneficiaries here.
Low-income and disabled Pennsylvanians who lost General Assistance payments when the state ended the cash assistance aspect of that program may still receive Medical Assistance but face a new process for applying for eligibility.
The current, one-page application form that was completed by providers has been expanded to a longer, more detailed form that seeks more information about the medical condition of the applicant.
Read more about the changes in the state program and the changes providers now face in this Philadelphia Inquirer article.
The new state budget passed in Harrisburg last weekend restored cuts to key payments to Pennsylvania’s safety-net hospitals.
Although the budget proposed by Governor Corbett in February called for a four percent cut in fee-for-service hospital base rate payments, that cut was restored – as were mid-year cuts to OB/NICU, burn center, and trauma center payments, which were restored to their FY 2012 enacted levels.
In addition, the budget increased payments to critical access hospitals and restored payments to academic medical centers and physician practice plans.
The budget also restored funding for separate fee-for-service payments for normal newborn care, thereby rescinding at least for FY 2013 an expedited regulation promulgated by the Department of Public Welfare that would have eliminated payments for such services.
For further information about Pennsylvania’s FY 2013 Medical Assistance budget and its implications for Pennsylvania’s safety-net hospitals, please contact Michael Chirieleison, SNAP’s president, at 717-234-6970 or mike@debrunner.us.
The Department of Public Welfare (DPW) has announced changes in the Medical Assistance fee schedule and prior authorization requirements. To read a notice describing these changes and find a list of affected procedure codes, see this notice in the Pennsylvania Bulletin.