Pennsylvania Medicaid policy Archives - Page 21 of 43 - Safety-Net Association of Pennsylvania

PA Updates Medicaid Expansion Timetable

The Pennsylvania Department of Human Services (DHS) has released a timetable for its planned transition from the Corbett administration’s Healthy Pennsylvania Medicaid expansion to its expansion of the state’s previous Medicaid program.
According to a DHS news release,

Phase 1

This phase will begin in April 2015 and be completed by June 1, 2015.
Individuals who were enrolled in the General Assistance and Select Plan program in December 2014 will begin to be transferred from the private coverage option (PCO) to the new streamlined Adult benefit package.
New applicants will no longer be enrolled in the PCO and will be enrolled in the new Adult benefit package with coverage provided by the HealthChoices managed care organizations.

Phase 2

This phase will begin in July 2015 and be completed by September 30, 2015.
All remaining PCO enrollees will transition from PCO plans into the HealthChoices by September 1, 2015.

For a closer look at the plan for Medicaid expansion, see this DHS news release.

PA Safety Net Admin2015-03-10T06:00:35+00:00March 10th, 2015|Pennsylvania Medicaid policy|Comments Off

PA Outlines Medicaid Transition Timetable

Pennsylvania should complete by the end of September its transition from former Governor Tom Corbett’s Healthy Pennsylvania Medicaid expansion program to new Governor Tom Wolf’s more traditional approach to Medicaid expansion.
According to Ted Dallas, acting secretary of the Department of Human Services, the transition involves combining the addition of newly eligible Pennsylvanians onto the state’s Medicaid rolls, moving all eligible participants into a single benefit plan instead of the two-tiered plan employed under Healthy Pennsylvania, and updating the state’s information systems to accommodate these changes.
Adding the newly eligible Pennsylvanians to the state’s Medicaid rolls and moving them into a single benefit plan should be completed by the end of April. Updating the state’s information systems will take longer and should be completed by the end of September.
For more on the planned transition, see this Philadelphia Inquirer article.

PA Safety Net Admin2015-03-06T06:00:54+00:00March 6th, 2015|Pennsylvania Medicaid policy|Comments Off

PA Revises Guidelines for Medicaid Presumptive Eligibility

The Pennsylvania Department of Human Services has revised its guidelines for hospitals qualified to make presumptive eligibility determinations for potentially Medicaid-eligible patients who seek services but are uninsured.
The revisions are described in Medical Assistance Bulletin 01-15-08, “Revised Presumptive eligibility as Determined by Hospitals,” which was issued on February 24 but is retroactive to January 1.
In support of that new guidance the state also has issued an addendum for providers outlining their responsibilities and a worksheet for hospitals to use in determining eligibility.

PA Safety Net Admin2015-03-05T06:00:02+00:00March 5th, 2015|Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

Update on PA’s Health IT Efforts

Last week leaders of Pennsylvania’s Health IT Initiative presented an update on their program’s efforts at a meeting of the Medical Assistance Advisory Committee.
The presentation focused on the distribution of funds made available through the American Reinvestment and Recovery Act of 2009. The purpose of this funding is to promote the adoption, implementation, and meaningful use of electronic health records (EHRs) by health care providers.
The presentation reviewed the goals of the program; the payments made through the state’s Medicaid program to hospitals and qualified physicians so far; upcoming deadlines for pursuing additional financial support; problems encountered by the program and lessons learned; and progress to date toward building the state’s health information exchange.
See the presentation here.

PA Safety Net Admin2015-03-03T06:00:59+00:00March 3rd, 2015|Pennsylvania Medicaid policy|Comments Off

States Seek to Reduce ER Use Among Medicaid Patients

Even though the rate at which non-Medicaid recipients inappropriately use hospital emergency rooms exceeds the rate of inappropriate use among Medicaid patients, a number of states are launching efforts to reduce ER overuse among their Medicaid recipients.
Medicaid patients currently use – as distinguished from inappropriately use – hospital ERs at twice the rate of privately insured patients, typically for a number of reasons: they are less healthy than insured patients; they have a more difficult time finding primary care physicians who will treat them; and they have jobs that prevent them from going to doctors during ordinary office hours.
To address overuse, states are trying a number of approaches. Nearly half of the states are imposing or increasing Medicaid co-pays for ER visits. Some are identifying Medicaid patients among their frequent ER users and making primary care appointments for them before they leave the ER. Some Medicaid managed care plans are doing the same, analyzing ER data among their users and making an extra effort to connect them to primary care physicians.
Some of these approaches are showing promise. When Washington state ER personnel started setting up appointments with primary care patients for Medicaid-insured ER visits, ER use among Medicaid patients fell 9.9 percent in the first year. When a Medicaid managed care plan in St. Louis tried a similar approach, ER use among its members declined 9.5 percent.
To learn more about what states and insurers are doing to reduce ER use among Medicaid patients, see this Stateline report.

PA Safety Net Admin2015-02-27T06:00:17+00:00February 27th, 2015|Pennsylvania Medicaid policy|Comments Off

New Web Site for PA Medicaid Expansion

Along with the Wolf administration’s decision to exit the Healthy Pennsylvania Medicaid expansion in favor of a more conventional approach comes a new web site dedicated to that expansion: HealthChoices PA.
The new HealthChoices PA site features sections that describe the program and address the immediate implications of the state’s shift from Healthy Pennsylvania to HealthChoices PA. It also offers an FAQ, resources for consumers and providers, and a gateway for applicants.
The address of the new site is http://www.healthchoicespa.com. Find it here.

PA Safety Net Admin2015-02-18T14:40:15+00:00February 18th, 2015|HealthChoices PA, Pennsylvania Medicaid policy|Comments Off

SNAP Looks to the Future

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The fourth of those papers, released this week, addresses the importance of innovation in addressing the challenges safety-net hospitals face in leading the way to serving Pennsylvania’s growing Medicaid population.
The paper describes the new demands being made of hospitals by insurers, government, and others; tools through which to pursue innovation; the goals of future innovation; and the role that SNAP and safety-net hospitals must play in that innovation.
The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
The third paper, “Transitioning Medicaid: Principles for Changing Course on Medicaid Expansion,” presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Find all four SNAP papers here.

PA Safety Net Admin2015-02-12T10:43:14+00:00February 12th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Wolf Administration to Shift Gears on Medicaid Expansion

Pennsylvania Governor Tom Wolf has taken the first step to short-circuit the state’s Healthy Pennsylvania Medicaid expansion in favor of a more traditional approach to Medicaid expansion.
In a news release issued yesterday, the Wolf administration announced that it will withdraw Pennsylvania’s request for a second tier of medical benefits for Medicaid recipients because it intends to change the state’s program to offer the same benefits to all participants.
This will be the first step toward building the state’s Affordable Care Act-authorized Medicaid expansion around the state’s HealthChoices-oriented structure instead of the private market insurance plans favored by Mr. Wolf’s predecessor, former Governor Tom Corbett.
Learn more about the new administration’s first step toward changing the state’s Medicaid expansion effort in this news release from the governor’s office.

PA Safety Net Admin2015-02-10T06:00:13+00:00February 10th, 2015|Pennsylvania Medicaid policy|Comments Off

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its January 2015 newsletter.
Among the articles in it are pieces on the launch of the Healthy Pennsylvania Medicaid expansion; an update on the temporary extension of the state’s Select Plan for Women; information on how Medicaid recipients who believe they need the state’s new Medicaid “Healthy Plus” benefits package can seek that enhanced coverage; and news on who should consider shifting from a health insurance plan purchased on the federal marketplace to Medicaid.
Find the newsletter here.

PA Safety Net Admin2015-02-04T06:00:34+00:00February 4th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Medicaid Expansion Glitch Hits Drug and Alcohol Patients, Providers

A flaw in the implementation of Pennsylvania’s Medicaid expansion has left many of the state’s Medicaid beneficiaries with no coverage for the treatment of their drug and alcohol problems – and some providers without payment for some care they have delivered.
Under the Healthy Pennsylvania Medicaid expansion program, beneficiaries with extensive health problems, like drug and alcohol issues, were supposed to be directed into the state’s “Healthy Plus” Medicaid benefits package, which covers services that address such problems. Instead, many were places in private, state-approved insurance plans for Medicaid beneficiaries, which do not cover those services.
State officials are aware of the problem and say they will soon have a plan to fix it.
Learn more about this glitch in Pennsylvania’s Medicaid expansion and how state officials hope to address it in this Philadelphia Inquirer article.

PA Safety Net Admin2015-01-30T06:00:14+00:00January 30th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

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