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SNAPShots

Feds Probe Steep Drop in PA Medicaid Enrollment

Federal officials have asked the Pennsylvania Department of Public Welfare why the state dropped 130,000 people from its Medicaid rolls between August of 2011 and January 2012 and what the state is doing about the administrative challenges state officials say is one of the reasons for the precipitous drop.
In response to previous federal inquiries about the large numbers of recipients whose Pennsylvania Medical Assistance eligibility was revoked, state officials pointed to a backlog of cases to review.  State and federal officials met to review the situation in April, and the latest federal correspondence with the state seeks answers to questions federal officials posed at the April meeting.
Read more about the problem, the interaction between state and federal officials, and the current status of this situation in this Philadelphia Inquirer articlePennsylvania State Map.

2012-07-12T09:10:59+00:00July 12th, 2012|Pennsylvania Medicaid policy|Comments Off on Feds Probe Steep Drop in PA Medicaid Enrollment

Disabled Face New Process for Medical Assistance Eligibility

Low-income and disabled Pennsylvanians who lost General Assistance payments when the state ended the cash assistance aspect of that program may still receive Medical Assistance but face a new process for applying for eligibility.
The current, one-page application form that was completed by providers has been expanded to a longer, more detailed form that seeks more information about the medical condition of the applicant.
Read more about the changes in the state program and the changes providers now face in this Philadelphia Inquirer articleHealth Benefits Claim Form.

2012-07-10T09:51:07+00:00July 10th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Disabled Face New Process for Medical Assistance Eligibility

SNAP’s Perspective on PA’s Budget

The state budget passed in Harrisburg last week represents both a victory for Pennsylvania’s safety-net hospitals and an affirmation of the manner in which the Safety-Net Association of Pennsylvania (SNAP) has pursued its advocacy on behalf of the state’s safety-net hospitals.
Safety-Net Association of Pennsylvania logoUnder this budget, and despite still-difficult economic times, safety-net hospitals came away almost entirely unharmed by state spending cuts.
The genesis of this success can be traced back to February, when Governor Corbett unveiled his proposed budget.  After years of SNAP’s vigorous advocacy that emphasized urging state officials to direct the state’s scarce resources to their primary partners in caring for Medical Assistance patients – Pennsylvania’s private safety-net hospitals – this year’s budget proposal did exactly that.  Instead of the usual proposals to cut Medicaid disproportionate share (Medicaid DSH) and other supplemental payments that only safety-net hospitals receive, the administration proposed spreading the potential financial pain to all hospitals, as exemplified by its original proposal to cut fee-for-service hospital base rate payments four percent while leaving the most critical supplemental payments untouched.
This proposal gave every hospital in the state, not just safety-net hospitals, a stake in opposing the proposed cuts.  This brought the entire hospital industry together to oppose those cuts.  This unified effort proved successful – vindication, we believe, of SNAP’s long-time approach to advocating the distinct interests of Pennsylvania’s safety-net hospitals.

Budget Brings Good News for PA Safety-Net Hospitals

The new state budget passed in Harrisburg last weekend restored cuts to key payments to Pennsylvania’s safety-net hospitals.
Harrisburg, PA capital buildingAlthough the budget proposed by Governor Corbett in February called for a four percent cut in fee-for-service hospital base rate payments, that cut was restored – as were mid-year cuts to OB/NICU, burn center, and trauma center payments, which were restored to their FY 2012 enacted levels.
In addition, the budget increased payments to critical access hospitals and restored payments to academic medical centers and physician practice plans.
The budget also restored funding for separate fee-for-service payments for normal newborn care, thereby rescinding at least for FY 2013 an expedited regulation promulgated by the Department of Public Welfare that would have eliminated payments for such services.
For further information about Pennsylvania’s FY 2013 Medical Assistance budget and its implications for Pennsylvania’s safety-net hospitals, please contact Michael Chirieleison, SNAP’s president, at 717-234-6970 or mike@debrunner.us.

2012-07-02T16:24:34+00:00July 2nd, 2012|Medicaid supplemental payments, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on Budget Brings Good News for PA Safety-Net Hospitals

Court Affirms Reform Law, Changes Medicaid Provision

The Supreme Court has upheld the constitutionality of the 2009 Affordable Care Act – including the much-disputed mandate that everyone obtain health insurance.
The court’s only disagreement with the reform law was with its provision requiring states to expand Medicaid eligibility as a future condition of obtaining federal Medicaid matching funds.  The court ruled that expanding Medicaid eligibility should be optional and that states that choose not to expand their Medicaid programs would still receive the federal matching funds to which they have always been entitled.
In the wake of this decision, SNAP is very concerned about the interplay between the loss of the mandated Medicaid expansion and the Affordable Care Act’s requirement that Medicare DSH and Medicaid DSH payments be cut significantly in the coming years.  Those cuts were predicated on the Medicaid expansion adding as many as 20 million people to the ranks of the insured, which was expected to provide additional revenue to hospitals that would help offset a reduction in their Medicare DSH and Medicaid DSH revenue.
For now, all eyes will be on Pennsylvania state officials as they decide what to do in light of the greatly enhanced federal matching funds still available for states that choose to expand Medicaid eligibility.

2012-06-28T15:19:30+00:00June 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off on Court Affirms Reform Law, Changes Medicaid Provision

If the Affordable Care Act Survives Legal Challenges…

$2 billion in extra costs over the first five years.  750,000 new recipients.
These are some of the changes that can be expected in Pennsylvania’s Medicaid program if the Medicaid expansion component of the Affordable Care Act is left standing after the Supreme Court rules on the legal challenge to the landmark health care reform legislation.
The online publication PA Independent takes a look at the implications of Medicaid expansion for Pennsylvania:  implications for the state’s finances, for potential beneficiaries, and for public health.  Read the article here.

2012-06-26T06:00:27+00:00June 26th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on If the Affordable Care Act Survives Legal Challenges…

DPW Announces Fee Schedule Changes, More

The Department of Public Welfare (DPW) has announced changes in the Medical Assistance fee schedule and prior authorization requirements.  To read a notice describing these changes and find a list of affected procedure codes, see this notice in the Pennsylvania Bulletin.

2012-06-25T06:00:41+00:00June 25th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Announces Fee Schedule Changes, More

PA to Discontinue Quality Incentive Program

The Pennsylvania Department of Public Welfare (DPW) is discontinuing its Hospital Quality Incentive Pilot Program.  The program had been “established to provide and reward a hospital’s performance on various quality related measures” in the state’s Medical Assistance program.
Read a formal notice of the termination of this program, and the state’s Hospital Quality Care Investment Grant Program, in this Pennsylvania Bulletin noticeBookshelf with law books.

2012-06-22T11:28:16+00:00June 22nd, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA to Discontinue Quality Incentive Program

DPW Publishes Bulletin Addressing Preventable Conditions

The Pennsylvania Department of Public Welfare (DPW) has posted a new Medical Assistance Bulletin presenting the state Medicaid program’s policies governing the reporting of “provider preventable conditions” effective July 1, 2012.  The policy applies to providers that serve Medical Assistance recipients enrolled in the fee-for-service and ACCESS Plus programs.
Find the Bulletin hereBookshelf with law books.

2012-06-20T06:00:09+00:00June 20th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Publishes Bulletin Addressing Preventable Conditions

Newspaper Joins Call for Restoring Newborn Payments

Last month, Pennsylvania’s Medical Assistance program stopped paying hospitals for the inpatient care they provide to healthy babies newly born to Medical Assistance-covered mothers.  The hospital industry – including the Safety-Net Association of Pennsylvania (SNAP) – immediately expressed opposition to this new policy and has continued to seek the restoration of these payments as the state legislature considers Pennsylvania’s fiscal year 2013 budget.
Now, the Pittsburgh Post-Gazette has weighed in on this issue – on the side of the hospital industry and the low-income patients it serves – with an editorial entitled “Dropping the baby:  DPW is wrong to cut newborns’ hospital care.”  Read that editorial here.

2012-06-11T06:00:13+00:00June 11th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off on Newspaper Joins Call for Restoring Newborn Payments
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