Pennsylvania Medicaid policy Archives - Page 27 of 43 - Safety-Net Association of Pennsylvania

Feds Question PA’s MCO Gross Receipts Tax

The federal government is questioning Pennsylvania’s use of proceeds from its tax on Medicaid managed care organizations to draw down federal Medicaid matching funds.
Federal law permits some use of revenue from health care-related taxes to help finance the state’s share of Medicaid spending, but such taxes must be “broad-based” and a 2009 change in the law narrowed the definition of what constitutes a broad-based tax.
According to an audit performed by the U.S. Department of Health and Human Services’ Office of the Inspector General, Pennsylvania’s current tax on HealthChoices managed care organizations (MCOs)

…is impermissible because it is not broad based (the Gross Receipts Tax does not apply to all MCOs) and because it holds the Medicaid MCOs harmless as taxpayers…

According to the inspector general’s report, the state collected $1.76 billion in gross receipts tax revenue from its Medicaid MCOs between FY 2009 and 2011 and drew down federal Medicaid funds to match that revenue.
State officials disagree with the inspector general’s findings and have submitted their opposing arguments to the federal government.
The loss of gross receipts tax revenue would leave an enormous hole in the state’s financing of its share of Medicaid spending and could pose a considerable challenge for the state’s private safety-net hospitals because they serve so many Medicaid patients.
Find the inspector general’s report, including its findings and recommendations and the state’s response to them, here on the web site of the Office of the Inspector General.

PA Safety Net Admin2014-06-03T06:00:47+00:00June 3rd, 2014|Pennsylvania Medicaid policy|Comments Off

CMS to Examine How States Set Medicaid Managed Care Rates

The Centers for Medicare & Medicaid Services (CMS) is launching an initiative to explore how states set the rates they pay managed care organizations to serve Medicaid patients.
The initiative consists of two parts: first, CMS is examining the adequacy of the process states employ to set their rates – a process that affects the adequacy of the rates themselves; and second, it is drafting updated Medicaid managed care regulations.
Because Pennsylvania safety-net hospitals serve so many Medicaid patients, this effort could have a future impact on the payments they receive for serving these patients.
Learn more about this new undertaking in this Kaiser Health News report.

PA Safety Net Admin2014-05-29T06:00:25+00:00May 29th, 2014|Pennsylvania Medicaid policy|Comments Off

No Observation Rate Yet for PA Medicaid

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin continuing its current payment methodology under the state’s Medicaid program but noting that it still has not developed an observation rate for the program.
Last year the state indicated that it wanted to establish such an observation rate, but it has not yet done so. The new notice states that

The Department also announced its intent to establish an observation rate for hospital cases for which an inpatient admission is not medically necessary, but medical observation of a patient is required. The Department received multiple public comments concerning an intended observation rate. At this time, the Department plans to develop a payment policy and rates for observation services and will provide an opportunity for public comment in a future notice of intent.

At the time the state expressed an interest in developing an observation rate, the Safety-Net Association of Pennsylvania wrote to the Department of Public Welfare expressing support for the concept. Read SNAP’s letter here.
Find the entire Pennsylvania Bulletin notice here.

PA Safety Net Admin2014-05-19T06:00:51+00:00May 19th, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Seeks Insurer Bids for Medicaid Expansion

In anticipation of the possibility of receiving approval from the federal government to expand its Medicaid program, the Corbett administration is soliciting bids from insurers interested in serving the state’s Medicaid expansion population.
The market for those insurers: approximately 600,000 people who would become eligible for Medicaid and free to choose from among eligible insurers.
The Corbett administration has taken a sometimes-controversial approach to Medicaid expansion, seeking to underwrite premiums to private insurers for those newly eligible for Medicaid coverage. For months the administration has been negotiating the terms of its proposed Healthy Pennsylvania Medicaid expansion plan with the federal government, and the decision to seek bids in anticipation of a possible January 1, 2015 launch of Medicaid expansion is viewed as a sign that those negotiations are going well.
Read about this latest development in Pennsylvania’s bid to expand its Medicaid program through a private market option in this Philadelphia Inquirer article. Find the state’s request for applications for insurers interested in serving the Medicaid expansion population here.

PA Safety Net Admin2014-05-09T06:00:34+00:00May 9th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Study Points to Risk of DSH Cuts

A new study suggests that future cuts in Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments could pose problems for hospitals that serve large numbers of uninsured patients.
According to a new report in the journal Health Affairs,

Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.

Medicare DSH and Medicaid DSH payments help underwrite the uncompensated care hospitals provide to their uninsured patients. These payments are a vital source of revenue for Pennsylvania’s safety-net hospitals and Pennsylvania is among the states that have not yet adopted Medicaid expansion.
Even after Affordable Care Act reforms take effect, 25 to 30 million Americans are expected to remain uninsured. Medicare DSH payments are expected to decline $22.1 billion between now and 2019 and Medicaid DSH payments, temporarily delayed by two separate actions of Congress, are expected to decline $17.1 billion through 2020.
Learn more about the Health Affairs study in this Washington Post article and find the study itself here, on the web site of Health Affairs.

PA Safety Net Admin2014-05-07T06:00:01+00:00May 7th, 2014|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Mackereth Explains Healthy PA Rationale

Last week, Pennsylvania Department of Public Welfare Secretary Beverly Mackereth met with the editorial board of the York Daily Record to talk about Healthy Pennsylvania, the Corbett administration’s proposal to expand the state’s Medicaid program using private insurers instead of an expansion of the state’s existing Medicaid program.
Among other things, Mackereth described why the administration chose to move in the direction it ultimately went.
Read a summary of that discussion here, on the web site of the York Daily Record.

PA Safety Net Admin2014-04-21T11:41:18+00:00April 21st, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Four in PA Congressional Delegation Question Medicaid Waiver Request

Four members of Pennsylvania’s congressional delegation have written to the Centers for Medicare & Medicaid Services (CMS) to question a specific aspect of the state’s Medicaid waiver application.
In a letter to CMS deputy director Cindy Mann, House members Allyson Schwartz, Robert Brady, Chaka Fattah, and Matt Cartwright urge the federal agency to determine whether the state’s proposed approach to Medicaid expansion would “unacceptably limit beneficiaries’ access to family planning services.”
See their letter here.

PA Safety Net Admin2014-04-17T14:44:48+00:00April 17th, 2014|Healthy PA, Pennsylvania Medicaid policy, Uncategorized|Comments Off

Public Comments on PA Medicaid Expansion Plan: Thumbs Down

Most of the people who submitted formal comments to the federal government about Pennsylvania’s plan to expand its Medicaid program wrote in opposition to the proposal.
The proposal, part of the Corbett administration’s “Healthy Pennsylvania” plan, calls for the state to use federal Medicaid funds to purchase private health insurance for people newly eligible for Medicaid.
According to a Community Legal Services of Philadelphia review completed two days before the April 11 submission deadline, 95 percent of those who expressed an opinion about the proposal opposed it, three percent supported it, and two percent offered mixed views.
The Safety-Net Association of Pennsylvania submitted formal comments expressing support for the Medicaid expansion proposal. SNAP’S comments can be found here.
Read a report about the comments, including why various groups did or did not support the proposal, in this Philadelphia Inquirer article.

PA Safety Net Admin2014-04-17T06:00:23+00:00April 17th, 2014|Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

Deadline for Commenting on PA Medicaid Expansion Proposal Approaches

The deadline for interested parties to submit formal comments to the federal government about Pennsylvania’s request for a waiver from selected federal Medicaid requirements in expanding its Medicaid program is this Friday, April 11 at 6:00 a.m.
Interested parties may submit their comments here.
Safety-net hospitals interested in submitting comments are invited to borrow from SNAP’s comment letter, which can be found here.

PA Safety Net Admin2014-04-08T06:00:37+00:00April 8th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Lack of Transportation Benefit in PA Medicaid Proposal Hurts, Critics Say

Pennsylvania’s application for a waiver from selected federal Medicaid requirements includes a request for permission to eliminate transportation services for Medicaid recipients.
And that hurts, some critics say.
The private insurance plans in which newly eligible Medicaid recipients would enroll under the state’s proposed Medicaid expansion plan would not be required to offer medical transportation to low-income recipients, and one critic of the state’s proposal told the Pittsburgh Post-Gazette that “Entitlement to health services is meaningless if you can’t access it.”
Read more about medical transportation, other so-called wraparound benefits, and how the Medicaid expansion component of the state’s Healthy Pennsylvania plan treats them in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-04-07T11:50:30+00:00April 7th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

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