Pennsylvania Medicaid policy Archives - Page 32 of 43 - Safety-Net Association of Pennsylvania

DPW Reaches Out to Stakeholders Over Tobacco $ Loss

Pennsylvania Department of Public Welfare Secretary Beverly Mackereth has sent the following message to health care providers and other stakeholders that will be affected by the state’s loss of $180 million in national tobacco settlement money as a result of a recent arbitrary decision.

October 2, 2013

I am reaching out to you, our valued stakeholder, to provide you with information about the potential impact of the recent tobacco master settlement agreement (MSA) decision. Please understand this legal action and the potential next steps are in no way a reflection of the quality of your work or actions as a partner with the Department of Public Welfare (DPW). This decision stems back to circumstances that occurred in 2003.

As you may be aware, the Pennsylvania Attorney General’s office recently notified the Governor’s Budget Office that the state’s annual share of the tobacco MSA will be reduced by an estimated $180 million, or 60 percent of the state’s base tobacco payment, as a result of a decision by an arbitration panel to address claims from 2003.

While this decision has immediate impacts to Pennsylvania’s health and human services programs, the Corbett Administration is committed to maintaining direct services and mandatory healthcare programs. I would like to reassure you that we are working diligently to ensure services will continue without interruption for all Pennsylvanians.

The reduction will occur in the state’s April 2014 MSA payment, which supports spending in the current fiscal year. This has forced the state to freeze discretionary funding from the MSA. As of now the only DPW program affected will be uncompensated care payments to hospitals.

Please be assured, this course of action was not arrived at lightly. Immediate action is necessary in the face of such a dramatic decrease in revenues due to the MSA decision. Moving forward, the Attorney General’s Office is preparing an appeal of the decision.

The attached press release provides additional information regarding this issue. I appreciate your time and understanding as we work together on this issue.

Sincerely,
Beverly Mackereth, Secretary
Department of Public Welfare

The loss of uncompensated care payments will pose a major challenge to the state’s safety-net hospitals, which are the primary providers of care to the uninsured in Pennsylvania and the primary recipients of these funds.
Go here for the press release cited above.

PA Safety Net Admin2013-10-04T06:00:00+00:00October 4th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Tobacco Money Loss Imperils Hospital Uncompensated Care Payments

Pennsylvania’s loss of $180 million from the national tobacco master settlement agreement could affect the state’s Tobacco Uncompensated Care program, which provides supplemental funding to hospitals that provide significant amounts of uncompensated care.
The $180 million cut represents 60 percent of the state’s overall tobacco revenue.
According to a news release from the governor’s budget office,

The reduction will occur in the state’s April 2014 MSA [master settlement agreement] payment, which supports spending in the current year’s budget. This is forcing the state to freeze discretionary funding from the MSA, which will reduce funds for health research (Commonwealth Universal Research Enhancement [CURE] grants), Life Sciences Greenhouses, uncompensated care to hospitals, and discretionary funds related to tobacco prevention and cessation programs.

To learn more about the funding loss and its implications, see the news release “Administration Receives Notification on Impacts from Tobacco Master Settlement Agreement Arbitration Panel Decision” from the governor’s budget office.

PA Safety Net Admin2013-10-03T09:22:36+00:00October 3rd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Arkansas Medicaid Plan Gains Federal Approval; Harbinger for PA?

A bid by the state of Arkansas to expand access to Medicaid by enabling newly eligible recipients to use federal Medicaid funds to purchase health insurance has been approved by the federal Centers for Medicare & Medicaid Services (CMS).
While the Arkansas Medicaid proposal is not identical to Governor Corbett’s recently released “Healthy Pennsylvania” plan, the two share a key common component: the use of federal Medicaid funds to enable newly eligible recipients to purchase private insurance through new health insurance exchanges that open for business on October 1.
The path to federal approval for Healthy Pennsylvania remains challenging, but the Arkansas ruling appears to be a clear sign that the federal government is receptive to one of the key components of Governor Corbett’s proposal.
To learn more about the Arkansas Medicaid plan and the federal decision to approve it, see this San Francisco Chronicle article.

PA Safety Net Admin2013-10-01T06:00:02+00:00October 1st, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

The Underlying Rationale For “Healthy Pennsylvania”

Reducing costs.
Sustainability.
Simplification.
These are among the reasons that members of the Corbett administration offer for why the Medicaid expansion components of the governor’s Healthy Pennsylvania proposal are structured as they are.
The online publication PA Independent talked to a number of administration officials about why they have chosen the proposed path to health care reform in the state. Read what they had to say in the article “PA looks to reform Medicaid, stave off cost increases” here, on the PA Independent web site.

PA Safety Net Admin2013-09-30T06:00:47+00:00September 30th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

CMS Finalizes Medicaid DSH Cuts

The Centers for Medicare & Medicaid Services (CMS) has issued a final Medicaid disproportionate share (Medicaid DSH) regulation that cuts federal spending on Medicaid DSH $500 million in FY 2014 and $600 million in FY 2015.
The Medicaid DSH cuts were mandated by the Affordable Care Act in anticipation of every state expanding its Medicaid program. The reform law’s Medicaid expansion mandate was later made optional by a Supreme Court ruling.
Medicaid DSH cuts will hurt all Pennsylvania safety-net hospitals, and the Safety-Net Association of Pennsylvania (SNAP) has conveyed its opposition to the cuts to CMS and also has asked members of Pennsylvania’s congressional delegation to support current legislation to delay the implementation of both Medicaid DSH and Medicare DSH cuts for two years.
While the Affordable Care Act calls for Medicaid DSH cuts through 2020, the new regulation covers only two years. CMS has indicated that it will review its reduction methodology for future years.
Read more about the Medicaid DSH cut, why it was made, the objections to it, and future Medicaid DSH cuts in this CQ Healthbeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-09-20T06:00:29+00:00September 20th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

More Than Better Pay Needed to Lure Docs to Medicaid

Primary care physicians want more than better reimbursement as an inducement to serve more Medicaid patients.
They also want simpler administrative procedures, faster payment, and lower costs associated with treating those patients.
These findings come from a survey of primary care physicians in Washington state.
Recruiting more primary care physicians to serve Medicaid patients is more important than ever because many states will be taking advantage of Affordable Care Act incentives to expand eligibility for their Medicaid programs.
The survey results and more can be found in the article “Physicians May Need More Than Higher Reimbursements to Expand Medicaid Participation: Findings From Washington State,” which was published in the September 2013 edition of the journal Health Affairs. Find that article here.

PA Safety Net Admin2013-09-18T06:00:34+00:00September 18th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Corbett Presents Health Care, Medicaid Proposal

Pennsylvania Governor Tom Corbett has unveiled a new “Healthy PA” proposal that includes the means through which the state would extend Medicaid coverage to approximately 520,000 additional people.
The new Medicaid recipients, instead of enrolling in the state’s traditional Medicaid program, would purchase their health insurance through the state’s health insurance exchange, a creation of the Affordable Care Act.
Funding for the new recipients would come almost entirely from the federal government, also through the Affordable Care Act.
Pennsylvania has long been one of the states that has resisted expanding its Medicaid population – a decision made optional by the Supreme Court after a challenge to the 2010 reform law’s constitutionality.
Read a summary of the Healthy PA plan, and find a link to the plan itself here, on the state’s own web site.

PA Safety Net Admin2013-09-17T06:00:26+00:00September 17th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Legislature to Participate in PA Medicaid Expansion Talks

The Corbett administration plans to spend the coming weeks bringing the state legislature into it Medicaid expansion deliberations.
While the administration reportedly has been working to develop a Medicaid expansion program that meets its own requirements for financial responsibility and will pass federal muster, it has been doing so largely without consulting with the state legislature, which has been in recess since early July. While legislative approval is not needed for most aspects of Medicaid expansion, Department of Public Welfare Secretary Bev Mackereth told the Pittsburgh Post-Gazette that the administration will begin consulting with the legislature.
Medicaid expansion, originally mandated by the Affordable Care Act, was made optional for states by a Supreme Court decisions. Only about half of the states have definitively acted to expand their programs, and while Pennsylvania officials previously expressed strong opposition to expansion, they now appear on course to unveil an expansion proposal this fall.
Read more about the administration’s latest efforts, and its intention to involve the legislature, in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2013-09-11T06:00:19+00:00September 11th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Gap in Reform Law Could Leave Many Low-Income People Uninsured

When the Supreme Court gave states discretion over whether to expand their Medicaid programs under the Affordable Care Act, it unintentionally created a gap in potential coverage options for many low-income people that may leave many of those people without affordable health insurance.
According to a new report from the Commonwealth Fund, the 2010 reform law anticipated that everyone with incomes below 133 percent of the federal poverty level would be covered by Medicaid. Individuals and families with incomes between 133 percent and 399 percent of the federal poverty level could use new federal subsidies to help purchase private health insurance.
In states that are not expanding their Medicaid programs, people with incomes between 133 percent and 399 percent of the federal poverty level will still be able to take advantage of federal premium subsidies. People with incomes less than 133 percent of the federal poverty level but who do not qualify for their state’s Medicaid program – qualification criteria vary from state to state – will not be eligible for the same subsidies as many who earn more than them because the reform law assumed that all such individuals would be covered by Medicaid.
According to the Commonwealth Fund, this unanticipated gap in the reform law means that as many as 42 percent of people who suffer from periodic or chronic lack of insurance and who live in states that are not expanding their Medicaid programs will not benefit in any way from Affordable Care Act insurance reforms.
Pennsylvania is one of the states in which this problem will occur because the state is not expanding its Medicaid program. It almost certainly will require Pennsylvania’s safety-net hospitals to provide more uncompensated care than originally expected when the reform law was enacted.
Read more about the unintended consequences of the Supreme Court’s decision and the choice by some states not to expand their Medicaid programs in In States’ Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, a new report from the Commonwealth Fund.

PA Safety Net Admin2013-09-09T06:00:22+00:00September 9th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

Hospitals in states that expand their Medicaid programs under provisions of the Affordable Care Act should see a reduction in their uncompensated care once people begin applying for Medicaid benefits.
That will not be happening in Pennsylvania, however, because the state is not expanding eligibility for its Medicaid program.
In states that do expand their programs, hospitals will continue to lose money serving Medicaid patients because Medicaid payments seldom cover the cost of the services hospitals provide. Demand for Medicaid services will grow in these states, moreover, as more people become eligible for benefits and some who have not had regular access to care for years begin to use their new benefits to address long-standing medical problems.
Recent published reports suggest that the Corbett administration is working on an expansion plan, to be negotiated with the federal government, and that this plan may be revealed to the public this fall.
Michigan became the most recent state to decide to take advantage of the Affordable Care Act and expand its Medicaid program. For a look at how Medicaid expansion will affect hospitals in that state, see this Detroit Free Press article .

PA Safety Net Admin2013-09-04T13:40:02+00:00September 4th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

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