The Pennsylvania Department of Human Services (DHS) has issued a report on its progress toward stated goals in the transition from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s Medicaid expansion via the state’s existing HealthChoices managed care program.
See that report here.
The Pennsylvania Department of Human Services (DHS) has issued a new Medical Assistance Bulletin on the state’s expansion of its Medicaid program via the HealthChoices managed care program.
The bulletin notifies providers of the introduction of a new adult benefit package that applies to all adult Medicaid recipients in the state, highlighting some of the major changes in benefits from past packages. It also provides information about the state’s plan for a phased transition from the current private care option (PCO) insurance plans to HealthChoices plans over the coming months.
See DHS Medical Assistance Bulletin 99-15-05 here.
Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program.
Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014. In the next few days they will receive written notification of the shift. All will receive the same Medicaid benefits: a basic adult benefit package.
Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by September 1.
For more information about the continued transition from Healthy Pennsylvania to HealthChoices, see this news release from the governor’s office.
With the state still struggling to enroll and revalidate Medicaid providers, the Pennsylvania Department of Human Services (DHS) presented an update on its efforts to improve that process at the April 23 meeting of its Medical Assistance Advisory Committee (MAAC).
According to the presentation, DHS is focusing its improvements in three primary areas: introducing a new electronic enrollment web portal this fall; standardizing its processes and procedures; and adding staff next month to facilitate enrollments.
DHS staff made a presentation on its latest efforts at the April 23 MAAC meeting. See that presentation here.
In response to the challenges the state has encountered processing Medicaid provider enrollment applications, the Pennsylvania Department of Human Services (DHS) has unveiled what it believes will be an improved approach to tackling this problem.
The improvements include electronic enrollment, standardization of policies and procedures, and additional provider enrollment staffing.
At the heart of the backlog are Affordable Care Act requirements.
Go here to see a message from DHS acting secretary Theodore Dallas on this subject.
The Pennsylvania Health Law Project has published its March 2015 newsletter.
Included in this edition are articles about the state’s changes in how it is expanding its Medicaid program; a look at Governor Wolf’s proposed FY 2016 Medicaid budget; and closer examinations of a proposed expansion of services for older adults and people with disabilities and the budget of the state’s Office of Mental Health and Substance Abuse Services.
Find the Pennsylvania Health Law Project’s latest newsletter here.
What are states looking for from “Medicaid reform”?
How do they evaluate the prospects of reform proposals – and how do they evaluate reforms that have been implemented?
Across the country, states are pursuing Medicaid reform through section 1115 waivers, Delivery System Reform Incentive Payment Programs (DSRIP), the State Innovation Models (SIM) Initiative, and other means. As they do, they must decide what innovations to pursue and then make decisions about whether those they have chosen have achieved their objectives and produced genuine payment and delivery system reform, improved outcomes, and laid a foundation for further improvement.
Many of these decisions are made by state Medicaid directors, and now, the National Association of Medicaid Directors has published a paper offering its perspective on Medicaid reform: what it is, what it looks like, and how they will approach it. See its paper Perspectives on Innovation here.
The Pennsylvania Department of Human Services (DHS) has posted a document outlining its plan for transitioning from the Healthy Pennsylvania Medicaid expansion to what it terms a “traditional Medicaid expansion.”
The document summarizes what the state is doing, why it is doing it, and how it plans to move from the previous approach to the new one. It also includes links to expansion-related documents and explanations, presents the cost of the transition and the new program, and explains to interested parties how they can comment on the state’s plans.
Find the notice document “Transition to Traditional Medicaid Expansion” here.
The Pennsylvania Health Law Project has published its February newsletter.
This edition features articles on Medicaid expansion in Pennsylvania; problems posed by Healthy Pennsylvania for individuals who receive drug and alcohol or mental health services and how the state is addressing those problems; and the new, special enrollment period for those who are uninsured to sign up through the federal marketplace and avoid the fine for failing to secure health insurance.
The newsletter also lists upcoming state legislative budget hearings that will address health care issues and raises the possibility of the state establishing an Affordable Care Act-authorized “Community First Choice” program, which gives a state access to additional federal matching funds to pay for attendant services for Medicaid beneficiaries with severe intellectual or physical disabilities.
Find the latest edition of Health Law PA News here.
Pennsylvania’s Department of Human Services (DSH) has restored access to drug and alcohol treatment services to Medicaid recipients who were placed in new Medicaid private coverage option plans that do not cover such care.
At fault was a glitch in the implementation of the Healthy Pennsylvania Medicaid expansion in which some Medicaid recipients were placed in “low risk” insurance plans that do not cover drug and alcohol treatment. DHS staff combed the rolls of Medicaid recipients who joined those plans in search of recipients who needed those services and shifted them into plans that provide such coverage.
About 8500 Medicaid beneficiaries affected by the problem have been moved into plans that enable them to resume resume treatment.
Some providers chose to continue treating their Medicaid patients who lost their coverage and have suffered financial problems as a result. The state intends to address those situations on a case-by-case basis, according to acting DHS secretary Ted Dallas.
Some of those recipients may eventually be on the move again as the Wolf administration continues phasing out the Healthy Pennsylvania program in favor of expanding the state’s pre-Healthy Pennsylvania Medicaid program.
For a close look at this problem, how it affects patients and providers, and how the state corrected it, see this Philadelphia Inquirer article.