Pennsylvania Medicaid policy Archives - Page 24 of 43 - Safety-Net Association of Pennsylvania

Pennsylvania Health Law Project’s October Newsletter

The Pennsylvania Health Law Project has released its October newsletter.
It includes articles about Healthy Pennsylvania’s Medicaid expansion and its impact on behavioral health benefits; about letters the state is sending to current Medicaid recipients about changes in their benefits; and about letters from the federal government to those enrolled in federal marketplace plans reminding them that they need to renew their health insurance.
The newsletter also features an article about how the state will address those currently enrolled in federal marketplace plans who will become eligible for Medicaid on January 1.
Find the Pennsylvania Health Law Project’s newsletter here.

PA Safety Net Admin2014-11-13T06:00:55+00:00November 13th, 2014|Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Contacts Medicaid Recipients About Benefits

The Pennsylvania Department of Public Welfare is in the process of sending letters to all current adult Medicaid recipients in the state advising them of changes in their Medicaid benefits to take effect on January 1 as a result of the state’s Healthy Pennsylvania Medicaid expansion.
The Pennsylvania Health Law Project has published an explanation of the situation, including sample copies of the letters the state is sending, information about the different benefit packages available to Medicaid recipients, and advice on how recipients who believe they have more serious medical problems can apply for a benefits package better suited to their needs.
Find the Pennsylvania Health Law Project notice here.

PA Safety Net Admin2014-11-10T09:05:50+00:00November 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Makes Healthy PA Implementation Official

The Pennsylvania Department of Public Welfare (DPW) has published an official notice in the state’s Medical Assistance Bulletin announcing the implementation of the Healthy Pennsylvania Medicaid expansion program on January 1, 2015.
The notice provides background information about the plan, how it will work, and how it will differ from the state’s current Medicaid program. It also presents the final word on how the state will define “medically frail” for determining which benefits package participants will receive, outlines how the program’s health screening of applicants will work, and explains enrollees’ cost-sharing responsibilities.
The Bulletin notes that the state will issue a separate announcement to providers with more information about the scope of benefits to be provided, how the program will employ private insurers to serve the state’s Medicaid population, and when training will be offered to familiarize providers on how to work with the new program.
Find the Bulletin here.

PA Safety Net Admin2014-11-05T06:00:17+00:00November 5th, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

MACPAC Not Yet Sold on Continuing Medicaid Primary Care Pay Increase

The independent federal agency that advises Congress on Medicaid and the Children’s Health Insurance Program is not ready to endorse continuing the Affordable Care Act’s two-year increase in Medicaid primary care fees as a means of encouraging more doctors to serve Medicaid patients.
At its October 30-31 public meeting in Washington, D.C., the staff of the Medicaid and Children’s Health Insurance Program Payment and Access Commission (MACPAC) reported that it has begun looking into the effectiveness of the temporary pay increase in persuading more doctors to care for Medicaid recipients. Among its preliminary findings are that

The payment increase had at best, a modest effect on provider participation according to states and MCOs
Most states reported that the provision had no effect on the use of primary care services

Consequently, MACPAC did not offer any recommendations on this issue at the public meeting and intends to continue studying the impact of enhanced Medicaid primary care fees on physician willingness to serve Medicaid patients.
For the two years ending on December 31, 2014, the federal government has paid for 100 percent of the fee increases. Some states have already decided to continue making the enhanced payments at their own expense, some will make enhanced payments but not necessarily at the level authorized by the Affordable Care Act, and some intend to restore the payments to their previous levels.
Pennsylvania plans to return its Medicaid primary care fee-for-service rates to their 2012 level.
The MACPAC presentation on Medicaid primary care physician payments can be found here.

PA Safety Net Admin2014-11-04T06:00:10+00:00November 4th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

To Increase or Not to Increase? That is the Question

To induce more primary care providers to serve Medicaid patients at a time when Medicaid enrollment was about to increase significantly nation-wide, the Affordable Care Act raised Medicaid primary care reimbursement to the same level as Medicare rates for 2013 and 2014, with the federal government to pick up the tab for 100 percent of the increase in state spending for these services.
With that two-year increase coming to an end, states now must decide whether to continue the increase and pay for it themselves or let their Medicaid primary care rates return to their old levels.
According to a survey taken by the Kaiser Family Foundation, 15 states will continue the increases either in part or in full; 24 do not plan to continue the increases; and 12 still have not decided.
Some states that are continuing the increases in some form also are changing the types of primary care providers that will receive the enhanced Medicaid payments.
Pennsylvania is among the 24 states not planning to continue the rate increase.
For a closer look at the issue, including a map that illustrates each state’s intentions, see the Kaiser Family Foundation report “The ACA Primary Care Increase: State Plans for SFY 2015” here, on the foundation’s web site.

PA Safety Net Admin2014-11-03T06:00:34+00:00November 3rd, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Some PA Women Could Lose State Medical Benefits

The expiration of a state health program could leave about 90,000 low-income Pennsylvania women without the free family planning and women’s health benefits they currently receive.
A program called SelectPlan for Women offers limited health benefits to low-income women between the ages of 18 and 44 who are otherwise ineligible for Medicaid. While there has been no formal announcement of the program’s termination, women’s health advocates have informally been told that such a termination is possible at the end of the year.
If the program expires, some of the women it currently covers will be eligible for Medicaid under the state’s Medicaid expansion to take effect on January 1 while others should be eligible for at least some subsidization of insurance premiums on the federal health insurance exchange.
The SelectPlan for Women, however, has no limits on visits, no co-pays, and no premiums.
Learn more about SelectPlan for Women, what it does, and why it may soon disappear in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-10-30T06:00:59+00:00October 30th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Medicaid Directors Weigh in On Managed Care Regulation

The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs.
In a paper entitled “Medicaid Managed Care Modernization: Advancing Quality Improvement,” the National Association of Medicaid Directors urges the Centers for Medicare Services (CMS) to work with the states to develop quality reporting measures that are both useful and not overly burdensome.
The association also asks CMS to leave decisions about accrediting requirements for state Medicaid managed care programs in state hands and not to establish a national quality rating system for Medicaid managed care plans.
The regulation of Medicaid managed care plans is especially important to Pennsylvania safety-net hospitals because they care for so many Medicaid patients and managed care has become the primary means through which the state’s Medicaid program serves those patients.
Learn more about Medicaid directors’ recommendations for improving and regulating state Medicaid managed care programs in this National Association of Medicaid Directors correspondence with the Center for Medicaid and CHIP Services.

PA Safety Net Admin2014-10-27T06:00:19+00:00October 27th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

New Video Explains PA Medicaid Expansion

The Pennsylvania Department of Public Welfare has posted a new presentation video on its Healthy Pennsylvania Medicaid expansion program. The video outlines how the program works, who is eligible to participate, what the benefits are, and more. It offers useful information for hospital employees and other Pennsylvania health care providers who will soon see an influx of as many as 600,000 new Medicaid recipients in the state.
Find the video here, on the state’s Healthy PA web site.

PA Safety Net Admin2014-10-24T06:00:48+00:00October 24th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Increased Utilization by New Medicaid Patients Levels Off, Study Finds

Spikes in hospital emergency room and inpatient admissions attributed to patients who have recently obtained Medicaid coverage eventually taper off, according to a new study.
According to the study Increased Service Use Following Medicaid Expansion is Mostly Temporary: Evidence From California’s Low Income Health Program, dramatic increases in ER use and hospitalizations among those newly insured by Medicaid eventually level off and should not especially tax either hospital capacity or state Medicaid budgets.
The study, performed by the UCLA Center for Health Policy Research, found that after pent-up demand for care among those who previously had limited access to services was satisfied, utilization dropped by more than two-thirds and then remained relatively constant. Outpatient utilization remains generally stable, the study found.
These findings may be a glimpse into Pennsylvania’s future and what its hospitals will face when the state eventually expands its Medicaid program.
For further information about the study and its implications for hospitals and state Medicaid budgets, see this Kaiser Health News report. To see the UCLA study itself, go here.

PA Safety Net Admin2014-10-16T11:53:50+00:00October 16th, 2014|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Insurers Struggle to Find Providers to Participate in Healthy PA Medicaid Expansion

The insurers selected to participate in Pennsylvania’s Healthy PA Medicaid expansion program are having a hard time persuading hospitals and doctors to join their provider networks.
Citing low Medicaid reimbursement rates, providers have been reluctant to work with the chosen insurers.
The state selected nine insurers to offer Medicaid coverage to approximately 600,000 new recipients beginning on January 1, but now, one of those insurers has withdrawn from the program and another is considering reducing the geographic region it intends to serve.
Originally, the Corbett administration said it hoped to have at least three insurance options in each of the nine regions created for the Medicaid expansion program. Now, it appears that two carriers per region is a more realistic expectation.
Read more about the challenges insurers are encountering in lining up participating providers, and how that problem could affect the overall Medicaid expansion effort, in this Pittsburgh Tribune-Review article.

PA Safety Net Admin2014-10-10T06:00:53+00:00October 10th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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