Pennsylvania Medicaid policy Archives - Page 23 of 44 - Safety-Net Association of Pennsylvania

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

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
The December edition includes articles about Medicaid benefits under Healthy Pennsylvania; the eligibility criteria for Medicaid; the continuation of the state’s General Assistance program for selected immigrants; and the process for some Pennsylvanians currently insured through the federal insurance marketplace to shift to Medicaid coverage instead.
Find the newsletter here.

PA Safety Net Admin2015-01-12T06:00:58+00:00January 12th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Medicaid Pay Bump Gone in PA; Will it Affect Access?

The temporary increase in Medicaid provider fees for primary care services ended yesterday, leaving observers to wonder whether it will affect access to care for the nation’s growing Medicaid population.
The increase, mandated by the Affordable Care Act, raised Medicaid primary care rates to the same level as Medicare payments in the hope that more primary care providers would begin serving Medicaid patients in anticipation of significant growth in the Medicaid population. Now that the two-year increase has ended, it is unclear whether providers who began serving Medicaid patients because of the increase will remain Medicaid providers and those who accepted more Medicaid patients will continue doing so.
Because of the relatively short duration of the increase, little research has been completed to determine whether the raise made a difference in access, but some states believe it did: a number will use their own money to continue the raises, which during the two-year experiment were paid entirely by the federal government.
Pennsylvania is not among the states that will continue paying the enhanced Medicaid fees for primary care services.
Kaiser Health News has taken a look at this issue and the potential implications of the end of the Medicaid pay raise; see its report here.

PA Safety Net Admin2015-01-02T06:00:57+00:00January 2nd, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

PA Addresses Healthy PA Transition Issues

The Pennsylvania Department of Human Services (DHS – formerly the Department of Public Welfare) has issued a memo to Medical Assistance stakeholders addressing two issues involving implementation of the state’s Healthy Pennsylvania Medicaid expansion that have been brought to its attention.
The first issue is that individuals who enrolled in Medicaid in December were not assigned to a behavioral health managed care organization.
The second addresses screening of individuals who currently qualify for Medicaid under the General Assistance category who have behavioral health needs and who likely qualify for the “Healthy Plus” Medicaid benefits plan beginning in 2015.
See the state’s message to stakeholders outlining what these issues are about and how it plans to address them in this memo from the state’s Office of Mental Health and Substance Abuse Services.

PA Safety Net Admin2014-12-30T06:00:43+00:00December 30th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Officially Ends Enhanced Medicaid Payments

The Affordable Care Act-mandated increase in Medicaid payments for primary care services ends on December 31.
While some states believe this increase improved access to care for their Medicaid population and will continue the increase using their own money, Pennsylvania will not, and a new Medical Assistance Bulletin informs primary care providers in the state that the fee-for-service rates they are paid will return to their previous level on January 1.
See the Medical Assistance Bulletin notice here.

PA Safety Net Admin2014-12-29T06:00:31+00:00December 29th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Medical Assistance Eligibility Manual Released

The Pennsylvania Health Law Project has updated its Medical Assistance eligibility manual.
Written in plain English for a general readership, the manual describes the various ways individuals may qualify for Medical Assistance (Medicaid) in Pennsylvania and how they can go about applying for benefits.
Find the updated manual here.

PA Safety Net Admin2014-12-26T06:00:08+00:00December 26th, 2014|Pennsylvania Medicaid policy|Comments Off

PA Wins Innovation Planning Grant

Pennsylvania is among 21 states that will receive State Innovation Models Initiative Model Design Awards from the federal Center for Medicare and Medicaid Innovation.
The award of $3 million will be used to

…engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Health Care Innovation Plan.

The purpose of the state innovation models program is to support

…states that are prepared for or committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. The Innovation Center is interested in testing innovative payment and service delivery models that have the potential to lower costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), while maintaining or improving quality of care for program beneficiaries.

The grant funds were awarded on a competitive basis, with funding decisions based on an initial round of state innovation model planning. Michael Chirieleison, president of the Safety-Net Association of Pennsylvania (SNAP), served on the committee that developed the commonwealth’s state innovation model proposal.
Learn more about the federal State Innovation Models Initiative here.

PA Safety Net Admin2014-12-24T06:00:48+00:00December 24th, 2014|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

PA Issues Bulletin Detailing Healthy PA Benefits

The benefits offered through Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion program are detailed in a new Medical Assistance Bulletin issued by the state’s Department of Human Services.
In addition to describing both the benefits and the processes the state will employ for seeking exceptions to the established benefits, the Bulletin includes several attachments: a benefit plan comparison chart; automatic benefit limit exceptions for APR-DRG; automatic benefit limit exceptions for radiology and imaging; automatic benefit limit exceptions for laboratory services; automatic benefit limit exceptions for durable medical equipment; and automatic benefit limit exceptions for medical supplies.
The program, the benefits, and the new guidelines take effect on January 1.
Find this Medical Assistance Bulletin here.

PA Safety Net Admin2014-12-22T06:00:27+00:00December 22nd, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Medicaid Primary Care Fees to Plummet

Payments to Pennsylvania primary care physicians who serve Medicaid patients will fall 52.4 percent after the first of the year, when the Affordable Care Act’s two-year increase in those payments ends.
The temporary fee increase was included in the Affordable Care Act to encourage more primary care physicians to serve Medicaid patients in anticipation of the significant growth of Medicaid as a result of the reform law’s Medicaid expansion. Under that law, Medicaid primary care fees were raised to the level of Medicare primary care rates for two years. Nation-wide, the average Medicaid primary care fee will fall 42.8 percent.
So far, 15 states plan to use their own money to prevent the dramatic reduction of Medicaid primary care payments. Pennsylvania is not among them.
The cut will be especially damaging to the state’s safety-net hospitals because they serve so many more Medicaid patients than the typical hospital and expect to serve even more such patients when the state’s Medicaid program expands beginning on January 1.
Learn more about the upcoming Medicaid payment cut in the new Urban Institute report Reversing the Medicaid Fee Bump: How Much Could Medicaid Physician Fees for Primary Care Fall in 2015?, which you can find here, on the Urban Institute’s web site.

PA Safety Net Admin2014-12-17T06:00:15+00:00December 17th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

SNAPShots

SNAPShots

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us