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DPW Issues Medical Assistance Bulletins

The Department of Public Welfare (DPW) has issued a number of new bulletins governing Pennsylvania’s Medical Assistance program.
These new regulations include an amendment to the state’s Medicaid plan for children with disabilities; the process for prior authorization of pituitary suppressive drugs; the process for prior authorization of erythropoiesis stimulating protein; the process for prior authorization of benign prostatic hyperplasia treatments; the process for prior authorization of antibiotics (GI); and the process for the prior authorization of platelet aggregation inhibitors.
In addition, DPW formally announced the expansion of HealthChoices to 13 counties in western Pennsylvania and the termination of ACCESS Plus in those counties effective October 1 and its intention to publish in the near future a new bulletin adding growth factors to the Medical Assistance program’s list of items requiring prior authorization.

2012-08-27T06:00:55+00:00August 27th, 2012|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Issues Medical Assistance Bulletins

PA Releases DSH Eligibility Lists

The Pennsylvania Department of Public Welfare (DPW) has released its annual list of inpatient hospitals that qualify for Medical Assistance disproportionate share (DSH) payments, including the DSH percentages for acute-care general hospitals, psychiatric units of inpatient hospitals, drug and alcohol units of inpatient hospitals, medical rehab units of inpatient hospitals, freestanding rehab hospitals, private psychiatric hospitals, and private drug and alcohol hospitals.
Find the list and the corresponding DSH percentages in this Pennsylvania Bulletin notice.

2012-08-23T06:00:56+00:00August 23rd, 2012|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Releases DSH Eligibility Lists

DPW Secretary Shares Views on Medicaid Program

In an extensive interview with the Central Penn Business Journal, Pennsylvania Department of Public Welfare Secretary Gary Alexander shared his views on the state’s Medicaid program, the changes he would like to see, and the challenges the state faces in the immediate future.
Among the issues Alexander addressed are his desire to have greater flexibility to operate the state’s Medical Assistance program; the state’s prospects for expanding Medicaid eligibility as called for in the Affordable Care Act; his concern that greater access will increase rather than decrease uncompensated care and emergency room use; his interest in greater transparency for health care costs and quality; and his fight against fraud, waste, and abuse.
Read the complete Central Penn Business Journal interview with Secretary Alexander here.

2012-08-21T06:00:48+00:00August 21st, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on DPW Secretary Shares Views on Medicaid Program

DPW Updates Dependence Treatment Procedures

The Pennsylvania Department of Public Welfare (DPW) has issued a new Medical Assistance Bulletin updating its procedures for seeking prior authorization for opiate dependence treatment.
The new bulletin, which can be found here, applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services through the Medical Assistance fee-for-service program.
An update of the Medical Assistance handbook for prior authorization of these services can be found hereBookshelf with law books.
The new policy takes effect on September 10.

2012-08-10T06:00:06+00:00August 10th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Uncategorized|Comments Off on DPW Updates Dependence Treatment Procedures

DPW Updates Pharmacy List

The Pennsylvania Department of Public Welfare has issued a new Medical Assistance Bulletin updating the state’s preferred drug list.  This bulletin applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services in the fee-for-service delivery system.  The new bulletin can be found here.
Another document, an update of the Medical Assistance prior authorization handbook for pharmaceutical services, can be found hereBookshelf with law books.
The new policies take effect August 13.

2012-08-08T06:00:33+00:00August 8th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Updates Pharmacy List

EHR Use Growing in State Medicaid Program

Roughly one in four Pennsylvania Medical Assistance recipients visited providers last year that used electronic health record (EHR) technology to help manage their health care information.
According to the Department of Public Welfare (DPW), the state has now distributed $130 million in federal EHR incentive payments to 90 hospitals and more than 3000 health care professionals.
Read more about the growing use of EHR technology and the availability of federal funds to support the use of that technology in this Central Penn Business Journal article.

2012-07-30T06:00:59+00:00July 30th, 2012|Pennsylvania Medicaid policy|Comments Off on EHR Use Growing in State Medicaid Program

Failure to Expand Medicaid Could Hurt PA Hospitals

A decision by Pennsylvania state officials not to expand the state’s Medicaid program as envisioned in the Affordable Care Act would be harmful to the state’s private hospitals – and especially to its safety-net hospitals, according to a Pittsburgh Post-Gazette report.
The law previously required all states to expand their Medicaid programs, but that mandate was struck down last month by the Supreme Court.
The court’s decision has serious implications, Safety-Net Association of Pennsylvania (SNAP) president Michael Chirieleison explained in the article.
“When you remove a critical part of the act like this, it leads to a lot of questions and concerns about the viability and credibility of the remaining initiatives.”
State officials have not yet indicated whether Pennsylvania will expand its Medicaid program.
Read the Post-Gazette article here.

2012-07-25T09:38:41+00:00July 25th, 2012|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Failure to Expand Medicaid Could Hurt PA Hospitals

PA Cuts Medicaid Dental Benefits

Group of healthcare workersPennsylvania has reduced its Medicaid dental benefits to basic services – mostly, cleanings, fillings, and extractions.
It has eliminated root canal and periodontal procedures and limits dentures.  The changes are expected to save $42 million this year.
Most states do not pay for any dental care.
Read more about the changes in Pennsylvania’s Medicaid dental benefits and their impact on beneficiaries here.

2012-07-17T06:00:55+00:00July 17th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Cuts Medicaid Dental Benefits

New PA Health Law Project Newsletter

The Pennsylvania Health Law Project has just published its June/July “Health Law PA News” newsletter.  The latest edition includes articles about the recently passed state Medical Assistance budget, the implications of the Supreme Court’s Affordable Care Act decision for Pennsylvania, changes in state human resources funding, a delay in HealthChoices expansion in western Pennsylvania, and the lawsuit to compel the state to reinstitute the AdultBasic program.
Read the newsletter here.

2012-07-16T06:00:50+00:00July 16th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on New PA Health Law Project Newsletter

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
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