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

PA Health Law Project Releases Monthly Newsletter

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.

PA Safety Net Admin2015-04-15T06:00:19+00:00April 15th, 2015|HealthChoices PA, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2016 Pennsylvania state budget|Comments Off

How States View Medicaid Reform

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.

PA Safety Net Admin2015-04-03T06:00:35+00:00April 3rd, 2015|Pennsylvania Medicaid policy|Comments Off

PA Releases Document Outlining Transition to “Traditional Medicaid Expansion”

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.

PA Safety Net Admin2015-03-23T06:00:57+00:00March 23rd, 2015|Pennsylvania Medicaid policy|Comments Off

New Pennsylvania Health Law Project Newsletter

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.

PA Safety Net Admin2015-03-13T06:00:18+00:00March 13th, 2015|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Restores Substance Abuse Services to Medicaid Patients

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.

PA Safety Net Admin2015-03-12T06:00:39+00:00March 12th, 2015|Pennsylvania Medicaid policy|Comments Off

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

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