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SNAP Rallies PA Delegation to Oppose MFAR

A proposed federal Medicaid regulation could limit Pennsylvania’s ability to finance its Medicaid program and jeopardize supplemental payments to the state’s private safety-net hospitals, so SNAP has asked members of the state’s congressional delegation to sign a letter to CMS Administrator Seema Verma asking her to reconsider the potentially damaging Medicaid fiscal accountability regulation.

Safety-Net Association of Pennsylvania logoIn its letter to members of the state’s congressional delegation, SNAP wrote on behalf of private Pennsylvania safety-net hospitals that

The proposed Medicaid fiscal accountability regulation (MFAR) would, if implemented, impose new limits on how states may raise their share of funds to support their Medicaid programs. If adopted, the commonwealth would face a serious challenge raising the money it needs to finance its share of the cost of its Medicaid program. In addition, MFAR would take a great deal of states’ Medicaid policy-making authority away from state governments and give it instead to the federal Department of Health and Human Services.

Two members of the state’s congressional delegation, Representatives Brendan Boyle (D-Montgomery/Philadelphia) and Mike Kelly (R-Butler/Crawford/Erie/Lawrence/Mercer), have written a bipartisan letter to be sent to CMS Administrator Seema Verma asking her to reconsider the troubling aspects of MFAR.  SNAP wrote to members of the state’s congressional delegation asking them to sign onto the letter.

Go here to see the full SNAP letter to the delegation.

 

2020-03-03T06:00:10+00:00March 3rd, 2020|Federal Medicaid issues, Pennsylvania Medicaid policy, Uncategorized|Comments Off on SNAP Rallies PA Delegation to Oppose MFAR

Wolf Administration Proposes New Human Services Initiatives for FY 2021

New human services efforts to support vulnerable populations are a major part of Governor Tom Wolf’s proposed $36.06 billion FY 2021 budget for Pennsylvania.

The proposed budget, presented to the state legislature earlier this week, includes the following new initiatives:

  • creating pathways to success in the workforce for low-income Pennsylvanians
  • increasing the minimum wage to $15
  • increasing Department of Human Services staffing to support licensing and oversight
  • supporting adults in long-term-care facilities
  • legal services for vulnerable populations
  • direct care worker comprehensive training
  • commitment to performance-based metrics, accountability, and transparency in services and licensing
  • supporting vulnerable populations through home- and community-based services and reducing waiting lists
  • prevention services to support at-risk families
  • improving food security while supporting agriculture

Go here to see DHS’s presentation of these initiatives.

In addition, the Safety-Net Association of Pennsylvania has prepared a detailed memo describing the proposed FY 2021 budget’s implications for Pennsylvania safety-net hospitals and the state’s Medicaid program.  For a copy of this memo, use the “contact us” link in the upper right-hand corner of this page.

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2020 newsletter.

Included in this month’s edition are articles about:

  • the transition to a new Medicaid prescription drug list (PDL);
  • the rollout of a new electronic visit verification system for Medicaid-paid home health services; and
  • progress in the state’s effort to introduce major changes in its Medical Assistance transportation program (MATP).

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

2020-02-05T06:00:12+00:00February 5th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on Pennsylvania Health Law Project Newsletter

PA Says No to Medicaid Block Grants

Pennsylvania is not interested in pursuing the new Medicaid block grants being offered by the administration, leading state officials said last week.

In a news release, Governor Wolf said that

I expanded Medicaid in Pennsylvania to allow for more than 700,000 people to have reliable health care access. Pennsylvania will not go backwards. I will not risk jeopardizing our progress by going along with another short-sighted, insensitive plan to cut Medicaid…

Department of Human Services Secretary Teresa Miller, who oversees the Pennsylvania Medicaid program that serves approximately 2.8 million people, echoed this sentiment:

Changing any part of Medicaid to a block grant structure is the federal government permitting states to grow health inequities experienced by the poorest Americans. This cruel policy will directly target people who have the most opportunity to see their life and circumstances improved by consistent access to necessary health care and will keep people trapped in the cycle of poverty.

Learn more about why Pennsylvania will not pursue a Medicaid block grant in the Wolf administration news release “Pennsylvania Will Not Participate in Trump Administration Scheme to Cut Medicaid.

2020-02-04T06:00:35+00:00February 4th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Says No to Medicaid Block Grants

Medicaid Transportation Program Defies Fixing

Pennsylvania is trying to fix its Medical Assistance Transportation Program – but that is proving harder than proponents of change envisioned.

For years, county governments ran their own programs, which provided free non-emergency transportation to doctor offices for Medicaid patients.  About 55,000 Pennsylvanians served by Medicaid use this program.

But with a growing trend among states of dividing a state into regions and awarding regional contracts to transportation brokers and amid objections from county governments, the General Assembly directed the state’s departments of Aging, Human Services, and Transportation to look into the matter.

And in the report those departments filed with the legislature, they say they do not know what to do.

Learn more about the challenges facing the Medical Assistance Transportation Program, the options, and the strengths and weaknesses of those options in the Philadelphia Inquirer article “Pennsylvania wants to fix its Medicaid transit program, but there’s no easy way to do it, report says.”

2020-01-10T06:00:02+00:00January 10th, 2020|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on Medicaid Transportation Program Defies Fixing

PA Introduces Medicaid PDL on January 1

Beginning tomorrow, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients.

And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs.

The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services.

While physicians may submit requests to the state for exemptions for specific patients for specific purposes, those exemptions may be relatively uncommon:  the managed care plans that serve the vast majority of the state’s Medicaid population face daily fines starting at $1000 a day if their adherence to the new PDL falls below 95 percent.

Learn more about Pennsylvania’s new Medicaid PDL and how it may affect providers and patients in the Philadelphia Inquirer article “Nearly 150,000 in Pa. could be forced to change medications beginning on Jan.1.  Here’s why.”

 

2019-12-31T06:00:53+00:00December 31st, 2019|Pennsylvania Medicaid policy|Comments Off on PA Introduces Medicaid PDL on January 1

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its November-December 2019 newsletter.

Included in this month’s edition are articles about:

  • Changes in care coordination in the Community HealthChoices program in southeastern Pennsylvania beginning on January 1.
  • Changes in the delivery of Medicaid-covered intensive behavioral health services in homes, schools, and the community for children and adolescents.
  • The switch from Medicaid to Medicare as primary payer for medication-assisted treatment for opioid use disorder for dually eligible (Medicare and Medicaid) patients.
  • Pennsylvania’s request for a delay in implementation of electronic visit verification for Medicaid-covered personal assistance services and home health aides.
  • The delay in implementation of the new public charge rule and its implications for taking advantage of Medicaid benefits among potentially affected individuals.

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

2019-12-23T06:00:51+00:00December 23rd, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter

DHS Unveils Strategic Plan

Pennsylvania’s Department of Human Services has a new strategic plan for 2019 through 2022.

While DHS’s area of endeavor is broad and goes beyond health care, Medicaid is an important aspect of its work and that importance is reflected in the plan, which includes descriptions of DHS’s ambitions in the following areas:

  • Provide every child with a strong foundation for physical and behavioral well-being
  • Bend the health care cost curve
  • Drive innovative whole-person care
  • Holistically assess needs and connect to resources
  • Address the social determinants of health
  • Expand health care beyond the doctor’s office and into the places people live, work, and play
  • Coordinate physical health care, behavioral health care, and long-term services and supports
  • Promote health equity
  • Lead the health care system toward value-based purchasing coordinated across payers
  • Serve more people in the community
  • Enhance access to health care and services that help Pennsylvanians lead healthy, productive lives
  • Coordinate services seamlessly across programs and agencies
  • Expand services and supports for individuals with mental illness
  • Expand services and supports for individuals with substance use disorder

Learn more about what Pennsylvania has in mind for its Medicaid program in the coming years, and for the Pennsylvania safety-net hospitals that serve so many participants in that program, by reading DHS’s new strategic plan for 2019 through 2022.

2019-11-14T06:00:50+00:00November 14th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on DHS Unveils Strategic Plan

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its October 2019 newsletter.

Included in this month’s edition are articles about:

  • the state’s release of a request for applications for insurers to serve participants in Pennsylvania’s HealthChoices physical health care program
  • Pennsylvania’s new Medicaid preferred drug list
  • legislation to expand the state’s Medical Assistance for Workers Program
  • the expansion of the state’s Living Independence for the Elderly (LIFE) program to 14 new counties over the next 18 months.

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

2019-11-13T06:00:20+00:00November 13th, 2019|HealthChoices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Law Project Newsletter

PA to Help Medicaid Beneficiaries Who Want to Work

While Pennsylvania does not have a mandatory work requirement for its Medicaid population, the state is taking a new approach to encouraging Medicaid beneficiaries to pursue work.

It is asking them if they want to work and then, if they say they do, directing them to help finding training an jobs.

As reported by Kaiser Health News,

Starting early next year, the Pennsylvania Medicaid agency under Democratic Gov. Tom Wolf will ask people when they enroll if they want job training assistance. It will then require its private Medicaid managed-care organizations to connect those who want help to local employment specialists and follow up to make sure they got it.

The Wolf administration has resisted legislative efforts to impose a work requirement on the state’s Medicaid population, with the governor twice vetoing legislation that would establish such a mandate.  The legislature is expected to take up a similar bill next year because, as one of the bill’s co-sponsors explained, “What they are suggesting is a tiny step in the right direction, but we need to do so much more.”

Learn more in the Kaiser Health News story “States Try A Gentler Approach To Getting Medicaid Enrollees To Work.”

2019-10-29T06:00:57+00:00October 29th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA to Help Medicaid Beneficiaries Who Want to Work
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