Pennsylvania Medicaid policy Archives - Page 3 of 43 - Safety-Net Association of Pennsylvania

PA Health Policy Update for April 21

The following is an update of selected state health policy developments in Pennsylvania from April 17 -21. (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro announced this week his administration submitted a notice of intent to temporarily add xylazine, commonly known as “tranq,” to the list of schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. This step is an effort to limit access to xylazine, which is increasingly being found in Pennsylvania’s illicit drug trade. The administration also intends to schedule nitazenes, a class of synthetic opioids, as a schedule I drug.

General Assembly

The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 20 on The State Master Plan on Aging. A recording of the hearing can be viewed here.

The House Children and Youth Committee held a public hearing Thursday, April 20 on overcrowding in Pennsylvania’s Juvenile Detention Facilities. A recording of the hearing can be viewed here.

The state House and Senate will return to Harrisburg on Monday, April 24 for voting session. Following are selected health-related committee proceedings.

- The Senate Consumer Protection and Professional Licensure Committee will hold a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. The hearing will be held in Hearing Room 1 of the North Office Building and will be livestreamed here.

- The House Insurance Committee will hold a voting meeting on Monday, April 24 at 11:00 a.m. to consider among other bills, SB 8 which requires insurers to cover all costs associated for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The meeting will be held in Room B31 of the Main Capitol and will be livestreamed here.

- The House Health Committee will hold an informational meeting Wednesday, April 26 at 9:00 a.m. on unregulated intoxicants and psychoactive substances. The hearing will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.

- The House Human Services Committee will hold a voting meeting Wednesday, April 26 at 9:15 a.m. to consider the following bills.
  - HB 409, which would establish a mental health care services clearinghouse.
  - HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits.

The meeting will be held in Room 523 of the Irvis Office Building and will be livestreamed here.

- The House Professional Licensure Committee will hold an informational meeting April 26 at 10:00am on the Bureau of Professional and Occupational Affairs. The hearing will be held in Room 140 of the Main Capitol and will be livestreamed here.

Department of Health

The Department of Health (DOH) issued Health Advisory – 691 (2023-PAHAN-691) with important information regarding a Hepatitis A Virus (HAV) outbreak in the southeast region of the state.

DOH published two notices in the Pennsylvania Bulletin formally announcing its intent to add xylazine as a schedule III controlled substance and nitazenes as a schedule I controlled substance. Following are the notices.
- Temporary Scheduling of Substance; Xylazine as a Schedule III Controlled Substance
- Temporary Scheduling of Substances; Nitazene Class of Compounds as Schedule I Controlled Substances

DOH reminded long-term care facilities that the obligation to report COVID-19 cases and deaths through the ERS will continue beyond the end of the federal PHE on May 11. These records are reportable within 24 hours of diagnosis. Only new cases should be reported and positive cases that later result in death should be amended rather than entered as a new data record. Find details on the reporting process here.

DOH encouraged nursing care facilities to make every effort to help temporary nurse aides to schedule and complete the required exams to become permanent certified nurse aides as soon as possible. When the federal PHE ends on May 11, candidates will have four months to complete the required testing as long as they are enrolled in an Approved Nurse Aide Training Program and candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here.

Department of Human Services

The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) April 27 meeting. In advance of the meeting, DHS also issued a briefing document outlining proposed changes and clarifications to the 340B Drug Pricing Program.

DHS issued proposed regulations to strengthen and clarify the Adult Protective Services Act (Act 70). Implementation of Act 70 began in 2015 but has operated under agency guidance and contract amendments rather than formal regulation. Find additional information and the proposed regulations in this Pennsylvania Bulletin notice.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into late May. Find the updated calendar here.

Insurance Department

The Insurance Department issued a request for comments on a proposal to suspend the reinsurance program for the state-based insurance exchange, PENNIE®, and potentially replace it with a possible “state subsidy wrap.” Additional information on the proposal and details on how to comment may be found in this Pennsylvania Bulletin notice.

Office of the Attorney General

Attorney General Michelle Henry joined a coalition of seventeen other Attorneys General submitting a letter in support of the Federal Trade Commission’s proposal to prevent businesses from having employees sign non-compete agreements as a condition of employment. Find additional information in this press release.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) released the agenda for its May 18 meeting. Following are certain health-related regulations IRRC will consider.

Temporary Graduate Perfusionist License
- No. 3365 State Board of Medicine #16A-4954
- No. 3366 State Board of Osteopathic Medicine #16A-5332
Environmental Quality Board #7-574: Radiological Health Fees

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m. Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DDAP – Xylazine: A New Drug Additive – June 12

The Department of Drug & Alcohol Programs (DDAP) will host two additional sessions of “Xylazine: A New Drug Additive,” presented by Savage Sisters Recovery, in Harrisburg on June 12, 2023. Please visit the Training Management System for details and to register.

PA Safety Net Admin2023-04-21T20:06:37+00:00April 21st, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off

PA Health Policy Update for April 7

The following is an update of selected state health policy developments in Pennsylvania from April 3 to April 7. (Some of the language used below is taken directly from state documents.)

General Assembly

The House and Senate Appropriations Committees will resume budget hearings next week.

- On Tuesday, April 11 at 10:00 a.m., the Department of Human Services will appear before the House Appropriations Committee. The hearing will be held in the House chamber and will also be live streamed here. 
- On Wednesday, April 12 at 9:30 a.m., the Department of Human Services will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here. 
- On Thursday, April 13 at 9:30 a.m., the Department of Health will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here. 
- A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.

The House Health Committee will hold an informational hearing Wednesday, April 12 at 10:00 a.m. on prescription drug affordability boards. The hearing will be held in in Room 205 of the Ryan Office Building and will be live streamed here.

The House Democratic Policy Committee will hold a public hearing Thursday, April 13 at 12:00 p.m. on black maternal health. The hearing will be held in Room G-50 of the Irvis Office Building and will be live streamed here.

The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 13 at 1:00 p.m. on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. The hearing will be held in Room 515 of the Irvis Office Building and will be live streamed here.

The state House and Senate are currently recessed.  They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings.

Department of Health

The Department of Health (DOH) published the Pennsylvania State Health Improvement Plan (SHIP) that outlines goals, objectives, and strategies to improve the health of Pennsylvania residents over the next five years. The 2023-2028 SHIP was developed in collaboration with the Healthy Pennsylvania Partnership, which is made up of nearly 300 health care professionals, associations, health systems, health and human services organizations, community collaborations, local public health agencies, and government agencies.

DOH issued a health update reminding healthcare facilities, providers, and laboratories to have heightened awareness for C. auris in their patients and updating a previous alert with information on new confirmed cases in Cumberland, Erie, and Monroe counties.  C. auris has been detected in ventilator-capable skilled nursing facilities, long-term acute care hospitals, and acute care hospitals since the current outbreak began in March 2020.  Find more information in this Health Update.

DOH has alerted providers and laboratories to current outbreaks of Marburg virus in Tanzania and Equatorial Guinea and recommends they consider Marburg virus in patients with recent travel to those areas.  Find details in the Health Alert here.

Department of Human Services

The Department of Human Services (DHS) announced the Centers for Medicare & Medicaid Services (CMS) approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) waiver amendment, which took effect April 1, 2023. Changes in the approved waiver include benefits counseling, home health aide services, nursing services, and occupational, physical, and speech and language therapy services. The current approved CHC Waiver can be found here.

OLTL released a transition plan to phase out temporary changes to the CHC 1915(c) Waiver. Effective May 11, 2023, OLTL will phase out its emergency flexibilities to coincide with the end of the federal Public Health Emergency.

DHS announced CMS has approved OLTL’s OBRA Waiver amendment, which took effect April 1, 2023, for home and community-based services. The current OBRA Waiver can be viewed here.

The Department of Human Services (DHS) issued a Medical Assistance Bulletin to notify dental providers enrolled in the Medical Assistance program that DHS will begin accepting the 2019 American Dental Association (ADA) Claim Form upon issuance of this bulletin and will no longer accept the 2012 ADA Claim Form for dates of service on and after June 1, 2023.

DHS released a Provider Quick Tip (#263) notifying providers about an electronic submission process for FFS 180-day exception requests and other claims requiring documentation will soon be available in the Promise Portal.

DHS has posted the minutes of the March 23, 2023 meeting of the Medical Assistance Advisory Committee.

Department of Drug & Alcohol Programs

The Department of Drug and Alcohol Programs and DHS jointly issued a bulletin to update the guidance in OMHSAS bulletin 06-03 dated February 10, 2006. This bulletin includes the definitions of co-occurring capable and co-occurring enhanced programs as set forth in The ASAM Criteria. The information may be used to assist SCAs, BH-MCOs, and treatment providers in identifying co-occurring capable and co-occurring enhanced programs and in referring individuals to those programs.

Revenue Collection Update

The Department of Revenue announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $499.4 million, or 8.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.3 billion, which is $1.1 billion, or 3.7 percent, above estimate.

Around the State

WHYY reported about the end of continuous Medicaid enrollment, beginning April 1, 2023, and how individuals can prepare for renewals.

The Erie Times-News published an article about the drug-resistant fungus, Candida auris, which was found in a patient at a health care facility in Erie County.

Stakeholder Events

PHC4 – Data Systems Committee – April 10

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Data Systems Committee meeting on April 10 at 10:00 a.m. Go here for additional information and details on how to participate.

DOH – State Child Death Review Team – April 20

The State Child Death Review (CDR) Team will hold a public meeting on Thursday, April 20 from 1:00 – 3:00 p.m. Go here for additional information and details on how to participate.

DOH – Renal Disease Advisory Committee – April 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 21 from 10:00 a.m. to 12:00 p.m. Go here for additional information and details on how to participate.

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

PA Safety Net Admin2023-04-20T17:15:29+00:00April 7th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for March 24

The following is an update of selected state health policy developments in Pennsylvania from March 18 to March 24. (Some of the language used below is taken directly from state documents.)

General Assembly

The House Appropriations Committee will hold a budget hearing next Tuesday, March 28 at 10:00 for the Department of Health and at 1:00 for the Department of Drug and Alcohol Programs. The hearings will be held in the House chamber and also will be live-streamed here. A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.
The House Health Committee will convene on Wednesday, March 29 to consider, among other bills, House Bill 155, which removes the requirement that direct-care workers be interviewed in person for a position, and House Bill 507, which requires medical schools, teaching hospitals, and medical institutions to receive explicit patient consent for all procedures and exams performed under anesthesia by medical students or for training purposes.
The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings.

Department of Human Services

The Department of Human Services (DHS) has announced updates of the Medical Assistance fee schedule that will take effect on April 1. Find the affected fees in this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin to inform providers that it has added CPT code 0044A to the Medical Assistance fee schedule for the administration of the booster dose of COVID-19 vaccine manufactured by Novavax. The new code takes effect immediately. Learn more from this Medical Assistance Bulletin.
DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into early May. Find the updated calendar here.
DHS has shared information for its community partners to use when helping their current Medicaid patients complete the process of renewing their Medicaid eligibility. The information includes key dates, web addresses and phone numbers for further information, links to FAQs, and more. Go here to find these resources.
DHS’s Medical Assistance Advisory Committee met on March 23. See the presentations delivered by the following DHS offices:
DHS has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of February.
DHS has updated its list of companies that participate in its Medicaid drug rebate program.

Department of Health

The Department of Health has added Mucopolysaccharidosis Type II Disorder (MPS II) screening to the supplemental conditions mandated for screening and follow-up under the state’s newborn screening program effective July 1. Learn more from this Pennsylvania Bulletin notice.
The Department of Health, which last month joined the Department of Agriculture and Department of Environmental Protection in establishing a temporary physical presence in Darlington Township, Beaver County to assist residents affected by the Norfolk Southern train derailment in East Palestine, Ohio, has announced that the three departments will maintain a weekly presence there to continue addressing the needs and concerns of local residents. Learn more about when the departments will be on site and what services they will offer from this Department of Health news release.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced an expansion of its free substance use disorder prevention and education tool “Just Five.” Learn more about the expansion of this tool and its new components from this Department of Drug and Alcohol Programs news release.

COVID-19: By the Numbers

The number of new COVID-19 cases reported in Pennsylvania fell 26 percent last week after 19 percent declines in each of the two previous weeks. The number of weekly deaths is holding steady.
In the past week the state surpassed 2.9 million confirmed cases of COVID-19; another 637,000 cases are considered “probable.”
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 fell 10 percent last week after falling 14 percent the previous week and 16 percent the week before that. The number of COVID-19 patients on ventilators rose slightly in the past week and the number in hospital ICUs fell slightly.
The CDC reports a 10 percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 after an 18 percent decline the previous week and a 13 percent decline the week before that.
For the week ending March 22, one Pennsylvania county (Sullivan) experienced a low rate of community transmission of COVID-19; 28 counties experienced a moderate rate of community transmission of COVID-19; 23 counties experienced a substantial rate of community transmission; and 15 counties experienced a high rate of community transmission.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting April 5

The Medical Assistance Advisory Committee’s managed long-term services and support subcommittee will hold a public meeting on Wednesday, April 5 at 10:00 in Harrisburg. For information about how to join the meeting in person or participate remotely, see this DHS notice.

Department of Health – Spinal Cord Research Advisory Committee Meeting – April 10

The Department of Health’s Spinal Cord Research Advisory Committee will meet in Sellersville and be available for participants virtually on Monday, April 1 at 1:00. For information about the committee, the location of the meeting, and how to join virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-03-24T20:58:02+00:00March 24th, 2023|COVID-19, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off

PA Health Policy Update for March 3

The following is an update of selected state health policy developments in Pennsylvania from February 27 to March 3. (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro will deliver his budget address before the General Assembly on Tuesday, March 7 at 11:00. The FY 2023-2024 budget proposal, the governor’s first, will be an opportunity for him to outline his agenda for the new administration. Go here to stream the governor’s budget address.

General Assembly

State Representative Mark Rozzi (D) resigned as Speaker of the House on Tuesday. Rozzi, who was unexpectedly elected Speaker on January 3, indicated that he accomplished what he set out to do. The House then elected Representative Joanna McClinton (D) as Speaker by a vote of 102-99. She will be the first woman to serve in the position.
Following the election of Speaker McClinton, the House Democratic Caucus announced a new leadership team. Representative Matt Bradford will serve as majority leader and Representative Jordan Harris will serve as chair of the Appropriations Committee. The complete list of leadership members can be viewed here.
The House and Senate are scheduled to be in session on Monday, March 6 through Wednesday, March 8. On Tuesday, March 7 the two chambers will convene at 11:00 for a joint session to hear Governor Shapiro’s budget address.
The Senate Banking & Insurance Committee met on Tuesday, February 28 and favorably reported Senate Bill 8, which requires insurers to cover costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutations if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer. It also requires insurers to cover all costs associated with a supplemental breast screening by MRI or ultrasound for women at increased risk of breast cancer pursuant to Act 52 of 2020. The bill received second consideration on Wednesday, March 1.

Revenue Collection Update

The Department of Revenue announced this week that Pennsylvania collected $2.8 billion in General Fund revenue during February, which was $351.8 million, or 14.2 percent, more than anticipated. Fiscal year-to-date General Fund revenue collections total $26.1 billion, which is $649.3 million, or 2.6 percent, above estimate.

Department of Human Services

DHS has posted a notice explaining that a recent audit uncovered recipient date of death discrepancies and reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death. Find the notice here.
DHS has established a consumer-oriented “Medical Assistance and CHIP Renewals” web page. Find it here.
DHS has shared the presentations made during the February 23 meeting of the Medical Assistance Advisory Committee.
DHS has updated its Medicaid managed care organization directory.

Department of Health

The Department of Health (DOH) has issued final-form rulemaking to replace the temporary regulations currently governing the state’s medical marijuana program. In its notice, DOH responds to public comments and explains differences between the temporary regulations and this final-form version. For further information, see this Pennsylvania Bulletin notice.
Another DOH notice on the medical marijuana program presents a statement of policy to provide guidance to all growers/processors and laboratories approved to test medical marijuana under the program. Learn more from this Pennsylvania Bulletin notice.
DOH has opened a health resource center in Darlington Township, Beaver County for residents of Beaver and Lawrence counties who have health concerns following the Norfolk Southern train derailment in East Palestine, Ohio on February 3. The Pennsylvania Department of Environmental Protection and the Pennsylvania Department of Agriculture also will participate in the center’s efforts to help interested residents sign up for free, independent water testing and to provide guidance on food and animal safety. The center will be open weekdays from 10:00 am to 8:00 pm and is scheduled to operate through March 10. Learn more from this Shapiro administration news release.
DOH has issued a health advisory warning providers of an increase in extensively drug-resistant shigellosis in the U.S. The advisory includes a CDC advisory on the same condition that includes information about identifying, diagnosing, treating, and reporting the condition. The advisory notes that no such cases have been reported in Pennsylvania. Find the advisory here.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania fell 17 percent over the past week while the number of daily deaths held steady.
Pennsylvania recently passed 50,000 deaths from COVID-19.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 fell nine percent last week while the number on ventilators and in hospital ICUs held steady.
The CDC reports a 13 percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
For the week ending March 1, one Pennsylvania county – Bedford – experienced a moderate rate of community transmission of COVID-19; 26 counties experienced a substantial rate of community transmission; and the remaining 40 counties experienced a high rate of community transmission.

Stakeholder Events

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00. For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates: March 9 and May 16, both at 8:30. This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that the March 9 and May 16 sessions will be identical.

Patient Safety Authority – Board Meeting – March 16

The Patient Safety Authority board will meet virtually on Thursday, March 16 at 1:00. For information about participating in the meeting, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – March 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday March 22 at 1:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – March 23

The Medical Assistance Advisory Committee will hold its next public meeting virtually on Thursday, March 23 at 10:00. Go here to register to participate.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-03-03T20:24:07+00:00March 3rd, 2023|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2023 Health Law News newsletter.

Included in this month’s issue are articles about:

Pennsylvania Medicaid’s decision to continue paying parents as home health aides.
Medicaid payments toward Medicare Part A premiums for qualified individuals.
Forgiveness for pandemic-era MAWD (Medical Assistance for Workers With Disabilities) premiums.
An Office of Mental Health and Substance Abuse Services bulletin on mental health treatment for minors.

Read about these subjects and more in the Pennsylvania Health Law Project’s February 2023 newsletter.

jsteinbock2023-02-28T20:30:44+00:00March 1st, 2023|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Advocates Seek More State Staff for Medicaid Eligibility Redeterminations

With the continuous Medicaid eligibility that marked the COVID-19 pandemic coming to an end on April 1 and roughly one-third of the 3.6 million Pennsylvanians enrolled in Medicaid thought to be in jeopardy of losing their coverage, health care advocates are asking the state to invest in more staff to help current participants submit the paperwork needed to retain their coverage as part of what has become known as “Medicaid unwinding.”

In a letter signed by representatives of the Pennsylvania Health Law Project, the Pennsylvania Health Access Network, the Pennsylvania Partnership for Children, and others, advocates noted that the county assistance offices that will play a major role in this process are already understaffed and need more help if deserving Pennsylvanians are to avoid falling through the Medicaid eligibility cracks. The state has acknowledged the staffing problems at its county assistance offices.

PHE-Phase1-Newsletter-HalfPage-Banner-MA-Renewal

The advocates also have asked the state to publish more information about Medicaid eligibility redetermination and to extend Medicaid and Children’s Health Insurance Program (CHIP) eligibility for children for another year.

A troubled Medicaid unwinding effort would be a troubling development for Pennsylvania’s safety-net hospitals because those hospitals care for especially large numbers of low-income and Medicaid-covered patients and could face the possibility of finding themselves serving significantly more uninsured and underinsured patients than they already do – without reimbursement for that care.

Learn more about the challenges inherent in the Medicaid eligibility redetermination effort and what the advocates seek from the state in the WESA-FM radio article “With major Medicaid changes ahead, advocates want to see increased staffing for assistance offices.”

jsteinbock2023-02-27T18:49:43+00:00February 28th, 2023|COVID-19, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

PA Health Policy Update for February 24

The following is an update of selected state health policy developments in Pennsylvania from February 18-24. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for a special session this week and approved two measures addressing the statute of limitations for victims of childhood sexual abuse – House Bill 1 and House Bill 2. Both pieces of legislation provide a two-year window for victims of childhood sexual abuse to file civil claims.
The state House and Senate will meet for regular session next week – Monday, February 27 through Wednesday, March 1.
The Senate Banking & Insurance Committee is scheduled to meet on Tuesday, February 28 to consider Senate Bill 8, which requires insurers to cover costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer. It also requires insurers to cover all costs associated with a supplemental breast screening by MRI or ultrasound for women at increased risk of breast cancer pursuant to Act 52 of 2020.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar for the delivery of Remittance Advice (RA) notices, electronic fund transfers, and mailing reimbursement checks into early April. Find the updated calendar here.
DHS has issued a Medical Assistance Bulletin advising providers that it will begin covering shadow nursing for private duty/shift nursing services provided to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after January 1, 2023. The bulletin includes a procedure code and rate information. Find the bulletin here.
DHS has released its physical health managed care program enrollment report for January.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has sent a notice to stakeholders explaining that with adoption of the federal Consolidated Appropriations Act of 2023, Congress has eliminated the “DATA-Waiver Program.” For DEA registrants, this means that DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder; all prescriptions for buprenorphine only require a standard DEA registration number; there are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine; and in Pennsylvania, no current state laws or regulations prohibit practitioners from adopting this change. The law also introduced new training requirements for all prescribers that will take effect on June 21. States now await further guidance on these requirements. Go here to see the message the Department of Drug and Alcohol Programs shared with stakeholders.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week declined slightly compared to last week.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs rose 17 percent.
The CDC reports a 13 percent increase in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
For the week ending February 22, two Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 13 counties experienced a substantial rate of community transmission; and the remaining 52 counties experienced a high rate of community transmission – all the same numbers as last week.

Stakeholder Events

DHS – Managed Long-Term Services and Supports Subcommittee Meeting – March 1

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00. For information on the location of the meeting or how to participate virtually, see this DHS notice.

Pennsylvania Health Care Cost Containment Council – March 2

The members of PHC4 will hold a public meeting on Thursday, March 2 at 10:00. For further information about the location of the meeting and its agenda, see this Pennsylvania Bulletin notice.