Pennsylvania Medicaid policy Archives - Page 34 of 44 - Safety-Net Association of Pennsylvania

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 .

PA Safety Net Admin2013-07-02T06:00:31+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Proposed FY 2014 Pennsylvania state budget|Comments Off

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 .

PA Safety Net Admin2013-07-02T06:00:20+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Primary Docs Can Get Medicaid Pay Raise

The Affordable Care Act calls for selected primary care providers to receive an increase in their Medicaid fees during calendar years 2013 and 2014.
The pay raise, which seeks to bring Medicaid fees to the same level as Medicare rates, is intended to induce more primary care providers to serve Medicaid patients in anticipation of the increase in Medicaid enrollment expected when the Affordable Care Act takes full effect.
Eligible providers must complete a form attesting to their eligibility for the pay raise and the Pennsylvania Department of Public Welfare has issued the form and instructions for completing it. Find both the form and the instructions here .

PA Safety Net Admin2013-06-27T06:00:15+00:00June 27th, 2013|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Announces Revisions of Medicaid Fee Schedule

The Pennsylvania Department of Public Welfare (DPW) has published a notice of its intention to implement changes in the Medicaid fee schedule and to update selected prior authorization requirements.
Those notices are published here, in the June 22 edition of the Pennsylvania Bulletin, and the changes took effect on June 24.
DPW also published a Medical Assistance Bulletin on the procedure code updates and a table showing the updates. Find the bulletin here and the table here.

PA Safety Net Admin2013-06-26T06:00:45+00:00June 26th, 2013|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Senate to Move on Medicaid Expansion

Pennsylvania state Senate leaders plan to bring a vote to expand the state’s Medicaid program to the Senate floor this week.
The bill, according to Senate leaders, will include conditions that will make it more palatable to more conservative Republicans and the governor. Democrats are already thought to support Medicaid expansion.
While the bill is considered likely to enjoy solid support in the Senate, it is not clear whether the state House is as interested in Medicaid expansion as envisioned under the federal Affordable Care Act.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about the Senate bill, who is behind it, and what the bill says in this Centre Daily Times article .

PA Safety Net Admin2013-06-24T06:00:32+00:00June 24th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

PA Health Law Project Issues Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Among the issues addressed in the letter are the prospects for Medicaid expansion in Pennsylvania and increased state oversight of the state’s private Medicaid managed care organizations. The newsletter also describes an effort by the U.S. Department of Health and Human Services to encourage all qualified health plans offered through health insurance exchanges to include “essential community providers” in their provider networks.
Find the newsletter here , on the web site of the Pennsylvania Health Law Project.

PA Safety Net Admin2013-06-20T06:00:15+00:00June 20th, 2013|Pennsylvania Medicaid policy|Comments Off

Administration Identifies Medicaid Expansion Obstacles

Corbett administration officials took advantage of a recent public briefing on Medicaid expansion to explain that the governor wants to expand the state’s Medicaid program but is seeking flexibility in how to do so that the Obama administration will not provide.
In particular, the administration wants to establish work requirements for new recipients, adjust benefits, and carve out a greater role for private health insurers.
The administration continues to negotiate these and other Medicaid expansion-related issues with federal officials.
Read more about the issues that the Corbett administration is attempting to address and the response of advocates of Medicaid expansion in this Harrisburg Patriot-News article .

PA Safety Net Admin2013-06-17T06:00:07+00:00June 17th, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Announces Plans for Increased Medicaid Fees

The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014. The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act.
A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here.
The revised fee schedule with the new, higher fees can be found here .

PA Safety Net Admin2013-05-29T06:00:17+00:00May 29th, 2013|Health care reform, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW Says Fiscal Office Understates Cost of Medicaid Expansion

The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.

PA Safety Net Admin2013-05-22T06:00:40+00:00May 22nd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Uncategorized|Comments Off

Medicaid Pay Raise Isn’t Reaching Docs

The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians.
Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients.
The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions. Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014.
Five months into 2013, however, only Maryland, Massachusetts, Nevada, and Michigan are making the higher payments.
Pennsylvania is among the states still not making the enhanced Medicaid payments, but state officials have promised further information about their plans in the coming days.
Learn more about the thinking behind the pay raise and why most states still are not paying it in this Washington Post article.

PA Safety Net Admin2013-05-21T06:00:54+00:00May 21st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off

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