Pennsylvania Medicaid policy Archives - Page 12 of 45 - Safety-Net Association of Pennsylvania

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.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-03-26T06:00:31+00:00March 26th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020.

Pennsylvania Administration

Since yesterday, the Department of Human Services has issued the following four new guidance documents:

We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information.

Any business that would like to seek a waiver to the mandate to close can send a request to this email address: RA-dcexemption@pa.gov
In addition, questions about whether or not your specific business needs to close can be directed to: ra-dcedcs@pa.gov

At the Secretary of Health’s daily update she noted that the number of diagnosed COVID-19 cases in the state doubled in the past two days.

Federal

Administration

CMS approved Washington state’s 1135 waiver request. The approval letter can be found here.

In addition, CMS released two telehealth toolkits: one for general practitioners that is available here and another for end-stage renal disease providers available here.

Congress

Congress is preparing a combination bill to both combat the spread of the coronavirus and also provide economic stimulus to counteract the negative effects of the state of emergency. As Congress deliberates, SNAP weighed in today with Pennsylvania’s congressional delegation, asking for immediate financial support for hospitals, the elimination of the Affordable Care Act Medicaid DSH cuts, and a moratorium on new regulatory requirements on hospitals. Find a summary of the bill here and SNAP’s letter to the delegation here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-23T06:00:11+00:00March 23rd, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logo The following is a summary of the major COVID-19-related developments in Pennsylvania today.

Telemedicine

The Office of Medical Assistance Programs has issued guidance for providers on the use of telemedicine services for Medicaid patients – those covered both by managed care plans and on a fee-for-service basis. Learn more from the newly posted telemedicine guidelines and a separate memo to the HealthChoices managed care plans from the state.

In addition, CMS issued a waiver for certain restrictions on the provision of telemedicine services under the Medicare program. The details of the wavier are described in a Fact Sheet and FAQ.

New Guidance From the State

Today the state published a number of COVID-19-related resources:

Letter from Department of Health Secretary

Attached to this memo, please find a letter and its attachment issued by the PA Department of Health providing additional hospital guidance on implementing your emergency preparedness plans.

PA Insurance Department Public Notice

You can find a preview copy of a pending public notice from the insurance department related to COVID-19 at this link.

PA General Assembly Update

Both the House and Senate are currently in recess with a 12-hour call of their respective chairs. Neither chamber is expected to be in Harrisburg through the remainder of this week and we will likely receive an update on next week’s session schedule over the weekend.

The House passed temporary rules during session yesterday to allow its members to work and vote remotely should the need arise in the coming weeks/months. This temporary rule still requires majority and minority leadership to be at the Capitol for bill movement and to tally votes. The same is required of Committee Chairs should they call voting meetings during this time away from Harrisburg.

Daily State Briefing

Department of Health Secretary Levine reported that the state is now receiving more COVID-19 test results from commercial and hospital laboratories, which are now doing most of the testing. As that number rises, the ability of officials to trace the origin of the disease is expected to decrease.
Mass testing sites for Philadelphia and Montgomery County are still being explored. They would perform drive-through testing and would only be for people showing symptoms.
With state liquor stores about to close, state officials are planning to meet later today to discuss possible resources for alcohol-dependent individuals who suffer withdrawal problems.
The state will be providing guidance to dentists, who are considered very high risk, later this week.
No hospitals are reporting to the state that they are overtaxed by COVID-19 patients at this time.

Secretary Miller’s Briefing

DHS Secretary Teresa Miller is holding an invitation-only briefing later today. If anything urgent arises we will let you know immediately. Otherwise, we will report on it tomorrow.

Resources to Consult

Pennsylvania Department of Human Services

Pennsylvania Department of Health

Centers for Disease Control and Prevention Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-18T16:53:47+00:00March 18th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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 logo In 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.

PA Safety Net Admin2020-03-03T06:00:10+00:00March 3rd, 2020|Federal Medicaid issues, Pennsylvania Medicaid policy, Uncategorized|Comments Off

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.

PA Safety Net Admin2020-02-07T06:00:38+00:00February 7th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2021 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

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.

PA Safety Net Admin2020-02-05T06:00:12+00:00February 5th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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.”

PA Safety Net Admin2020-02-04T06:00:35+00:00February 4th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

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.”

PA Safety Net Admin2020-01-10T06:00:02+00:00January 10th, 2020|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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