Pennsylvania Medicaid policy Archives - Page 22 of 43 - Safety-Net Association of Pennsylvania

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

SNAP Principles for Changing Course on Medicaid Expansion in Pennsylvania

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 third of those four papers 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.
Those eight principles are:

communicate changes effectively to the provider community
ensure beneficiaries’ continuity of coverage and continuity of care
ensure the adequacy of provider networks
simplify beneficiary and provider enrollment
preserve vital supplemental payments to safety-net hospitals
continue pursuing Medical Assistance payment reforms
ensure the long-term financing of Medical Assistance in response to current and future threats to that financing
invest in innovative, population-based infrastructure and programmatic improvements

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.
Find all three SNAP papers here.

PA Safety Net Admin2015-01-28T06:00:12+00:00January 28th, 2015|Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Medicaid “Pay Bump” Worked, New Study Suggests

A federally mandated increase in Medicaid payments for primary care services appears to have achieved its goal of improving access to care for Medicaid recipients – especially in Pennsylvania.
The increase, part of the Affordable Care Act, called for raising payments for Medicaid primary care services to the same level as Medicare payments in the hope that such an increase would lead more primary care providers to serve Medicaid patients, thereby improving access to primary care services for those patients. Historically, primary care providers have been reluctant to serve Medicaid patients, citing low pay as their reason for avoiding such patients.
That Medicaid pay increase – often referred to as the “Medicaid pay bump” – was mandated for two years and expired at the end of 2014. One of the reasons policy-makers resisted extending it was the lack of proof that it achieved its goal of improving access. Now, a new study in the New England Journal of Medicine provides the first broad look at the program’s impact – and the first proof of its success.
In the study, researchers selected ten states and measured the availability and waiting times for primary care appointments for two limited periods of time. They found that

…The availability of primary care appointments in the Medicaid group increased by 7.7 percentage points, from 58.7% to 66.4%, between the two time periods. The states with the largest increases in availability tended to be those with the largest increases in reimbursements, with an estimated increase of 1.25 percentage points in availability per 10% increase in Medicaid reimbursements.

Among the ten states evaluated in the study was Pennsylvania, where the benefits of the Medicaid pay bump were especially noteworthy: while the availability of appointments rose eight percent overall in the states that were part of the study, appointment availability rose 13 percent in Pennsylvania.
One possible reason: the Medicaid pay bump doubled Medicaid primary care fees.
The study’s conclusion?

Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times.

Learn more about the study from this Allentown Morning Call article or find the New England Journal of Medicine article here.

PA Safety Net Admin2015-01-27T06:00:28+00:00January 27th, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Millions Live in ACA Coverage Gap

Nearly four million people who were supposed to be helped to health insurance through the Affordable Care Act remain uninsured today because they earn too much to qualify for Medicaid and not enough to qualify for the reform law’s health insurance subsidies.
When the law was passed in 2010, it was supposed to provide Medicaid coverage for those earning up to 138 percent of the federal poverty level and offer subsidies to other low-income earners. But when the Supreme Court made the reform law’s mandatory Medicaid expansion optional for states and some states chose not to expand their Medicaid programs, nearly four million people found themselves wedged between eligibility for Medicaid and eligibility for subsidies, with no help forthcoming.
Among the four million, more than half work at least part-time and two-thirds reside in a household with at least one wage-earner. Most work for small companies that are not required to provide health insurance for their employees and many earn the minimum wage. Many are single adults.
The coverage gap has been a problem in Pennsylvania, which until recently did not expand its Medicaid program. As a result, many people who fell into this gap turned to the state’s safety-net hospitals when they needed care but had no health insurance.
The Washington Post has taken a look at the challenges these low-income and often medically vulnerable people face living in states that have chosen not expanded their Medicaid programs. See its report here.

PA Safety Net Admin2015-01-26T06:00:19+00:00January 26th, 2015|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Problems Reported in Healthy PA Medicaid Enrollment

It appears some people may be having trouble taking advantage of Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion.
The Pittsburgh Post-Gazette reports that there is a backlog in processing applications, some people who are eligible to participate are getting rejected for coverage, and some who need drug and alcohol treatment services have been placed in plans that do not provide such coverage.
The state has acknowledged the problem with drug and alcohol coverage but notes that processing applications can take up to 45 days. So far, the state estimates that 150,000 Pennsylvania households have applied for Medicaid coverage since the enrollment period started on December 1.
To learn more about the challenges Pennsylvania’s Medicaid expansion is encountering, see this Pittsburgh Post-Gazette article.

PA Safety Net Admin2015-01-16T06:00:04+00:00January 16th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Will High Court Help Pave the Way to Higher Medicaid Payments?

In a case that could have nation-wide implications for health care providers, the U.S. Supreme Court will hear an appeal of a lower court decision that ordered the state of Idaho to raise Medicaid payments to providers serving the developmentally disabled because the state’s payments were too low.
While litigants in some states have used the courts in recent years to seek redress for what they believed were inadequate Medicaid payments, Supreme Court action on that matter could have national implications: if the court supports the state of Idaho’s appeal of the order to raise fees it could limit the use of litigation in the future as a means of increasing payments and improving access to care for the Medicaid population. If, on the other hand, the court rejects the Idaho appeal, it could potentially open the door to more such litigation, especially in states with Medicaid payments that do not even cover the cost of services providers deliver.
The outcome of this case will be of special interest to Pennsylvania’s safety-net hospitals because the state still underpays hospitals for much of the care they provide to their Medicaid patients.
To learn more about the Idaho case, similar litigation elsewhere, and the implications of the case about to go before the Supreme Court, see this Kaiser Health News report.

PA Safety Net Admin2015-01-14T06:00:35+00:00January 14th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

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