Pennsylvania Medicaid policy Archives - Page 10 of 44 - Safety-Net Association of Pennsylvania

PA Health Policy Update for the Week of June 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of June 21-25, 2021. (Some of the language used below is taken directly from state documents.)

State-Wide Mask Mandate

The Department of Health announced that it is lifting its order requiring universal face coverings at 12:01 a.m. on Monday, June 28.   See the announcement here. The department continues to urge Pennsylvanians to follow CDC guidance for wearing a mask where required by law, rule, and regulations, including health care, local business, and workplace guidance.  For the protection of themselves and others, individuals who have not yet been vaccinated or are partially vaccinated are still encouraged to wear a mask when in public.

Legislative Update

The following are health care bills that have received third and final consideration in the state House and/or Senate as of Thursday, June 24. Both chambers will hold voting session on Friday and Saturday and we anticipate there will be additional health care-related measures passed. We will provide an update following the end of session on any pertinent bills.

Senate Bill 115 – establishes the Nurse Licensure Compact Act, which upon enactment makes the Commonwealth a party to the Nurse Licensure Compact with all other states that have joined the compact. The bill was passed by the House 146-55 and sent to the Governor’s desk.
Senate Bill 425 – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions, or medications and devices. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 484 – adds the chair of the State Veterans’ Commission or a designee to the Pennsylvania Long-term Care Council. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 618 – prohibits the use of vaccine passports by government entities. It also prohibits institutions of higher education from requiring proof of vaccination against COVID-19 to use a service, enter a building, or undertake an activity, including attending class in person. In addition, the bill further restricts the Secretary of Health’s ability to implement certain disease control measures for individuals who have not been exposed, potentially or otherwise, to a contagious disease. The bill was signed in the state House and Senate on June 24^th and sent to the governor. The governor has indicated he will veto

Department of Human Services

DHS and its Office of Medical Assistance Programs have posted a Medical Assistance Bulletin on the state’s Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program periodicity schedule reminding all providers they must revalidate the Medical Assistance enrollment of each service location every five years. Find the notice here.
DHS has added two COVID-19 antigen laboratory test codes to the Medical Assistance Program Fee Schedule, effective with dates of service on and after November 2, 2020.
DHS has proposed rescinding a regulation that prohibits a provider from leasing space within its office to another provider; see the proposed change in this Pennsylvania Bulletin notice. The agency will accept public comment on this proposal and it will become effective when final formal regulations are published in the Pennsylvania Bulletin.
DHS and its Office of Medical Assistance Programs have updated their guidance on providing direct services via telemedicine in the School-Based ACCESS Program during the COVID-19 emergency.
DHS has posted updates of six of its “provider quick tips.”
DHS has updated its list of providers participating in its Healthy Beginnings Plus program. See the list here.
DHS announced its proposed rates for non-public and county nursing facilities for FY 2022 in this Pennsylvania Bulletin notice. These figures will be posted on the DHS web site here.
DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.
DHS and its Office of Child Development and Early Learning have posted an FAQ on guidance for tuberculin skin testing and COVID-19 vaccinations.

Department of Health

Effective at midnight on June 23, 2021, the Department of Health terminated its order requiring skilled nursing facilities to complete a vaccine needs assessment survey since those facilities are now reporting to the federal government.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline significantly. The 174 new COVID-19 cases reported on Wednesday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths continues to decline significantly as well.
For the week from June 11 through June 17 the state’s overall COVID-19 test positivity rate was 1.4 percent, down from 1.9 percent last week and 2.9 percent the week before.
Sixty-four counties had a positivity rate lower than five percent, up from 62 last week, and no counties had a positivity rate greater than 20 percent for the eighth consecutive week.
Thirty-seven counties are currently experiencing low levels of community transmission of COVID-19, up from 22 last week; the remaining 30 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
Since June 1 the number of Pennsylvanians hospitalized with COVID-19 has fallen 62 percent; the number on a ventilator has fallen 54 percent; and the number in hospital intensive care units has fallen 70 percent.
5.3 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past month and only about 150,000 new vaccinations were reported in the past week. Another 760,000 people have been vaccinated in Philadelphia. According to the state, 59.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.2 percent of the entire population has now received at least the first dose of a vaccine.

Around the State

Two Pennsylvania children’s hospitals ranked among the best ten such hospitals in the U.S. in the latest rankings published by U.S. News & World Report: Children’s Hospital of Philadelphia ranked second and UPMC Children’s Hospital of Pittsburgh ranked ninth.

Two Pennsylvania-based health insurers, Highmark and Independence Blue Cross, are among five Blues plans joining forces in a new venture called Evio, a for-profit venture that will seek to make prescription drugs more affordable and improve health care outcomes. Learn more here.

Stakeholder Events

Maternal Mortality Review Committee

June 28 at 8:00

This meeting will be held via conference call. The purpose of the meeting is to discuss new and ongoing procedural issues relating to the review process for the committee. To join the call, dial +1 (267) 332-8737 and when prompted, enter the following conference code: 522 321 931#.

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar. Public comments will be taken after each presentation and questions can be entered in the chat box. Interested parties can participate in the following ways:

Webinar registration – go here

Dial in: 1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting. The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728# United States, Pittsburgh

(866) 588-4789,,785376728# United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Medical Assistance Advisory Committee Meeting – June 24

Deputy DHS Secretary Sally Kozak announced that DHS will perform readiness reviews of the managed care organizations selected to participate in the latest HealthChoices program procurement. The procurement remains the subject of litigation so DHS will stop short of negotiating with the managed care organizations until there is a final decision in that case.

Stakeholder Events Materials

DHS has posted four presentations offered at the June 24 meeting of the Medical Assistance Advisory Committee. Those presentations were delivered by its:

Office of Mental Health and Substance Abuse Services (crisis services)
Office of Mental Health and Substance Abuse Services (medication-assisted treatment during the public health emergency)
Office of Medical Assistance Programs
Office of Long-Term Living

jsteinbock2021-06-26T13:46:01+00:00June 26th, 2021|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2022 budget, Pennsylvania state budget issues|Comments Off

Pennsylvania Health Policy Update for the Week of June 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of June 14-18, 2021. (Some of the language used below is taken directly from state documents.)

Pennsylvania’s COVID-19 Disaster Declaration

With the certification of November’s election results, Governor Wolf’s COVID-19 emergency disaster declaration has officially ended but most of the regulatory waivers issued during the emergency will remain in effect until the end of September. Learn more here.

Update on State FY 2021-2022 Budget

The General Assembly continues to work toward a final budget agreement, with both the House and Senate beginning to position bills that could ultimately serve as vehicles for a final budget agreement by June 30. The Senate sent a General Fund appropriations bill (Senate Bill 255) to the House earlier this week and scheduled a Finance Committee meeting on Monday, June 21 to consider a fiscal code bill (House Bill 1348). We will continue to keep you apprised of any relevant budget updates.

Legislative Update

The following are health care bills that received third and final consideration in the state House and/or Senate during the week of June 14. We are tracking other health care bills as they move through the legislative process as well.

House Bill 1082 requires the Department of Health to establish and maintain an Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder toolkit. The toolkit, among other things, shall include best practice and cognitive assessment tools, primary care workforce education resources, and materials on the importance and value of early detection and timely diagnosis. The House passed the bill 201-1 and sent it to the Senate for consideration.
House Bill 1428 permits a resident, or their guardian, to authorize the installation and use of video surveillance devices in long-term-care nursing facilities provided certain conditions are met. The House passed the bill 160-42 and sent it to the Senate for consideration.
House Bill 1429 adds a new section to the state Crimes Code providing for the offense of financial exploitation of an older adult or care-dependent person. It also clarifies that district attorneys have the right to investigate and institute criminal proceedings for any violation of this new section. The House unanimously passed the bill and sent it to the Senate for consideration.
House Bill 1431 adds a new section to the Crimes Code that defines as abuse and establishes as a misdemeanor the use of social media by employees who post pictures of care-dependent individuals without permission. The House passed the bill 198-4 and sent the bill to the Senate for consideration.
Senate Bill 445 permits a person renewing a driver’s license, identification card, or vehicle registration electronically through the Department of Transportation’s web site to contribute $5 to the Pennsylvania Breast Cancer Coalition for breast cancer research. The House passed the bill unanimously and sent the bill to the governor for his consideration.
Senate Bill 416 establishes the certified registered nurse anesthetist (CRNA) designation in the commonwealth. The legislation grants an individual licensed to practice professional nursing and who meets the requirements of this act the right to use the CRNA designation exclusively. The Senate passed the bill unanimously and sent it to the House for consideration.
House Bill 649 requires the Department of Health, in consultation with the Department of Human Services, to establish protocols to permit an essential caregiver to provide in-person physical and emotional support to a congregate care facility resident during a declaration of disaster emergency. The Senate passed the bill 32-18 and sent it to the governor.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline. With 277 new COVID-19 cases reported, yesterday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths continues to decline significantly.

For the week from June 4 through June 10 the state’s overall COVID-19 test positivity rate was 1.9 percent, down from 2.9 percent last week and 3.8 percent the week before.
Sixty-two counties had a positivity rate lower than five percent, up from 55 last week, and no counties had a positivity rate greater than 20 percent for the seventh consecutive week.
Twenty-two counties are currently experiencing low levels of community transmission of COVID-19, up from 13 last week; 53 counties are experiencing moderate levels of community transmission; and only one county (Potter) is currently experiencing a substantial level of community transmission, the same number as last week.
In just 17 days since June 1 (as of Thursday, June 17), the number of Pennsylvanians hospitalized with COVID-19 has fallen 54 percent; the number on a ventilator has fallen 44 percent; and the number in hospital intensive care units has fallen 54 percent.
5.2 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past three weeks. Another 760,000 have been vaccinated in Philadelphia. According to the state, 58.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 61.1 percent of the entire population has now received at least the first dose of a vaccine.

Department of Human Services

The American Rescue Plan offers a temporary 10 percent increase in federal Medicaid matching fund for certain state Medicaid expenditures for home and community-based services (HCBS). DHS has submitted a preliminary spending plan to the federal Centers for Medicare & Medicaid Services (CMS) as part of the process of seeking approval for this additional funding and has invited stakeholder comment on its proposal. Comments are due July 6. Go here to see DHS’s announcement of this endeavor; go here to see a Wolf administration news release on the subject; and go here to see DHS’s preliminary spending plan.

DHS has updated its list of mailing dates for the most current four Remittance Advices and corresponding checks.

Department of Drug and Alcohol Programs

In response to the COVID-19 pandemic, the Department of Drug and Alcohol Programs suspended three of its regulations governing narcotic treatment programs: one limiting the supply of medicine those programs can dispense at one time to their patients; another requiring those programs to meet patients in person before prescribing buprenorphine; and the third requiring them to have a physician on the premises. While the governor’s declaration of a disaster emergency has been terminated, the department has advised all stakeholders that these three regulations will remain suspended until September 30. Go here for more information.

The Department of Drug and Alcohol Programs has issued an alert clarifying the requirements that licensed providers must meet to use certain medications, including methadone, buprenorphine, and naltrexone.

Around the State

Of the more than 600,000 residents of Allegheny County who are fully vaccinated, according to county health officials, only 420 have contracted COVID-19 – so-called breakthrough cases; only 11 of the 420 required hospitalization. The Pittsburgh Tribune-Review provides the details.
Demand for COVID-19 vaccinations is falling in the Lehigh Valley and throughout Pennsylvania and the Allentown Morning Call offers the numbers to prove it.
While COVID-19-related hospitalizations have declined state-wide they are rising in Erie and Crawford County. GoErie looks into why.
Cumberland County has made masks optional for staff and visitors at any county facility except the Claremont Nursing and Rehabilitation Center and Cumberland County Prison, according to the Carlisle Sentinel.
The city of Pittsburgh has announced plans for its workforce to return to city offices, the Pittsburgh Business Times reports.
“The company responsible for administering Pennsylvania’s contact tracing program has called on current and former employees to help it locate and secure documents online that might still contain the personal information of those who were contacted, “ according to Spotlight PA, which added that “…a lawyer for Insight Global asked them to contact the company’s information security team if they had any paper or electronic records, internet links and files, or Google Drive documents related to the program.” The company was fired because of data leaks.
Black maternal morbidity rates in Philadelphia are among the highest in the country, the Pennsylvania Capital-Star reports.
“Medical marijuana sales in Pennsylvania topped more than $900 million over one year during the COVID-19 pandemic, and could soon see $3 billion in total sales with just a few operating years under its belt,” the Delaware County Daily Times writes, adding that “According to figures provided by the Pennsylvania Department of Health, sales from growers/producers to dispensaries have reached almost $1.2 billion and sales from dispensaries to patients have crested $1.7 billion.”

Pennsylvania Bulletin

The latest issue of the Pennsylvania Bulletin is now available. It includes new items from the Department of Human Services, Department of Health, the General Assembly, and others. Find it here.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar. Public comments will be taken after each presentation and questions can be entered in the chat box. Interested parties can participate in the following ways:

Webinar registration – go here

Dial in: 1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

jsteinbock2021-06-18T19:18:59+00:00June 18th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2022 budget|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May 2021 newsletter.

Included in this month’s edition are articles about:

Medicaid eligibility changes permitted for people with Medicare during the COVID-19 emergency.
Changes in the Medical Assistance work supports program.
The introduction of changes in the process for enrolling in the state’s Living Independence for the Elderly Program (LIFE).
The simplification of the dental benefit limits exceptions process.
A listening session during which Community HealthChoices participants expressed dissatisfaction with receiving their benefits through managed care.
Actions to terminate some participants from state home and community-based Medicaid programs because their health status has not been reassessed.

Read about these subjects and more in the Pennsylvania Health Law Project’s May 2021 newsletter.

jsteinbock2021-06-07T18:26:31+00:00June 9th, 2021|HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2021 newsletter.

Included in this month’s edition are articles about:

The impact of the American Rescue Plan on health insurance eligibility.
The impact of the American Rescue Plan on “Pennie,” Pennsylvania’s health insurance marketplace.
Federal updates on nursing home visitation.
Medicare coverage of COVID-19 testing and vaccines.
Using the Medical Assistance Transportation program to get the COVID-19 vaccine.
Advancing maternal health care coverage in Pennsylvania.

Read about these subjects and more in the Pennsylvania Health Law Project’s April 2021 newsletter.

PA Safety Net Admin2021-05-06T11:13:13+00:00May 6th, 2021|Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2021 newsletter.

Included in this month’s edition are articles about:

the continuation of certain Medicaid protections, including continuous coverage, during the COVID-19 emergency;
COVID-19 vaccinations and state reimbursement for those vaccines;
the availability of Medicaid-covered remote and in-home adult daily living services;
Medicaid services for individuals between the ages of 18 and 20 who have chronic disabilities;
a new monthly webinar that will be offered by the state’s Office of Mental Health and Substance Abuse Services; and
Pennsylvania’s selection of a vendor to operate its Resource Information and Services Enterprise (RISE-PA), the state’s planned resource and referral tool.

Read about these subjects and more in the Pennsylvania Health Law Project’s February 2021 newsletter.

PA Safety Net Admin2021-03-05T06:00:34+00:00March 5th, 2021|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

GAO: CMS Should Pay More Attention to States’ Financing of Medicaid

The federal government does not adequately monitor how states finance their Medicaid programs.

It also lacks a sufficiently clear understanding of how they pay providers of Medicaid-covered services.

These are among the conclusions in a new study on Medicaid financing and payments by the U.S. Government Accountability Office.

According to the GAO report,

GAO estimated that states’ reliance on provider taxes and local government funds decreased states’ share of net Medicaid payments (total state and federal payments) and effectively increased the federal share of net Medicaid payments by 5 percentage points in state fiscal year 2018. It also resulted in smaller net payments to some providers after the taxes and local government funds they contribute to their payments are taken into account. While net payments are smaller, the federal government’s contribution does not change. This effectively shifts responsibility for a larger portion of Medicaid payments to the federal government and away from states.

To address this challenge, the GAO urged CMS to collect more complete and consistent information about both state financing of their Medicaid programs and the manner in which states pay Medicaid providers. CMS neither agreed nor disagreed with the GAO’s recommendation.

Such a study could have implications for Pennsylvania safety-net hospitals because of the state’s growing dependence on provider taxes to fund its Medicaid programs in recent years.

Learn more about what the GAO found and recommended in its new report “Medicaid: CMS Needs More Information on States’ Financing and Payment Arrangements to Improve Oversight.”

PA Safety Net Admin2020-12-15T06:00:16+00:00December 15th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its November 2020 newsletter Health Law News.

Included in this month’s edition are articles about:

How the renewal of the federal COVID-19 public health emergency declaration extends key Medicaid protections.
State planning for children with complex needs.
State efforts to connect people to COVID-19 testing and care.
An upcoming webinar about challenging Medicaid and Community HealthChoices waiver service denials.

Read about these subjects and more in the Pennsylvania Health Law Project’s November 2020 newsletter.

PA Safety Net Admin2020-11-17T15:00:32+00:00November 4th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.

In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date, CMS will enforce its own interpretation of the policy.

In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its Office of Medical Assistance Programs have not yet indicated how they will respond to the options CMS has presented.

Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”

PA Safety Net Admin2020-08-31T19:55:39+00:00August 27th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its August 2020 newsletter Health Law News.

Included in this month’s edition are articles about:

The Department of Human Services’ selection of new managed care plans to serve Pennsylvania Medicaid’s Community HealthChoices program.
The end of ensured continuity of long-term services and supports for participants in the Community HealthChoices program in northeastern Pennsylvania.
The availability of navigators to help connect people to COVID-19 testing and treatment.

Read about these subjects and more in the Pennsylvania Health Law Project’s August 2020 newsletter.

PA Safety Net Admin2020-08-05T06:00:27+00:00August 5th, 2020|HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

COVID-19 Update: March 25, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 5:15 on March 25.

State Legislature

Today the Senate passed House Bill 1232, as amended, which includes up to $50 million of additional funding to be made available for the state’s COVID-19 response efforts. The legislation stipulates that funding shall only be used to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand. It also requires available federal funding and any funding made available through the governor’s disaster proclamation to be used before these funds. The authority to transfer funds expires on September 30, 2020.

Senate leadership noted that this is the first phase in its crisis response and recognizes that additional funds will likely be needed. The House is expected to pass the bill as amended today. The bill will then be signed in both chambers and sent to the governor for consideration and he is expected to sign it. It would take effect immediately.

The Administration

Governor Wolf

Today the governor added Lehigh and Northampton counties to his stay-at-home order.

Department of Health

Secretary Levine today issued an order requiring hospitals to make daily report of specified data regarding hospital facilities, beds, supplies, equipment, and staffing. Among the measures hospitals will be required to report daily are available beds, psychiatric beds, number of other beds in facilities, current emergency department capacity, number of COVID-19 patients, expected number of days remaining N-95 masks will last, expected number of days remaining until other personal protective equipment supplies will exhausted, supply of remaining NP specimen collection supplies in days, number of ventilators in facility and in use, and number of employees available for work. See the secretary’s order here.

Department of Human Services – Office of Medical Assistance Programs

The Office of Medical Assistance Programs has issued billing guidance to CHIP managed care organizations on the subject of alternative screening sites related to COVID-19. Find that two-page document here.
It issued another policy clarification to CHIP managed care organizations with directions to bypass the prior authorization requirements for chest CT scans for COVID-19 payments. See that policy clarification document here.

Another notice announces a new ICD-10 code for COVID-10 that takes effect on April 1. Find it here.

The Office of Medical Assistance Programs has posted an FAQ on Medicaid program coverage of COVID-19 testing and related services. It includes information about what Pennsylvania Medicaid will pay for COVID-19 testing, the services it will cover, and more. Find it here.

Department of Human Services – Office of Long Term Living

The Office of Long Term Living (OLTL) has published guidance on conducting pre-admission screening and resident reviews for applicants to and residents of Medicaid-certified nursing facilities. This includes an explanation of performing such screens by phone or video conference. See the guidance here.
OLTL also has sent a memo to nursing home transition coordination agencies about a new, COVID-19-motivated nursing home transition tenant-based rental assistance process. Find that memo here.
OLTL also communicated via its listserv that it is delaying the implementation deadline for electronic visit verification (EVV) until October 1, 2020.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has issued a document clarifying the state’s response to federal guidance on the disclosure of patients’ substance abuse disorder records during the telehealth process. See that policy clarification here.
DDAP has issued a policy bulletin addressing telehealth services for gambling treatment. Find that bulletin here.

Department of State

The Pennsylvania Department of State, which is responsible for licensing many health care providers, has announced new guidelines and processes for reactivating the licenses of retired health care professionals such as doctors, nurses, nurse practitioners, pharmacists, and others. This new policy supplements previous announcements the department has made on this subject. Find this updated information here.

Pennsylvania Health Centers Awarded Federal Funds

The federal Health Resources and Services Administration has awarded $100 million in grants to 1381 health centers across the country. Among them are 43 health centers in Pennsylvania that will share $12.9 million in federal funds. See a list of those grant recipients here.