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PA Inching Closer to Medicaid Expansion

Pennsylvania state officials are working on a proposal to expand Medicaid eligibility in the state as provided for in the Affordable Care Act.
But newly eligible Pennsylvanians would not participate in the state’s current Medicaid program.
Speaking to a rotary club in York, Department of Public Welfare Secretary Bev Mackereth told her audience that because the state lacks confidence in the willingness of the federal government to continue funding care for new Medicaid enrollees, the state is developing a plan to present different Medicaid options to newly eligible people.
State officials continue to negotiate the terms of such a program with the federal government and anticipate submitting their proposal to the federal government in the near future.  If approved, they do not anticipate launching such an initiative until at least January of 2015.
Read more about the state’s plans in this Calkins Media report.

2013-08-30T06:00:24+00:00August 30th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on PA Inching Closer to Medicaid Expansion

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Features include articles about the state budget and the possible expansion of Medicaid eligibility in Pennsylvania; upcoming changes facing CHIP and PA Fair Care participants; an upcoming study on serving dual eligibles in the state; a new state Medicaid waiver application; and more.
Find the latest Pennsylvania Health Law Project newsletter here.
 

2013-08-15T06:00:04+00:00August 15th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on New Pennsylvania Health Law Project Newsletter

MAAC Meets

The Medical Assistance Advisory Committee that works with the Pennsylvania’s Department of Public Welfare met recently in Harrisburg.
Among the subjects discussed during the meeting were the state’s recently passed budget, the Medical Assistance program, the prospects for Medicaid expansion, and more.
Read the official state file note summarizing the meeting hereHarrisburg, PA capital building.

2013-08-07T06:00:18+00:00August 7th, 2013|Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on MAAC Meets

The Implications of Rejecting Medicaid Expansion

Twenty-one states have decided not to expand their Medicaid programs under the Affordable Care Act and another six states remain undecided.
How will these decisions affect these states and their residents?  How many people who might have become eligible for Medicaid will remain uninsured?  How much federal Medicaid revenue will these states forgo?  How will these decisions affect hospitals’ uncompensated care costs?  How might payments to hospitals be affected?
Pennsylvania is one of the six states where Medicaid expansion is still being considered, and the report includes specific projections for the commonwealth.  The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
A new study from the Urban Institute attempts to quantify the answers to these and other questions.  Find “The Cost of Not Expanding Medicaid” here, on the web site of the Kaiser Commission on Medicaid and the Uninsured.

2013-07-25T06:00:48+00:00July 25th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on The Implications of Rejecting Medicaid Expansion

SNAP Comments on Observation Rate Proposal

The Safety-Net Association of Pennsylvania has submitted a formal comment letter to the state’s Department of Public Welfare in response to the department’s expressed interest in establishing an observation rate in the state’s Medical Assistance fee-for-service program.
DPW expressed this interest in a June 29 Pennsylvania Bulletin notice.
SNAP supports the creation of an observation rate, and in its letter it outlines how it believes DPW should go about developing a rate that is fair to hospitals.
Safety-net hospitals have a special interest in this issue because observation rate candidates enter hospitals through their emergency rooms and safety-net hospitals typically have among the busiest emergency rooms in the communities they serve.
Read SNAP’s observation rate comment letter hereSafety-Net Association of Pennsylvania logo.

2013-07-23T16:12:30+00:00July 23rd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on SNAP Comments on Observation Rate Proposal

Closer Scrutiny Needed for Medicaid Managed Care?

With Medicaid expansion about to begin in many states and managed care expected to be a major tool in that expansion, advocates are suggesting that states need to do a better job of monitoring the performance of the managed care plans that serve their Medicaid population.
Currently, according to advocates, different states monitor their Medicaid managed care plans for different aspects of their performance and some states do a better job than others.  With relatively few federal standards, state-to-state comparisons either are difficult or impossible.
Thirty-six states and the District of Columbia have at least some Medicaid patients enrolled in managed care plans, and together, those plans receive about one out of every four dollars that the states and the federal government spend on Medicaid.
With nearly all of the state’s Medicaid recipients now in managed care plans, this issue is of special interest to Pennsylvania’s safety-net hospitals.
Read more about the issue, the challenges, and why this issue is now receiving attention in this Kaiser Health News report.
 

2013-07-10T06:00:18+00:00July 10th, 2013|Pennsylvania Medicaid policy|Comments Off on Closer Scrutiny Needed for Medicaid Managed Care?

PA Considering Medicaid Observation Rate

The Pennsylvania Department of Public Welfare is considering instituting a Medicaid observation rate for some hospital services.
According to a recently published Pennsylvania Bulletin,

The Department is considering the establishment of 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 is currently considering developing criteria under which observation services provided by a hospital may be compensable under the MA Program. The Department intends to establish a comprehensive rate to cover observation services determined to be compensable under the Program.

DPW will accept written comments about this proposal for the next 30 days.
Read the Pennsylvania Bulletin notice here.

2013-07-02T06:00:31+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Proposed FY 2014 Pennsylvania state budget|Comments Off on PA Considering Medicaid Observation Rate

DPW Seeks to Renew Philadelphia Assessment

The Pennsylvania Department of Public Welfare has announced its intention to seek renewal of the Philadelphia hospital assessment first authorized in 2008.
The purpose of the assessment is to generate additional revenue to fund state Medicaid expenditures for hospital outpatient and emergency department services in Philadelphia and to provide additional funding to support the city’s public health clinics.
Read the Pennsylvania Bulletin announcement of DPW’s intention here.

2013-07-02T06:00:20+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on DPW Seeks to Renew Philadelphia Assessment
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