Pennsylvania Medicaid policy Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for October 24

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

Budget Update

Earlier this week, the Senate passed Senate Bill 160 (PN 1258) by party line vote in yet another volleying of a General Appropriations Act bill to the House. The Senate’s amendments to the bill reduced the overall spend number to $47.9 billion, down from the House’s last proposal of $50.25 billion.

The bill reflects a prior version (PN 529) of the budget bill but with increased appropriations for debt service payments and school employees’ pensions, while also reducing operating expense line items for the General Assembly. The Governor labeled the Senate’s most recent effort as “unserious.”

As the impasse continues, meaningful impacts to Pennsylvanians and providers are becoming more frequent. Absent budget enactment, Head Start providers are signaling closures, Westmoreland County plans to furlough workers soon, and Lancaster County intends to pause social services payments.

The House and Senate are both set to return on October 27^th.

General Assembly

Last week, the Senate was in session and passed by a margin of 49-1, Sen. Rosemary Brown’s SB 507, legislation to update and modernize midwifery services in Pennsylvania. The bill will be considered by the House Professional Licensure Committee on October 28^th.

The Senate Labor & Industry Committee voted in support of SB 69 offered by Sen. Langerholc by a party line vote. This bill would create a “Recovery-to-Work” pilot program.

Next week, on October 28^th, the House Health Committee will hold an informational meeting on the Department of Health’s Newborn Screening program.

On October 29^th, the House Human Services Committee will meet to consider Rep. Benham’s HB 1939, and House Bill 1974 by Rep. Venkat. HB 1939 would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee will meet on October 29^th to vote on HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

On October 27^th, the Senate State Government Committee will consider SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

Marla Brown introduced HB 1962 which would cease state funding for any provider offering abortion services in PA.
HB 1965, introduced by Rep. Ryan Bizzarro, would allow EMS providers to perform community paramedicine services.
Paul Takac introduced HB 1980 which would require doctors to do an hour of medical nutrition continuing education every two years.
Mastriano introduced SB 1018 which would eliminate any mRNA vaccine mandates in Pennsylvania.
SB 1041 by Sen. Rosemary Brown would create the Complex Care Assistant Program, creating a certification program for family caregivers offering complex medical care to loved ones.
Senator Tartaglione introduced SB 1054 which would require the availability of opioid antagonists in Pennsylvania public schools.
Senator Collett has introduced SB 1055, companion legislation to HB 1881, which would expand pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines.

Department of Human Services

The Department of Human Services released September’s Physical Health Managed Care enrollment report.

Department of Health

In response to revised CMS guidance on conducting facility surveys during the federal shutdown, which will allow states to request approval from CMS to conduct revisit surveys, DOH notified providers that it will be reviewing outstanding surveys, their timelines, and the deficient practice(s) to request permission from CMS to perform revisit surveys that are necessary to prevent termination or the denial of payment for new admissions.

DOH updated the Resident Data Reporting Manual for long-term care facilities to reflect changes to use the Patient Driven Payment Model (PDPM) for the Pennsylvania case mix payment system.

Stakeholder Meetings

On Nov. 7 from 10am to 3pm, the Brain Injury Advisory Board will hold their quarterly meeting to discuss the Department of Health’s Head Injury Program.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-24T19:20:42+00:00October 24th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 17

The following is an update of selected state health policy developments in Pennsylvania from October 14- October 17 (Some of the language used below is taken directly from state documents).

Budget Update

The budget process has remained at a stalemate this week with no changes following House action last week. The Senate is scheduled to return this upcoming week. The House is set to return on October 27^th.

General Assembly

Rep. Melissa Shusterman introduced HB 2005, which would remove the counseling and waiting period requirements for abortions in Pennsylvania. This legislation along with several other abortion-related bills will be considered by the House Judiciary Committee on October 22^nd.

The Senate Labor & Industry Committee will convene on October 22^nd to consider Sen. Wayne Langerholc’s SB 69, which would create a “Recovery-To-Work” pilot program.

Rep. Jessica Benham introduced HB 1939, which would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index.

Senator Michele Brooks introduced SB 1043 and SB 1051, both designed to strengthen Pennsylvania’s eligibility for new federal Rural Health Transformation Fund dollars. The funding application offers states additional points in their total application score if they have adopted certain policy priorities of the Trump Administration or introduced legislation to do so. SB 1043 would require nutrition continuing medical education (CME) for clinicians to ensure providers are better equipped to address diet-related chronic disease. SB 1051 would require PA to join the Physician Assistant Licensure Compact to expand our rural workforce by making it easier for PAs from other states to practice in Pennsylvania.

Sen. Brooks also introduced SR174, which would urge Congress to establish a national database or system to share wage, employment, unemployment compensation and other relevant eligibility data with the states to improve compliance with the recent eligibility verification changes in the federal HR1.

Senator Tina Tartaglione introduced SB 1054, which would require all high schools in Pennsylvania to maintain opioid antagonists, such as naloxone or Narcan, onsite.

Department of Human Services

The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) issued a request for proposals from non-profit organizations interested in expanding the Fairweather Lodge (FWL) model in the commonwealth. The FWL model is a structured, community-based program that supports individuals with serious mental illness reintegrate themselves into the community after facing homelessness or transitioning from state hospitals, correctional facilities, or long-term care settings. FWL providers offer emotional support, a place to live, and employment. OMHSAS is interested in establishing two to five new lodges that would serve up to 18 individuals. Find details and application materials here.

DHS issued Remittance Advice guidance for providers that do not receive a check or Remittance Advice (RA) within established time frames for each RA cycle.

DHS proposed rulemaking on minimum standards for the issuance of licenses to provide emergency behavioral health crisis intervention services in alignment with national best practices for crisis services. This proposed rulemaking also establishes new requirements related to service modalities including facility requirements, quality monitoring, staffing qualifications, services provided and training.

Department of Health

DOH issued a request for proposals from eligible community-based health care clinics (CBHCs) to fund the development of new CBHCs or the expansion of existing clinics to enhance maternity and postpartum care, hospital partnerships, or alternative care delivery systems. The deadline for applications is November 17. Find the RFP with more details and budgeting materials here.

Pennsylvania Insurance Department

PID announced the releasing of the final Affordable Care Act (ACA) health insurance rates for 2026, which reflect significant price increases for Pennsylvanians if Congress fails to extend enhanced premium tax credits (EPTCs).

Department of Aging

The Department of Aging (PDA) announced a new tool for screening in-home care workers to increase hiring transparency and protect older adults.

PDA reminded older Pennsylvanians that Medicare Open Enrollment begins October 15, with free insurance counseling available through Local Aging Agencies.

Stakeholder Meetings

DHS is hosting its next Medical Assistance Consumer Subcommittee meeting on October 22, 2025, at 1:00 pm. Interested attendees can register here. The full MAAC will meet at 10 a.m. on October 23^rdin the Keystone Building, Harrisburg.

DHS and the Treasury Department are partnering on a webinar on a PA Achieving a Better Life Experience (ABLE) Savings Program for OLTL Service Coordinators, Direct Service Providers, MCO Staff, and anyone working in employment support services. The webinar is scheduled for October 29^th from Noon to 1pm. Individuals can register here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-17T19:25:43+00:00October 17th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 3

The following is an update of selected state health policy developments in Pennsylvania from September 29- October 3 (Some of the language used below is taken directly from state documents).

Budget Update

As the state budget impasse continues on, with added pressure of a federal shutdown, this week the House positioned a budget bill, SB 160, into the House Appropriations Committee for future potential action. Additionally, the House amended HB 1331, Capital Debt Itemization legislation, with additional capital projects for future consideration.

General Assembly

Both the House and Senate will return for voting session beginning on Monday, October 6^th, the first time both chambers will be in voting session together since June. For the week ahead, the following hearings and voting meetings are scheduled:

On Monday, the House Aging & Older Adult Services Committee will hold a voting meeting on Chairwoman Maureen Madden and Chairman Steve Mentzer’s HB 1894, legislation which would enhance educational efforts for the LIFE program during the Medicaid long-term care enrollment process. The committee will also consider HB 1528, Grandfamilies Assistance legislation to benefit grandparents raising grandchildren.

On Tuesday, the House Insurance Committee will meet to consider HB 1828 which would set into law the Governor’s recent actions requiring private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACOP), or the American Academy of Family Physicians (AAFP) according to their immunization schedules. The committee will also consider HB 1123, updating the recommended age for insurance coverage of colorectal cancer screenings from 50 to 45.

On Wednesday, the House Professional Licensure Committee will consider adding a pharmacy technician and a second acute care institutional pharmacist to the State Board of Pharmacy through HB 980. Also, the committee will also consider HB 1881 which would guarantee that Pennsylvania pharmacists’ vaccination practice authority can be guided by recommendations from Pennsylvania’s health authorities that may be informed by our state’s professional medical societies.

Below are some health care-related legislation introduced or co-sponsorship memos circulated this week:

Rep. Marla Brown circulated a co-sponsor memo for legislation to remove staffing ratios for nursing homes in Pennsylvania.

Sen. Judy Ward released a co-sponsor memo on legislation to address lags in MA enrollment in long-term care.

Sen. Cris Dush filed SB 125 proposing a Constitutional Amendment giving the General Assembly the authority to establish laws on venues for civil litigation in the Commonwealth as a way to address venue shopping in malpractice cases.

Department of Human Services

The Department of Human Services (DHS) has shared an update for Community Service Support Provider fee-for-service rates for the start of the new federal fiscal year.

Department of Health

The Department of Health (DOH) issued a health alert with recommendations for health care providers to take in preparation for the 2025-2026 Respiratory Season, including details on reporting requirements. The Department also updated its Respiratory Virus Outbreak Toolkit, which gives recommendations to long-term care facilities on how to prepare for and respond to outbreaks of influenza, RSV, COVID-19, adenovirus, and more.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) approved final regulations from the State Board of Nursing making additions to the continuing education requirements for certified registered nurse practitioners (CRNP) and registered nurses (RN) in the areas of opioid prescriptions and organ donation.

Around the State

On Thursday, Governor Shapiro signed an Executive Order at the Children’s Hospital at Philadelphia directing the Department of Health to develop a plan to preserve access for children in the Vaccines for Children program without cost sharing if future Advisory Committee on Immunization Practices (ACIP) changes impact access, aligning vaccine guidance with American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Pediatrics (AAP), creating a website for vaccine information and guidance, ensuring insurance coverage without prior authorizations or cost sharing, among other points.

Stakeholder Meetings

DHS will hold their scheduled MAAC meeting on October 23, 2025, at 10am. Prior Authorization Guideline briefing documents are linked here (downloaded as zip file) for review and public comments are due as indicated on each document.

DOH announced upcoming meetings of several of its advisory committees:

Organ Donation Advisory Committee – November 6

Renal Disease Advisory Committee – October 24

Special Pharmaceutical Benefits Program Advisory Council – October 23

PA Safety Net Admin2025-10-03T21:07:51+00:00October 3rd, 2025|Governments, Medical Assistance Advisory Committee, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for July 25

The following is an update of selected state health policy developments in Pennsylvania from July 21 – July 25. (Some of the language used below is taken directly from state documents).

Fiscal Year 2025-26 Budget Update

Governor Shapiro and legislative leaders continue to negotiate a final Fiscal Year (FY) 2025-26 budget agreement. The state House of Representatives and Senate are currently in recess pending a final budget agreement.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has informed states, including Pennsylvania, that it “does not anticipate approving new state proposals of section 1115 demonstration expenditure authority that allow for expanded continuous eligibility or extending existing section 1115 demonstration authority for expanded continuous eligibility, beyond what is required or available under the Medicaid or CHIP statutes.” This will likely prevent Pennsylvania from implementing continuous eligibility for children on Medicaid until the age of six and 12 months of Medicaid coverage to individuals leaving state correctional facilities.

Department of Human Services

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of June 2025.

DHS has announced that the Human Services Provider Directory has moved to a new web address. The new address is https://www.humanservices.dhs.pa.gov/human_service_provider_directory/.

Department of Health

The Department of Health (DOH) has announced the launch of seven new training opportunities to assist health care providers reduce overdose risk and improve patient outcomes. Training is available online and in-person at no cost and includes continuing education credits for health care providers. Find additional information in this press release.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of its Cardiac Procedures Report, which includes results for six cardiac procedures performed in Pennsylvania acute care hospitals from January 1, 2022 through December 31, 2023. This report displays hospital-specific ratings for in-hospital mortality, readmissions, extended postoperative length of stay, volume of cases, and average hospital charges.

Board of Dentistry

The State Board of Dentistry has published final form rulemaking to implement licensure by endorsement for dentists. The rulemaking is effective upon its publication in the Pennsylvania Bulletin. Find the final rulemaking here.

Board of Examiners in Speech-Language Pathology and Audiology

The State Board of Examiners in Speech-Language Pathology and Audiology has published final form rulemaking to implement licensure by endorsement. The rulemaking is effective upon its publication in the Pennsylvania Bulletin. Find the final rulemaking here.

Around the State

Spotlight PA has published a piece on the closure of pharmacies across Pennsylvania and the broken payment system that’s being blamed for their closure.

Pennsylvania’s ongoing budget impasse and the impact it will potentially have on schools, county governments, and mass transit was the focus of an article published by The Philadelphia Inquirer.

PennLive has written an article about the potential for additional rural hospital closures due to the federal changes in H.R. 1 that will impact Medicaid funding for hospitals.

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – August 6

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on August 6 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Organ Donation Advisory Committee – August 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-07-25T19:33:08+00:00July 25th, 2025|Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for July 3

The following is an update of selected state health policy developments in Pennsylvania from June 30 – July 3. (Some of the language used below is taken directly from state documents).

Fiscal Year 2025-26 Budget Update

Governor Shapiro and legislative leaders have yet to reach a final agreement on the commonwealth’s Fiscal Year (FY) 2025-26 spending plan. In a statement released by Senate Republican leadership, they indicated they’ll continue to “work with all parties to reach a final agreement.” Governor Shapiro and House Democratic leadership have indicated an agreement may be possible in the coming weeks. Presently, the Senate is recessed until the call of the chair and the House is scheduled to return to Harrisburg on Monday, July 7.

Governor Shapiro

Governor Shapiro has signed into law House Bill 640, which is now known as Act 14 of 2025. Act 14 updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP) and eliminates the sunset date of the state’s provider assessments in anticipation of certain changes to provider assessments being contemplated by the U.S. Congress.

Governor Shapiro has signed Senate Bill 411 into law. Act 24 of 2025, as it’s now known, provides the ability for the Pennsylvania Department of Health to create and utilize a stroke registry.

The Shapiro administration has released a document with estimates regarding how many Pennsylvanians may lose Medicaid and SNAP benefits as a result of the reconciliation package being considered by the U.S. Congress.

General Assembly

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

The Senate voted to concur with the House amendments to Senate Bill 95, which permits EMS providers to leave naloxone with a caregiver of a patient who overdosed. The bill also places certain disclosure requirements on pharmacies related to the retail and generic versions of prescribed medications and allows for the provisional licensing of pharmacists. The bill has been presented to Governor Shapiro for his signature.

The House of Representatives passed House Bill 1234, which expands the Medical Assistance (MA) program to cover blood pressure monitors for home use as a pregnancy-related service on a per pregnancy basis. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 482, which authorizes Pennsylvania to join the National Occupational Therapy Licensure Compact. The bill will now be sent to the Senate for consideration.

The House of Representatives voted to concur with the Senate’s amendments to House Bill 309, which amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license. The bill was subsequently presented to Governor Shapiro for his signature.

The House Labor & Industry Committee met on Tuesday, July 1 and favorably reported House Bill 1676, which establishes the Nursing Shortage Assistance Program. A recording of the meeting is viewable here.

The House Health Committee met on Tuesday, July 1 and favorably reported Senate Bill 715, which extends the Rare Disease Advisory Council’s sunset date to 2028. A recording of the meeting is viewable here.

The House Finance Committee met on Monday, June 30 and favorably reported House Bill 1129, which allows early-stage technology and biotechnology businesses to sell their net operating losses (NOL) and unused research and development tax credits to unrelated companies. A recording of the meeting is viewable here.

The House of Representatives is currently scheduled to return to session on Monday, July 7. The Senate is recessed until the call of the chair.

Department of Human Services

The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) for nursing facilities. Find the list and additional information in this Pennsylvania Bulletin notice.

DHS has issued an updated Pennsylvania Medicaid Managed Care Directory.

DHS has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of May 2025.

Department of Health

The Department of Health (DOH) has published notice that, effective July 1, 2025, ConcussionWise is no longer an approved concussion management certification training course. The only approved courses are through the Centers for Disease Control and Prevention (CDC) and the National Federation of State High School Associations (NFHS). Find additional information in this Pennsylvania Bulletin notice.

Revenue Collection Update

The Department of Revenue has announced that Pennsylvania ended the 2024-25 fiscal year with $46.4 billion in General Fund collections, which is $321 million, or 0.7 percent, above estimate. The Independent Fiscal Office’s (IFO) monthly revenue update for June 2025 is viewable here.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced that the agency recently issued Pennsylvania’s first telehealth exceptions for a DDAP-licensed substance use disorder (SUD) treatment provider. Prior to this, only SUD treatment facilities with a physical location in Pennsylvania could apply to DDAP for a license to also offer telehealth services. This new program does not require a physical location in order for a treatment provider to administer telehealth services.

Board of Medicine

The State Board of Medicine has published final-form rulemaking, which is effective upon publication in the Pennsylvania Bulletin, implementing Act 79 of 2021. This rulemaking modernizes physician assistant (PA) practice by removing certain restrictions and allowing for greater autonomy for PAs. Find additional information in this Pennsylvania Bulletin notice.

Board of Physical Therapy

The State Board of Physical Therapy has published final-form rulemaking regarding changes to the physical therapy examination process and continuing education requirements. Find the final rule in this Pennsylvania Bulletin notice.

Around the State

Spotlight PA has written an article about the increasing prevalence of Nitazines, a class of powerful synthetic opioids, and the Department of Health’s efforts to reschedule these drugs to limit access and allow prosecutors to charge suppliers.

The Philadelphia Inquirer has published an article about Pennsylvania’s late FY 2025-26 budget and what the immediate impact may be. CBS 21 has also published a piece of the status of the state budget.

PA Safety Net Admin2025-07-03T20:30:51+00:00July 3rd, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for May 9

The following is an update of selected state health policy developments in Pennsylvania from May 5 – 9. (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. The following is an overview of selected legislative activity that occurred.

The House of Representatives passed House Bill 1200, which legalizes and regulates adult-use cannabis, by a party-line vote of 102 – 101. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 926, which seeks to prevent health care workplace violence by placing several requirements on health care facilities, by a vote of 124 – 79. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1117, which updates language defining DDAP’s duties and responsibilities. The bill will now be sent to the Senate for consideration.

The Senate passed Senate Bill 115, which requires the Department of Human Services to offer a skills competency exam in lieu of high school diploma or GED requirements for individuals seeking employment as direct care staff in personal care homes or assisted living residences. The bill will now be sent to the House of Representatives for consideration.

The House Aging & Older Adult Services Committee held an informational meeting on Monday, May 5 regarding updates to Pennsylvania’s Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.

The House Judiciary Committee met on Monday, May 5 and favorably reported, among other bills, House Bill 282, which authorizes the Department of Corrections (DOC) to establish a medical assistance (i.e., Medicaid) reentry program for incarcerated individuals who are scheduled to be released and returning to the community. A recording of the meeting is viewable here.

The House Professional Licensure Committee met on Tuesday, May 6 and favorably reported, among other bills, House Bill 554, which authorizes the commonwealth to join the Social Work Licensure Compact.

The Senate Institutional Sustainability & Innovation Committee held an informational meeting on Wednesday, May 7 regarding hospital and health system sustainability in Pennsylvania. Testimony presented to the committee and a recording of the hearing are viewable here.

The House Health Committee met on Wednesday, May 7 and favorably reported, among other bills, House Bill 1269, which establishes a Brain Injury Advisory Board at the Department of Health (DOH). A recording of the hearing is viewable here.

The House Insurance Committee met on Wednesday, May 7 and favorably reported House Bill 1088, which expands maternal blood pressure monitoring coverage, and House Bill 1140, which expands access to contraceptives. A recording of the meeting is viewable here.

The House Judiciary Committee met on Wednesday, May 7 for an informational meeting on the Mental Health Procedures Act. A recording of the meeting is viewable here.

The House of Representatives and the Senate will return to Harrisburg for voting session Monday, May 12 through Wednesday May 14.

Department of Human Services

The Department of Human Services (DHS) has announced it will hold a listening session on May 19 from 1:00 – 2:30 p.m. entitled, “Food is Medicine: Screening and Referral.” This is part of DHS’ Keystone of Health Section 1115 demonstration waiver initiative. The listening session is intended for representatives from health care and other settings that interact with consumers that may be eligible for Food is Medicine programs. Find additional information and register here.

DHS has issued Provider Quick Tip #207 with Medical Assistance (MA) program fee schedule updates for Act 62 of 2008, the Pennsylvania Autism Insurance Act, procedure codes.

Department of Aging

The Department of Aging has announced a 30-day public comment period on its updated Intrastate Funding Formula (IFF), which is used to distribute federal funding to the commonwealth’s 52 Area Agencies on Aging. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

Around the State

The House of Representatives’ passage of an adult-use cannabis legalization measure and its prospects in the Senate is the subject of an article published by Spotlight PA. Cannabis legalization and the revenue it would generate are a hallmark of Governor Shapiro’s FY 2025-26 budget proposal.

An article written by City & State Pennsylvania highlights the Senate Institutional Sustainability & Innovation Committee’s hearing on the financial health of hospitals.

Spotlight PA has published an article about security enhancements the Pennsylvania State Police will be making in response to the arson attack at the Governor’s Residence last month.

Stakeholder Meetings

DHS – Consumer Sub-MAAC – May 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 21 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – May 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 22 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2025-05-09T20:27:09+00:00May 9th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for March 21

The following is an update of selected state health policy developments in Pennsylvania from March 17 – 21. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives convened for voting session this week. The following is an overview of selected health care-related legislative activity.

The House of Representatives passed House Bill 157, which establishes the Rural Health Care Grant Program to provide grants to entities in rural counties and designated medically underserved areas to pay for the education debt of certain health care practitioners. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 60, which allows pharmacies to make a one-time transfer of a prescription for a controlled substance to another pharmacy without requiring a new prescription. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 33, which implements greater oversight of medical marijuana labs and product testing. The bill will now be sent to the Senate for consideration.

The House Insurance Committee met on Monday, March 17 and favorably reported the following package of bills, which seek to codify the federal Affordable Care Act (ACA) patient protections in state statute.

- House Bill 404, which enables an adult child to receive insurance coverage until 26.
- House Bill 535, which prohibits annual and lifetime coverage limits.
- House Bill 618, which prohibits the denial of health insurance coverage due to pre-existing conditions.
- House Bill 755, which maintains access to preventative health care services.

The House Aging & Older Adult Services Committee held an informational hearing on Tuesday, March 18 about the Department of Aging’s newly launched oversight program of the Area Agency on Aging (AAA) network. A recording of the hearing is viewable here.

The House Human Services Committee held an informational hearing on House Bill 561, which expands Act 80 of 2015 to include all forms of FDA-approved medications for the treatment of substance use disorder (SUD). A recording of the hearing is viewable here.

The House Majority Policy Committee held an informational hearing on Wednesday, March 19 examining sustainable long-term care. Testimony offered to the committee is viewable here and a recording of the hearing is viewable here.

The Senate Majority Policy Committee held an informational hearing on improving access to quality health care through technological innovation. Testimony offered to the committee and a recording of the hearing is viewable here.

The state House of Representatives and the Senate will convene in Harrisburg for voting session next Monday, March 24 through Wednesday, March 26.

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 April. Find the updated calendar here.

Department of Insurance

The Pennsylvania Department of Insurance (PID) has published a Consumer Price Index for All Urban Consumers (CPI-U) adjustment, which is utilized as a benchmark for the maximum benefit for autism services required to be covered by an insurer. The CPI-U adjustment for policies issued or renewed in calendar year 2026 is a 2.9 percent increase, which results in a maximum benefit of $51,908. The department does not expect this to have any impact on the coverage of autism services in the commonwealth. Find additional information in this Pennsylvania Bulletin notice.

Department of Aging

The Department of Aging has announced the rollout of its new platform to increase transparency and accountability of Pennsylvania’s Area Agency on Aging (AAA) network – Comprehensive Agency Performance Evaluation (CAPE). In addition, the department will begin publicly posting performance results on its website for the first cohort of AAAs to be monitored under CAPE.

Around the State

The Pittsburgh Post-Gazette published an article about the reopening of Sharon Regional Medical Center and legislation being considered in the General Assembly focused on rural health and health care mergers and acquisitions.

Spotlight PA has written an article about hospital charity care programs and their lack of standardization, which was the focus of a recent Health Affairs article.

Legislative efforts to provide more assistance for health care practitioners’ student loan repayment was the focus of an article published by The Center Square.

Harold Brubaker has written an article for The Philadelphia Inquirer about the most recent emergency court hearing held on efforts to keep Crozer Health open in Delaware County.

Stakeholder Meetings

DHS – Consumer Sub-MAAC – March 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – March 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2025-03-21T20:37:58+00:00March 21st, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 Assembly

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.

DOH has published a notice in the Pennsylvania Bulletin announcing the Nursing Home Patient Safety Trust Fund (MCARE) surcharge of $14.40 per bed for Fiscal Year 2024-25.

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 Safety Net Admin2025-03-07T22:13:24+00:00March 7th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

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 Assembly

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.

PA Safety Net Admin2025-01-31T22:45:42+00:00January 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 Safety Net Admin2024-10-07T15:57:14+00:00October 4th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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