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PA Health Policy Update for March 7

The following is an update of selected state health policy developments in Pennsylvania from March 3 – 7.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

  • The state House of Representatives and Senate concluded their hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.
  • The Department of Human Services (DHS) appeared before the House Appropriations Committee on Tuesday, March 4. A recording of that hearing is viewable here and here.
  • DHS also appeared before the Senate Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here and here.
  • The Pennsylvania Insurance Department and PENNIE appeared before the House Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here. 
  • The House Health Committee held an informational meeting on Monday, March 3 to examine the practice of community health workers. A recording of the meeting is viewable here.
  • The House Human Services Committee held a voting meeting on Wednesday, March 5 and favorably reported the bills below. A recording of the hearing is viewable here. 
  • House Bill 269, which requires the Department of Health, in consultation with the Department of Drug & Alcohol Programs, to develop opioid overdose public education materials. 
  • House Bill 640, which updates the annual reporting requirements for the Department of Drug & Alcohol Programs.
  • House Bill 749, which requires the Department of Human Services to conduct a study of Pennsylvania’s SNAP payment distribution. 
  • The Senate Democratic Policy Committee will hold a meeting on Monday, March 10 at 2:00 p.m. to discuss “health care accessibility and the impacts of hospital closures.” The meeting will be held at Neumann University in Aston, PA and virtually. Find additional details here. 
  • The House and Sente are currently recessed until Monday, March 17 and Monday, March 24, respectively, 

Department of Health 

  • The Department of Health (DOH) has announced the 2024-25 Patient Safety Surcharge (MCARE) letter and invoices for hospitals, ambulatory surgery centers, abortion facilities, and birthing centers have been emailed. Payment is due by June 1, 2025. If you have any questions, please call the Division of Acute and Ambulatory Care (DAAC) at 717-783-8980 or email RA-DAAC@pa.gov.
  • DOH has announced the Event Reporting System (ERS) has been updated with a new Flu A and separate Flu B, as well as RSV reporting enhancement to streamline the reporting of these event types. DOH has shared a Quick Start Guide (opens as a separate Microsoft Word document) for the new enhancement. This enhancement will function in the same manner as the COVID-19 enhancement initiated in March of 2021.

Department of Human Services

The Department of Human Services (DHS) has shared the following presentations utilized at the Medical Assistance Advisory Committee (MAAC) meeting on February 27.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in February, which was $44.0 million, or 1.6 percent, more than anticipated. Fiscal year-to-date General Fund collections total $27.0 billion, which is $104.3 million, or 0.4 percent, below estimate. 

Around the State  

WHYY has published an article about Prospect Medical Holdings’ plan to file a preliminary request to begin closing its remaining Delaware County hospitals. 

The Patriot-News has reported about potential for significant Medicaid cuts in Washington, D.C. and the concern that has raised in Pennsylvania with medical professionals and state legislators. 

Stakeholder Meetings

DOH – Health Policy Board – March 21

The Health Policy Board of the Department of Health will meet on Friday, March 21 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 25

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Tuesday, March 25 from 10:00 a.m. until 12:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

PA Health Policy Update for January 31

The following is an update of selected state health policy developments in Pennsylvania January 27 – 31.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro will deliver his Fiscal Year (FY) 2025-2026 budget address to a joint session of the Pennsylvania General Assembly on Tuesday, February 4. 

General AssemblyHarrisburg, PA capital building

The state House of Representatives and Senate convened for voting session in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.  

  • The Senate Health & Human Services Committee met on Monday, January 27 and favorably reported Senate Bills 155, 156, and 157, which are part of a package of bills aimed at eliminating waste, fraud, and abuse in public assistance programs.
  • The House Aging & Older Adult Services Committee convened for an informational meeting on direct care workers and the homecare industry. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, January 28 and favorably reported, among other bills, House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile.  A recording of the meeting is viewable here.
  • The House Human Services and Insurance Committees jointly convened on Wednesday, January 29 for an informational hearing on traumatic brain injury care needs and coverage options. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, January 29 and favorably reported House Bill 27, which requires health care facilities to adopt and implement policies to mitigate exposure to surgical smoke through the use of a smoke evacuation system for each procedure that generates surgical smoke, and House Bill 33, which implements greater oversight of medical marijuana labs and product testing. A recording of the hearing is viewable here.
  • The House Professional Licensure Committee met on Wednesday, January 29 and favorably reported House Bill 309, which enables team physicians traveling internationally with their club or national team to treat their team players on site during games without requiring a Pennsylvania medical license. A recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for session in Harrisburg again next week. The chambers will hold a joint session on Tuesday, February 4 for Governor Shapiro’s FY 2025-2026 budget address. 

Department of Human Services 

The Department of Human Services (DHS) has issued an updated PA Promise™ Provider Handbook for providers who submit claims via the 837 Professional format or the CMS-1500 Claim Form.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on January 23.

Health Department  

The Shapiro administration, including the Department of Health (DOH) and the Department of Drug & Alcohol Programs (DDAP), highlighted its $3.6 million investment to develop regional maternal health coalitions. Find more information in this press release. 

Around the State

  • The Philadelphia Inquirer has published an article about Governor Shapiro’s plan to again propose the legalization of recreational marijuana in his budget address next week as a strategy to address the state’s growing budget shortfall.  
  • WESA has reported about the potential for a significant increase in premiums for Pennsylvanians enrolled in Pennie, the state’s health insurance marketplace, if federal tax credits are allowed to expire in 2026. The average premium increase would be 81 percent.
  • Democratic lawmakers in Harrisburg introduced a package of bills this week seeking to codify protections provided by the Affordable Care Act (ACA) in Pennsylvania state law, as reported by the Pittsburgh Post-Gazette. 

Stakeholder Meetings

DOH – Organ Donation Advisory Committee – February 6

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 6 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – WIC State Advisory Board – February 11

The WIC State Advisory Board will hold its next regular meeting on February 11 from 11:00 a.m. to 12:00 p.m. This is a rescheduling of the board’s January 14 meeting, which was cancelled due to technical challenges. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – February 13

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, February 13 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – February 18

The Patient Safety Authority will hold a meeting of the Authority’s board on Tuesday, February 18 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-01-31T22:45:42+00:00January 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 31

PA Health Policy Update for October 4

The following is an update of selected state health policy developments in Pennsylvania from September 30 – October 4.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The House of Representatives passed House Bill 2295 and House Bill 2294, which allow a physician assistant to work with either an allopathic or osteopathic physician without having to obtain a license from both medical boards. The bills were subsequently received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Labor & Industry Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2548, which requires employers to provide paid sick leave. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Monday, September 30 for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care. A recording of the hearing is viewable here.
  • The House Insurance Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. A recording of the hearing is viewable here. The Insurance Committee also met on Tuesday, October 1 for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes. A recording of the hearing is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, October 1 and favorably reported, among other bills, Senate Bill 1303, which lowers the influenza vaccine offering from age 65 and older, down to age 50 and older. A recording of the hearing is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, October 1 and favorably reported the following bills.
    • House Bill 155, which allows two-way video calls to satisfy the face-to-face requirement for job interviews for direct care workers.
    • House Bill 1608, which requires coverage of doula services in the Medical Assistance program.
    • House Bill 2084, which establishes a license for virtual prescription drug manufacturers.
    • House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with information about postpartum depression and counseling resources.

A recording of the Senate Health & Human Services Committee is viewable here.

  • The House Health Committee met on Wednesday, October 2 and favorably reported the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

A recording of the Health Committee meeting is viewable here.

    • The Human Services Committee met on Wednesday, October 2 for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee held a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. A recording of the meetings is viewable here.

The state House of Representatives and Senate will convene again for voting session Monday, October 7 through Wednesday, October 9. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced a Request for Applications (RFA) seeking managed care organizations to administer services for the Children’s Health Insurance Program (CHIP) program. 
  • DHS has announced its intent to increase rates paid in its Behavioral HealthChoices program, which provides access to mental health, substance use disorder, and other behavioral health services for Medicaid recipients. Once approved by CMS, the new rates to the Behavioral HealthChoices Managed Care Organizations (MCOs) will be retroactive to July 1, 2024 for their current 2024 contract agreements. 
  • DHS announced an increase in the assessment fee that managed care organizations (MCOs) will pay per member per month as a means to generate federal matching funds to support the capitation payments. The increase, which becomes effective in January, is expected to generate an additional $223.531 million in assessment revenue for FY 2024-2025. 
  • DHS has shared the following presentations from the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee meeting on September 25.
  • The Independent Regulatory Review Commission (IRRC) approved the DHS Psychiatric Rehabilitation Services regulations that were first proposed in 2022. With this revision, the regulations expand eligibility for psychiatric rehabilitation services to include individuals 14 years of age or older but under 18 years of age and expand the diagnoses that allow individuals to access PRS without going through the exception process. Find more information in this Pennsylvania Bulletin notice. 

Department of Health 

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 772) regarding health care and long-term care facility preparedness for the 2024-2025 respiratory virus season.
  • DOH has issued a Health Advisory (PA-HAN 771) with information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo and prevention strategies for U.S. travelers visiting countries with an outbreak.
  • DOH has issued a Health Advisory (PA-HAN 770) announcing that has received adequate supplies of Benzathine Penicillin G (Bicillin L-A®) and is now lifting the restrictions for the administration of Bicillin L-A® for individuals who are diagnosed with or suspected of having syphilis. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued a licensing alert regarding DDAP’s implementation of the updated federal regulations for the certification of Opioid Treatment Programs (OTPs).

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate. 

Stakeholder Events

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.
  • DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20

PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

  • Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.
  • Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release. 

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA).  These changes are effective for dates of service on or after September 9, 2024.
  • DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.
  • DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Health Policy Update for July 26

The following is an update of selected state health policy developments in Pennsylvania from July 15 – 26.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

  • Governor Shapiro has signed several bills into law, including the following health care bills.
    • House Bill 1664 (Act 58 of 2024), which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card.
    • House Bill 1633 (Act 74 of 2024), which establishes restrictions on non-compete covenants for certain health care practitioners.
    • House Bill 1853 (Act 75 of 2024), which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys.
    • House Bill 1993 (Act 77 of 2024), which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients.
    • House Bill 2200 (Act 79 of 2024), which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts.
  • Governor Shapiro joined Insurance Commissioner Michael Humphreys, members of the General Assembly, and local pharmacists in Lawrence County this week to tout the recent enactment of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs). Read more in this press release.
  • The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.  

General Assembly 

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through August 2024. Find the updated calendar here.
  • DHS has issued Provider Quick Tip #85 with eligibility and enrollment information for the Breast & Cervical Cancer Prevention & Treatment (BCCPT) program, which provides eligible individuals treatment for confirmed cases of breast and cervical cancer or precancerous conditions of the breast or cervix. 

Department of Health 

The Department of Health (DOH) has reminded providers who operate mobile clinics to complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services. 

Department of Drug & Alcohol Programs  

The Department of Drug & Alcohol Programs (DDAP) has issued a Licensing Alert to notify licensed treatment facilities and recovery houses of the new process for submitting licensing regulation exceptions and facility requests to DDAP. 

Around the State 

  • The Citizen’s Voice has published an article about Pennsylvania’s Cancer Drug Repository Program and barriers to its utilization.
  • The Patriot-News has written an article about President Joe Biden’s decision to withdraw from the U.S. presidential race and what it means for Governor Shapiro.
  • Governor Shapiro’s signing of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs), and its potential impact on local pharmacies and patients was featured in an article published by the Times Leader.
  • The Pittsburgh Business Times has published an article about the challenges confronting rural health care and efforts to find solutions.

PA Health Policy Update for July 12

The following is an update of selected state health policy developments in Pennsylvania from July 8 – 12.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.
  • The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration. 

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024. 

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee. 

Centers for Medicare and Medicaid Services 

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics.  In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas.  For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking. 

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Health Policy Update for May 24

The following is an update of selected state health policy developments in Pennsylvania from May 20 – 24.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives returned to Harrisburg this week for voting session. Following is a selection of health care-related legislative activity that occurred.

  • The House passed Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board, on final consideration by a vote of 119-83. The bill will now be sent to the governor’s desk.
  • The House passed House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service, by a vote of 154-48. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana, by a vote of 196-6. The bill will now be sent to the Senate for consideration.
  • The House Health Committee convened on Tuesday, May 21 and favorably reported, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Wednesday, May 22 for an informational hearing on the Living Independence for the Elderly (LIFE) program. A recording of the hearing is viewable here.

The state House and Senate are both recessed until Monday, June 3.

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding and end-dating procedure codes as a result of the 2024 updates published by CMS to the Healthcare Common Procedure Coding System (HCPCS). These changes are effective for dates of service on and after May 28, 2024.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June 2024. Find the updated calendar here.
  • The Office of Long-Term Living (OLTL) has communicated to personal care homes and assisted living residences that unlicensed staff persons may not administer Glucagon-like peptide (GLP)-1 agonist medications, such as Ozempic (Semaglutide) and Trulicity (Dulaglutide) via subcutaneous injection unless they seek a regulatory waiver and submit it to ra-pwarlheadquarters@pa.gov. 

Department of Health 

  • The Department of Health (DOH) has announced it is extending the temporary scheduling of any material, compound, mixture or preparation which contains any quantity of Nitazene substances for an additional year. Find additional information in this Pennsylvania Bulletin notice. 
  • DOH has issued a Health Advisory (PA-HAN 749) with Influenza A/H5N1, a highly pathogenic avian influenza (HPAI) virus, guidance for health care providers.
  • DOH also issued a Health Advisory (PA-HAN 750)  alerting healthcare providers of an increase in meningococcal disease, linked to Umrah travel to the Kingdom of Saudi Arabia. 

Health Insurance Exchange Authority 

The Pennsylvania Health Insurance Exchange Authority, which is the state-affiliated entity that operates the commonwealth’s state-based health insurance marketplace, has issued a proposed regulation that would require insurers selling qualified plans through the Exchange Authority to be accredited in health equity. 

Around the State   

  • PennLive has published an article about legislative efforts to require state-regulated commercial insurers to cover blood pressure monitors when necessary during pregnancy and for up to a year after delivery. 
  • The Philadelphia Inquirer has reported about an effort to subpoena Philadelphia mayor Cherelle Parker’s administration regarding its plans to expand addiction treatment services in the city. 
  • An article published by PennLive highlights the Shapiro administration’s efforts to seek a Medicaid 1115 waiver to provider continuous Medicaid coverage for children from birth through age six.
2024-06-03T17:42:15+00:00May 24th, 2024|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for May 24

PA Health Policy Update for May 17

The following is an update of selected state health policy developments in Pennsylvania from May 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

  • The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
  • The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024. 

Department of Health 

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page. 

State Board of Medicine 

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice 

State Board of Osteopathic Medicine 

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.
  • City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.
  • The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120. 

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

PA Health Policy Update for May 10

The following is an update of selected state health policy developments in Pennsylvania from May 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed Senate Bill 739 by a vote of 47-1. Senate Bill 739, which was amended before final passage, provides for coverage of telemedicine services. The bill will now be sent to the House for consideration.
  • The Senate unanimously passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system. The bill will now be sent to the House for consideration.
  • The House passed House Bill 1632, which amends the Workers’ Compensation Act to recognize post-traumatic stress injuries as eligible for workers’ compensation claims, by a vote of 154-46. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries, by a vote of 164-37. The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, May 6 and favorably reported, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.
    • House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange.

A recording of the meeting is viewable here.

  • The House Labor & Industry Committee met on Tuesday, May 7 and favorably reported House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee held an informational meeting on the nursing workforce crisis. A recording of both meetings is viewable here.

The state House of Representatives and Senate are now recessed. The House will return to session Monday, May 20 and the Senate will return Monday, June 3.

Department of Human Services 

The Department of Human Services (DHS) has announced its intent to increase the funding for a class of supplemental payments to qualifying hospitals for Fiscal Year (FY) 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional information in this Pennsylvania Bulletin notice. 

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on April 25.

Department of Health 

The Department of Health (DOH) has announced it will hold a public hearing on its proposed Preventive Health and Health Services Block Grant application for Federal Fiscal Year 2024. The hearing will take place on May 28 from 10:00 – 11:00 a.m. Find additional details on how to attend and comment in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Pharmacy’s proposed pharmacy technician registration regulations. Find additional information and IRRC’s comments in this Pennsylvania Bulletin notice 

Around the State 

  • The Pennsylvania Capital-Star has reported about legislation that would cover post-traumatic stress injuries for first responders under the state’s Workers’ Compensation Act.
  • Governor Shapiro has indicated he will sign legislation criminalizing the misuse of xylazine, which is contributing to a growing number of overdose deaths, according to a Philadelphia Inquirer article. 
  • PennLive has published an article about House Democrats’ efforts to pass legislation that would enact a key part of Governor Shapiro’s budget proposal to provide assistance to individuals purchasing insurance of the commonwealth’s state-based insurance exchange, Pennie.

Stakeholder Events 

PA Chamber – Healthcare Summit – May 22

The Pennsylvania Chamber of Business and Industry is holding its inaugural health care summit on Wednesday, May 22. The event will feature conversations about leading health care topics, including innovations in pharmaceuticals, workforce development, the medical malpractice landscape, and the role of AI in health care. To view additional details and register click here 

DOH – Preventive Health and Health Services Block Grant Committee – May 28

The Preventive Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, May 28 from 2:00 – 4:00 p.m. The purpose of the meeting is to present the Federal Fiscal Year 2024 workplan and budget information. The meeting will be held virtually and in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

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