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Cost of Medicaid Expansion Would be Minimal for PA

Expanding Pennsylvania’s Medicaid program as envisioned in the Affordable Care Act would cost Pennsylvania $1.96 billion over the ten years beginning in FY 2013, according to a new report released by the Kaiser Family Foundation.
While that price tag may seem steep, it is only 1.4 percent more than the additional money the state would spend if it declines to expand its Medicaid program as the 2010 health care reform law envisioned.
Expanding Medicaid would spur a 52 percent increase in the number of Pennsylvanians with health insurance.  Without the Medicaid expansion, the number of insured would rise 28.9 percent because of other Affordable Care Act provisions.
Pennsylvania’s safety-net hospitals would benefit greatly from the expansion of Medicaid in the state.  Many of the uninsured patients they currently serve would almost certainly become eligible for Medicaid under such an expansion.
Learn more about how Medicaid expansion would affect Pennsylvania in this Central Penn Business Journal article.  The Kaiser Family Foundation study on which it is based can be found here.

2012-11-29T11:41:24+00:00November 29th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Cost of Medicaid Expansion Would be Minimal for PA

Editorial Endorses PA Medicaid Expansion

In a Sunday editorial, the Philadelphia Inquirer has urged Pennsylvania Governor Tom Corbett to expand the state’s Medicaid program, as called for in the 2010 Affordable Care Act.

Expansion, the editorial notes, would bring health insurance to 600,000 additional people, with the federal government picking up most of the tab, while creating jobs and boosting the state’s economy.

Read the Philadelphia Inquirer editorial here.

2012-11-27T06:00:17+00:00November 27th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Editorial Endorses PA Medicaid Expansion

Pennsylvania and OB DSH Payments

As part of a three-part series titled “Labor Pains,” the Philadelphia Business Journal has documented the OB/NICU disproportionate share (DSH) payments that Philadelphia-area hospitals have received from Pennsylvania’s Medicaid program since 2007.  Many of the recipients are safety-net hospitals, including a number of members of the Safety-Net Association of Pennsylvania (SNAP).
Read about the payments and why they were created and gain access to other parts of the “Labor Pains” series via this Philadelphia Business Journal articleDoctor giving patient an ultrasound.

2012-11-26T06:00:18+00:00November 26th, 2012|Medicaid supplemental payments, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Pennsylvania and OB DSH Payments

Corbett Hints at No PA Medicaid Expansion

Without explicitly ruling out expansion of the state’s Medicaid program, which is now an optional part of the federal health care reform law, Pennsylvania Governor Tom Corbett has hinted broadly that the state may not be prepared to spend the additional money such an expansion would necessitate.
“I don’t think there’s any way we can absorb this,” the governor told the Pennsylvania Press Club, speaking of the Medicaid expansion that is a major part of the 2010 Affordable Care Act.
Read more about what those costs would be, and the challenges the state would face in expanding its Medicaid program, in this PA Independent article.

2012-11-23T06:00:34+00:00November 23rd, 2012|Pennsylvania Medicaid policy, Uncategorized|Comments Off on Corbett Hints at No PA Medicaid Expansion

Will PA Expand Medicaid Program?

With President Obama re-elected and Congress unlikely to repeal the Affordable Care Act, Pennsylvania officials now face a major decision:  will they expand the state’s Medicaid programs as the law originally intended?
The original health care reform law made that expansion mandatory, but earlier this year, the Supreme Court left the expansion decision to individual states.  While some governors have already declared their intention to expand their Medicaid programs and others have announced that they will not, Pennsylvania Governor Tom Corbett has not yet announced a decision.
Why would the state choose to expand its Medicaid program, considering that it will end up costing taxpayers more money?  On the other hand, why would it choose to leave billions of federal dollars on the table?
Because they serve so many low-income, uninsured patients who might benefit from an easing of Medicaid eligibility criteria, Pennsylvania’s private safety-net hospitals have a major stake in this decision.
Read more about the decision now facing the Corbett administration in this CQ HealthBeat article presented by the Commonwealth Fund.  For a closer look at the Pennsylvania perspective, read this PA Independent articlePennsylvania State Keystone.

2012-11-15T06:00:12+00:00November 15th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Will PA Expand Medicaid Program?

Shift to HealthChoices Hits Bumps in the Road

Pennsylvania’s switch to HealthChoices to serve nearly the entire state Medicaid population is running into short-term obstacles in parts of the state.
Some recipients, for example, failed to choose a participating managed care plan, were assigned to plans, and now are confused about where to go and how to obtain care.  In other instances, physicians are still negotiating with those plans or waiting to be credentialed for participation.
Some Pennsylvania safety-net hospitals, because of where they are located and their especially large numbers of Medicaid patients, may experience these problems more than the average hospital.
Read more about the challenges Medicaid recipients are encountering during this transition in this Erie-Times News articlePennsylvania State Map.

2012-11-08T06:00:02+00:00November 8th, 2012|Pennsylvania Medicaid policy|Comments Off on Shift to HealthChoices Hits Bumps in the Road

Medicaid Primary Care Pay Raise Set; OB/GYNs, ER Docs Excluded

When the Affordable Care Act’s mandatory rate increase for primary care services provided to Medicaid patients takes effect on January 1, ob/gyns and emergency room physicians will not be among the beneficiaries of the temporary raise in pay.
Under a new regulation issued last week, only family doctors, internists, and pediatricians will receive the pay increase, which was established as a short-term (two years) incentive to attract more physicians to serve Medicaid patients in anticipation of the significant increase in enrollment expected when many states expand their Medicaid eligibility criteria in 2014.
When working under the supervision of eligible primary care physicians, nurse practitioners and physician assistants also will receive the enhanced Medicaid payments.
State Medicaid payments for primary medical care typically fall well below comparable Medicare rates.  Under the reform law, Medicaid payments for such services will be raised to Medicare levels for two years, with the federal government footing the bill for the difference.
Because they serve so many Medicaid patients and the state’s outpatient fees are so much lower than those paid by Medicare, Pennsylvania’s safety-net hospitals and the primary care physicians they employ should benefit greatly from this new policy.
Read more about who will and won’t benefit from the primary care fee increase and how it will be implemented in this Kaiser Health News articleDoctor listening to patient.

2012-11-05T06:00:03+00:00November 5th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Medicaid Primary Care Pay Raise Set; OB/GYNs, ER Docs Excluded

Implementation of Reform Act’s Medicaid Doc Pay Raise Uncertain

With the Affordable Care Act-mandated increase in Medicaid payments to primary care physicians now just a little more than two months away from taking effect, much remains unknown about how the increase will be implemented.
Financial paperworkUnder the 2010 reform law, payments to Medicaid primary care physicians will be increased to the same level as comparable Medicare payments, with the federal government picking up the entire $11 billion tab.
At this point, however, there are no regulations delineating how the increase will be achieved, leaving unanswered a number of questions, including what the new rates will be; how and when they will be paid; which physicians will receive them; and how physicians caring for Medicaid patients through managed care plans will receive their enhanced payments.
The purpose of the temporary, two-year increase is to attract more physicians to the care of Medicaid patients in time for the increased Medicaid eligibility that begins under the reform law in 2014.
Many physicians serving communities with large numbers of Medicaid patients, and those employed by Pennsylvania’s safety-net hospitals, are expected to  benefit from this pay increase.  Currently, Medicaid primary care physician payments in Pennsylvania are just 56 percent of comparable Medicare payments.
Learn more about the challenges of implementing this primary care physician Medicaid pay raise in this Kaiser Health News article.

2012-10-29T06:00:15+00:00October 29th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Implementation of Reform Act’s Medicaid Doc Pay Raise Uncertain

Lawsuit Challenges Social Services Block Grants and the End of General Assistance Payments

A lawsuit has been filed in Pennsylvania’s Commonwealth Court challenging the state’s termination of General Assistance payments to low-income Pennsylvanians and the redirection of some state social services funding into block grants for selected counties.
General Assistance grants are small sums of money that were paid monthly to low-income Pennsylvanians.  Many were thought to use this money for food, medicine, and other necessities.
Pennsylvania’s counties have long received social services funding from the state.  Now, some counties have voluntarily agreed to accept less money in exchange for greater flexibility in how they spend it.  Some of the services provided with this money are delivered by hospitals, including the state’s private safety-net hospitals.
The legal challenge is on procedural rather than policy grounds, with the plaintiffs alleging that the legislation that ended the General Assistance grants and created the social services block grant program violated a provision in the state constitution that requires legislation to address only a single issue.
Read more about the General Assistance and social services block grant lawsuit in this Philadelphia Inquirer article.

2012-10-26T06:00:16+00:00October 26th, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on Lawsuit Challenges Social Services Block Grants and the End of General Assistance Payments

Pennsylvanians Who Lost Medicaid Eligibility Given Path to Restoration

More than 100,000 Pennsylvanians who were dropped from the state’s Medical Assistance rolls in the latter part of 2011 will receive a new opportunity to regain eligibility.
Under an agreement between the Pennsylvania Department of Public Welfare and lawyers for advocacy groups, 100,000 people who lost their eligibility will receive a letter describing their right of appeal.  Those who appeal successfully will be restored to the state’s Medicaid rolls and could have their medical bills resolved for the period during which they were off those rolls.
Read more about why these 100,000 people lost their eligibility and how advocates won this opportunity for restoration in this Philadelphia Inquirer articleHealth Benefits Claim Form.

2012-10-24T09:33:38+00:00October 24th, 2012|Pennsylvania Medicaid policy|Comments Off on Pennsylvanians Who Lost Medicaid Eligibility Given Path to Restoration
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