Pennsylvania Medicaid policy Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for April 24

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

Rural Health Transformation Program

Today, DHS announced the qualifications for providers to receive Rapid Response Stabilization payments of at least $10,000 and up to $1 million to be used for the purchase of supplies, equipment, renovations, or structural improvements in alignment with the goals outlined in the commonwealth’s RHTP application to the federal government. Providers may submit the eligibility certification and required documentation beginning on May 1 to show they meet all of the following criteria:

Licensed as a hospital, health care provider, or rural health facility;
Currently in operation in Pennsylvania at the time of application and at the time funding is received;
Located in one of the RHTP-eligible rural counties or in a HRSA-defined rural census tract of a county of the second class A or third class.

This program payment is limited to one payment per qualified entity. Under the first tranche of this program request, program payments are limited to two program payments per region. There is a planned second tranche of funds to be made available after June 1, 2026 and that second tranche will not be limited by region.

DHS will authorize program payments in the order eligibility certifications are received, as evidenced by the date and time the email containing the full eligibility certification and receipt of all required documents. Providers should begin preparing the required documentation and budget narrative now for email submission on May 1. Submissions can be made via email to: RA-HHRRLHLTHTRNSPLAN@pa.gov.

General Assembly

The Senate held session earlier week addressing the following issues:

Monday
- The Senate passed Sen. Rosemary Brown’s SB 998, by a measure of 43-4, which would provide an expansion of resources for accredited nursing programs in PA through the Nurse Education Capacity Expansion Grant program.
Tuesday
- The Senate Local Government Committee advanced HB 1442, which would require that all autopsies include a review to whether a seizure or epilepsy was part of the cause of death.
Wednesday
- HB 1251, which is part of the “MOMNIBUS 2.0” bill package, will now head to the Governor’s desk following a 45-2 final passage vote. This legislation would allow nurse midwives to refer patients to physical therapy for access to pelvic floor therapy.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Sen. Amanda Cappelletti circulated a co-sponsor memo for legislation requiring the inclusion of Gaucher’s Disease on Pennsylvania’s Newborn Screening Panel and a co-sponsor memo for legislation that would allow access to PrEP and PEP medications without prescriptions.
Sen. Elder Vogel issued a co-sponsor memo for a resolution recognizing IgA Nephropathy Awareness Day in Pennsylvania.
Senator Michele Brooks released a co-sponsor memo for a resolution to designate May 2026 as Lyme Disease & Tick-Borne Illness Awareness Month in PA.
Rep. Frank Burns introduced HB 2431 which would require PBMs to accept Medicaid prescriptions from any pharmacy and pharmacist in good standing with the State Board of Pharmacy and US DEA.
Rep. Maureen Madden introduced HB 2435, providing for dementia training for EMS personnel. This legislation will receive a public hearing in the House Aging & Older Adult Services Committee on Monday April 27th.

The House is scheduled to return to session this upcoming week. In addition to the hearing on HB 2435, the following activity is anticipated:

On Monday, the House Human Services Committee will meet to consider House Resolution 134, a resolution directing a comprehensive review of home & community-based services waiver programs and areas of improvement that can be identified.
On Tuesday, the House Health Committee will meet to consider HB 916, legislation to update the Child Blood Lead Testing Act.

Both the House and Senate will return to session on May 4^th.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities. Recently highlighted in DHS’ Human Services Helpers Substack was a toolkit for Long-Term Care Services & Caregivers to help all parties better understand and navigate the enrollment process.

DHS is currently hiring Regional Policy Specialists and an Executive Policy Specialist to help implement PA’s Rural Health Transformation Plan.

The Department issued its March 2026 HealthChoices Enrollment Report.

DHS announced its schedule for onboarding provider types to begin using the Qualitrac electronic prior authorization portal for MA fee-for-service claims. For each wave of the rollout, providers will receive a kickoff communication with instructions on how to register for the portal, then complete the registration and attend an initial training session focused on how to use the portal for their specific review type. There is no deadline at this time for mandatory use of Qualitrac for these authorizations, but DHS strongly encourages providers to use the portal once they are ready.

Department of Health

The Department released a Health Advisory Network alert for an increase in emergency department visits for tick bites and urging providers to heighten suspicion for tickborne diseases.

DOH, the Patient Safety Authority, and other stakeholders released updated guidance to acute care facilities regarding the definition of serious events, incidents, or infrastructure failures.

Stakeholder Meetings

The Patient Safety Authority will hold a public meeting on April 28^th at 1pm.

DOH’s Special Pharmaceutical Benefits Program will hold a public teleconference on April 30^th from 10am to Noon.

The Department of Health’s Spinal Cord Research Advisory Committee Meeting will hold a public meeting on May 1^st from 9am – 10am and the Brain Injury Advisory Board Meeting will also hold their public meeting on May 1^st from 10am – 3pm.

DOH’s Statewide HIV Planning Group will hold a public meeting on May 20^th from 9am to Noon.

Federal Update

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

PA Safety Net Admin2026-04-24T20:24:41+00:00April 24th, 2026|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for April 17

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

General Assembly

The House held session earlier week addressing the following issues:

Monday
- The House Judiciary Committee voted out HB 1104, proposing to cap fees for obtaining medical records, by a margin of 14-12.
- The House Human Services Committee held an informational hearing on the impacts of HR 1 on the SNAP Program in PA.
Tuesday
- The House Health Committee held a voting meeting on HB 836, preserving access to fertility treatment, which passed out of committee with amendment by a measure of 17-9 and HB 2254, which would allow for medical marijuana usage in licensed healthcare facilities passed 22-3; along with several resolutions. HB 916, providing for further Blood Lead Testing was to be considered but was passed over.
- The House Aging & Older Adult Services Committee held an informational hearing on the LIFE Program. The hearing highlighted the current state of the program in PA and nationally, aired enrollment challenges experienced by providers, and vetted potential legislative and policy solutions that could help address barriers to care.
- The House Democratic Policy Committee held a public hearing on Black Maternal Health and Hospital Accountability.

The Senate is scheduled to return to session this upcoming week. The House will return to session on April 27^th.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Rep. Bridget Kosierowski circulated a cosponsor memo for legislation to ensure commercial and government insurance plan coverage for orthotics and prosthetics and another cosponsor memo requiring coverage of fertility preservation for cancer patients.
A cosponsor memo released by Rep. Maureen Madden providing for dementia training for EMS personnel.
Rep. Melissa Cerrato issued a cosponsor memo for legislation to require DHS to submit a waiver request to CMS to allow legally responsible family members to perform paid care for a care-dependent relative.
Rep. Maureen Madden introduced HB 2378, which would expand flu vaccine availability for patients age 50 and older.
HB 2379, sponsored by Rep. Marla Brown, would require continuing education in Trauma-Informed Maternity Care.
Rep. Rob Kauffman introduced HB 2399, which would place additional identification requirements for public assistance benefits.
Sen. Tracy Pennycuick introduced SB 1285, to establish the PA BioBonds Innovation Fund to help spur further bio-tech and life-sciences investment.

Department of Human Services

Recently highlighted in DHS’ Human Services Helpers Substack was a toolkit for Long-Term Care Services & Caregivers to help all parties better understand and navigate the enrollment process.

DHS issued its May 2026 Remittance Advice Dates.

PA Healthcare Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) announced the release of new data detailing ownership of hospitals and ambulatory surgery centers (ASCs) across Pennsylvania, along with updated access to care information on facility locations and services for hospitals, ASCs, and nursing homes.

Stakeholder Meetings

The Patient Safety Authority will hold a public meeting on April 28^th at 1pm.

DOH’s Special Pharmaceutical Benefits Program will hold a public teleconference on April 30^th from 10am to Noon.

Federal Update

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

PA Safety Net Admin2026-04-17T19:33:18+00:00April 17th, 2026|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for March 6

The following is an update of selected state health policy developments in Pennsylvania from March 2 – March 6 (Some of the language used below is taken directly from state documents).

General Assembly

Appropriations Committee hearings were held this week examining the Governor’s 26-27 Budget with executive agencies. Below are links to watch the relevant health & human services hearings that have been held so far along with a schedule for forthcoming hearings in the next two weeks.

Senate Hearing for the Department of Human Services Morning Session
Senate Hearing for the Department of Human Services Afternoon Session
House Hearing for the PA Insurance Department and Pennie®
House Hearing for the Department of Human Services: Morning Session
House Hearing for the Department of Human Services: Afternoon Session
Senate Hearing for the Governor’s Budget Office

Upcoming Hearings:

Department of Aging: House – Mar. 10^th at 1pm
Governor’s Budget Office: House – Mar. 12^th at 10am
Department of Health and Department of Drug & Alcohol Programs: Mar. 12^th at 1pm

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Senators Devlin Robinson and Chris Gebhard released a co-sponsor memo for legislation to include Medicaid Fee for Service coverage for biomarker testing.
Sen. Michele Brooks issued a co-sponsor memo for two-year licensure for programs licensed by the Department of Drug & Alcohol Programs.
Rep. Paul Takac and Rep. Tina Pickett introduced House Bill 2265, which would require on-site Emergency Physicians in all Hospital Emergency Departments.
Rep. Dan Frankel sponsored House Bill 2254, which would require healthcare facilities in PA to allow certain medical marijuana use for terminally ill patients.

Department of Human Services

DHS released updated prior authorization guidelines for GLP-1 medications in the MA program.

The Department issued fee schedule rate updates for Office of Developmental Programs’ Consolidated, Community Living, and Person/Family Directed Support Waivers and Targeted Support Management.

Department of Health

DOH released notice for their MCARE Act Surcharge for Ambulatory Surgical Facilities in PA.

Department of Aging

The Department of Aging released a bulletin notice for a reorganization of the Department.

Stakeholder Meetings

DOH’s Statewide HIV Planning Group will hold a public meeting on Wednesday Mar. 18^th from 10am to Noon.

The Independent Regulatory Review Commission will review proposed updates to the State Board of Pharmacy’s Final Immunization Regulation Updates at a public meeting on March 19^th at 10am.

DOH’s Medical Marijuana Advisory Board released their schedule of board meetings for 2026 with the first upcoming on March 26^th from 10:30am to 12:30pm.

The Council on Aging released their 2026 Meeting Schedule.

Federal Update

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

PA Safety Net Admin2026-03-06T17:30:01+00:00March 6th, 2026|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for December 5

The following is an update of selected state health policy developments in Pennsylvania from November 24 – December 5 (Some of the language used below is taken directly from state documents).

Shapiro Administration Staffing Changes

The Shapiro Administration announced a change in senior leadership with Budget Secretary Uri Monson leaving his post to serve as Executive Director at the PA Public School Employees Retirement System (PSERS). The Governor has appointed Zach Reber, current Deputy Secretary for Fiscal Policy and Program Coordination in the Budget Office, to serve as the next Secretary of the Budget.

General Assembly

The Senate returns next week for three voting session days from December 8^th through the 10th. The House will return for non-voting session on December 15^th and voting session on the 16^th & 17^th.

On Monday, Dec. 15th at 1pm, the House Communications & Technology Committee is holding a public hearing on HB 1925, Rep. Arvind Venkat’s AI in Healthcare legislation.

Rep. Bryan Cutler released a cosponsor memo for Certificates of Merit in Healthcare liability claims.

Department of Health

DOH updated its respiratory virus outbreak toolkit with minor changes and issued a new FAQ about Fall 2025 respiratory viral illness guidance.

Department of Human Services

DHS is launching Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued Medical Assistance Bulletins on the following areas:

DHS released its October 2025 Managed Care Enrollment Report.

The Department issued revisions to its list of drug companies participating in the Medicaid Drug Rebate Program.

DHS issued a notice of intent to update its Chapter 5100 Mental Health Procedures Regulations to align with Act 32 of 2022.

Independent Fiscal Office

The IFO released a report detailing its assessment of factors contributing to anticipated structural deficits for Pennsylvania’s budget.

Independent Regulatory Review Commission

IRRC approved the final form covered outpatient drug regulations, which updated the payment methodology for pharmaceutical services, recognized the prescriptive and dispensing authority of certified registered nurse practitioners and midwives as well as made technical amendments to recognize advances in information technology.

Pennsylvania Health Care Cost Containment Council

The PA Health Care Cost Containment Council (PHC4) released its 2024 Hospital Performance Report, which examines trends on mortality and readmissions, among other data points.

Stakeholder Meetings

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here.

Federal Update

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

PA Safety Net Admin2025-12-05T20:44:06+00:00December 5th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for November 7

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

General Assembly and Budget Update

After Pennsylvania’s judicial and local election this past Tuesday, four members of the PA House won local elected offices which will require special elections early next year following their respective swearing-in to those offices. As Rep. Lou Schmitt, winner of a county judicial race indicated, “People were focused on the election… Now that the election is out of the way, people can go back to policy.” The House and Senate will have the opportunity to do so when both chambers are set to return on November 17^th.

On Monday, November 10^th at 10am, the Senate Democratic Policy Committee will hold a public hearing on supporting home care workers and consumers. The hearing can be streamed live here.

Department of Health

The Department’s Special Pharmaceutical Benefits Program released their approved covered drug list in their October Advisory Council meeting which will take effect on December 1^st. The Department also updated its list of Medicare Part C and D plans with premium payment agreements with SPBP for 2026.

Department of Human Services

DHS has issued helpful guidance and information to assist individuals in understanding the federal SNAP work requirements instituted earlier this fall.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

State Board of Medicine

The State Board of Medicine shared Education and Volunteer Services proposed regulations to add new mandatory education requirements and clarify the process for a volunteer license.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

DOH’s Infant Hearing Screening Advisory Committee will meet on Thursday Nov. 13^th from 10am – Noon.

The DHS Medical Assistance Advisory Committee plans to meet December 4^th at 10am. You can register for the meeting here.

Federal Update

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

PA Safety Net Admin2025-11-07T20:33:35+00:00November 7th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off

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

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