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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its August 2022 Health Law News newsletter.

Included in this month’s issue are articles about:

  • Pennsylvania Medicaid beneficiaries who have been auto-assigned to a HealthChoices plan
  • an upcoming deadline for dual-eligible (Medicare and Medicaid) individuals to change Medicare plans
  • an introduction to the state’s new “Whole Home Repair Program” for low- and middle-income families
  • the new National Suicide Prevention Lifeline

Read about these subjects and more in the Pennsylvania Health Law Project’s August 2022 newsletter.

2022-09-07T15:38:12+00:00September 7th, 2022|HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter
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PA Health Policy Update for Friday, September 2

The following is an update of selected state health policy developments in Pennsylvania for the week of August 29-September 2, 2022.  (Some of the language used below is taken directly from state documents.)

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for August.  General Fund revenue collection exceeded estimate by $63.8 million, or 2.3 percent, for the month.  Fiscal year-to-date General Fund collections total $5.6 billion, which is $60.4 million, or 1.1 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to notify providers of updates to the Medical Assistance fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to expand the scope of eligible providers that may render certain services to include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and physicians and to add behavioral health providers to certain procedure codes and make other procedure code changes.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from the implementation of the 2022 Healthcare Common Procedure Coding System (HCPCS) procedure codes updates.  In addition, it also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance fee schedule, including setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 29, 2022.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics of updates to the Medical Assistance fee schedule for the distribution of take-home supplies of nasal or injectable naloxone to Medicaid
    beneficiaries.  Find the bulletin here.
  • DHS has published brief notices addressing extra recoupments it has returned to some providers and provider enrollment summary enhancements.
  • DHS has posted federal financial participation rate changes and continued billing requirements for community support service providers.  Find the notice here.
  • DHS has posted HealthChoices enrollment and Medical Assistance Transportation Program utilization data for July.  Find the information here.

Department of Health

  • The Department of Health (DOH) has updated its “Innovative Hospital Model” guidance to make requested changes about locations eligible to operate outpatient emergency departments.  Find that updated information here.
  • DOH has revised its guidance for contacting the Division of Acute and Ambulatory Care prior to an event or change that requires advance notification, such as addition of new equipment or occupancy.  The updated guidance includes email subjects that providers should use when sending these notices to expedite review by the Division of Acute and Ambulatory Care.  Find the updated guidance here.
  • DOH’s annual Pennsylvania Long Term Care Questionnaire is now open until Friday, October 28.  Providers that have not received an email containing login information and instructions should contact Thomas Gavrish at tgavrish@pa.gov.
  • DOH will offer free potassium iodide, or KI, tablets on Thursday, September 15 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants as part of routine preventive efforts in case of future emergencies.  Learn more from this department news release.

COVID-19:  By the Numbers

Monkeypox

  • DHS has published a Medical Assistance Bulletin to advise providers of the addition of procedure codes to use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of the monkeypox vaccines.  Find the bulletin here.
  • The CDC has posted an updated map showing the distribution of 19,465 confirmed cases of monkeypox in the U.S. as of September 1, up from 16,926 cases on August 25.  561 of those cases were in Pennsylvania, up from 465 a week ago.
  • As of August 29, 327 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Mental and Behavioral Health Considerations for Long-Term Care – September 8

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on mental and behavioral health considerations for long-term care on Thursday, September 8 at 2:00.  This presentation will explore the most common behavioral health diagnoses seen among residents living in nursing facilities and will share approaches to managing appropriate use of psychotropic medication and best practices around deprescribing.  Learn more about the event and how to participate from this notice.

Pennsylvania Health Care Cost Containment Council – September 8

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, September 8 at 10:00.  Agendas will be available here 24 hours.  The public is invited to participate. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Patient Safety Authority – September 8

The Patient Safety Authority will meet virtually on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-02T18:45:52+00:00September 2nd, 2022|COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 2
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PA Health Policy Update for Friday, August 26

The following is an update of selected state health policy developments in Pennsylvania for the week of August 22-26, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

In the wake of the governor’s signing of Act 54, the Wolf administration has written to institutional facilities and programs that will receive American Rescue Plan Act funding.  Among the recipients will be nursing facilities, personal care homes, assisted living residences, home- and community-based providers, and LIFE programs.  The correspondence outlines how much funding has been allocated to each category of recipient, notes any tasks recipients may need to complete to receive their money, explains that recipients should know how much they will receive before their money arrives, and notes that payments will be made during the fall of 2022.  Find the communication here.

The Courts

The state Supreme Court has issued an order amending the Pennsylvania Rules on Civil Procedure governing venue for medical malpractice.  The amendment eliminates the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.  The court’s order, amendment, and the Civil Procedural Rules Committee adoption report may be viewed here.  It will take effect January 1, 2023.

Pennsylvania’s Commonwealth Court has ordered the state’s Department of Health to make public information about how many medical marijuana patients have been authorized by the state to use cannabis to treat an opioid addiction.  Learn more from the Commonwealth Court decision.

Department of Health

The Department of Health announced in this Pennsylvania Bulletin notice that it will adopt the 2022 edition of the Guidelines for Design and Construction of Hospitals and Guidelines for Design and Construction of Outpatient Facilities (Guidelines) to set the standard for renovation and constructions at hospitals and ambulatory surgery facilities effective February 1, 2023.  The department had previously adopted the 2018 Guidelines and will permit hospitals and ambulatory surgical facilities to elect to use either the 2018 or 2022 Guidelines from August 1, 2022, until January 31, 2023.  After February 1, 2023, the 2022 Guidelines must be used.

The Department of Health announced details on how it will implement the Cytomegalovirus Education and Newborn Screening Act that was signed into law on June 27, 2022 in this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin implementing Act 33, which Governor Wolf signed on July 7 and took effect immediately.  Act 33 makes significant changes in the confidentiality provisions for substance use disorder treatment records under Pennsylvania law and in the Department of Drug and Alcohol Programs’ enforcement of those provisions.  Find the bulletin here.

Auditor General

The Pennsylvania Department of the Auditor General announced the release of tobacco settlement fund audits for 22 health care facilities in Allegheny, Berks, Bucks, Chester, Clarion, Cumberland, Dauphin, Luzerne, Montour, Montgomery, Philadelphia, Schuylkill, Washington, Westmoreland, and York counties.

COVID-19:  By the Numbers

Monkeypox

The Department of Health has established a “what you need to know about monkeypox” web page.  Find it here.

The CDC has posted an updated map showing the distribution of 16,926 confirmed cases of monkeypox in the U.S. as of August 25.  465 of those cases were in Pennsylvania.

As of August 22, 257 of those Pennsylvania monkeypox cases – more than half of them – were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Improving Resident Relationships in Long-Term Care– September 1

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on improving resident relationships in long-term-care facilities.  The webinar will seek to educate staff about the prevalence of resident-to-resident aggression in nursing facilities and teach webinar participants how to recognize and address it in their facilities.  The webinar will be held on Thursday, September 1 at 2:00.  Learn more about the webinar and how to participate from this notice.

Behavioral Health Commission for Adult Mental Health – September 1

The next meeting of the Behavioral Health Commission for Adult Mental Health will take place on September 1 from 1:00-6:30.  Interested individuals may attend in person or virtually.  Go here to learn more about the participation options.

Department of Health – Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee – September 7-8

The Statewide HIV Planning Group will hold a public meeting at the Best Western Premier Central Hotel and Conference Center, 800 East Park Drive, Harrisburg, PA on Wednesday, September 7, 2022, and Thursday, September 8, 2022, from 9 a.m. to 4:30 p.m.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

 

 

2022-08-29T15:44:30+00:00August 29th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, August 26
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PA Health Policy Update for Friday, August 5

The following is an update of selected state health policy developments in Pennsylvania for the week of August 1-5, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a news release reminding current HealthChoices participants that as a result of changes in that program, approximately 500,000 people must select a new health plan by August 16.  Those people have received written notices explaining the situation and their need to act.  Individuals who do not choose a new plan will have one auto-assigned to them.  Learn more about this situation, including where individuals can turn for assistance, from this DHS news release.
  • Providers also can help their Medical Assistance patients select new plans, if they need to do so, by directing them to a virtual event during which representatives from DHS, PA Enrollment Services (the state’s independent enrollment service), the Pennsylvania Health Law Project, and the Pennsylvania Health Access Network will answer questions about enrollment concerns.  The webinar will be held on Wednesday, August 10 at 2:00.  Registration is required and space is limited.  For further information and registration information, providers should direct Medical Assistance patients here.
  • While Governor Wolf signed legislation last month amending the state’s Mental Health Procedures Act to align with federal health privacy standards to permit providers, facilities, and health plans to share patient mental health and substance use disorder-related information more easily, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has informed stakeholders that it is still reviewing the new law to determine its next steps and will be in touch with stakeholders when it is prepared to act.  Learn more in the message OMHSAS sent to stakeholders about this subject.
  • DHS has published Medicaid managed care enrollment data for April, May, and June of 2022.
  • DHS has announced a grant opportunity for home health agencies that provide pediatric shift nursing services to fund the installation and use of certified electronic health record technology.  Learn more about the grant opportunity here.  Applications are due September 19.

Department of Health

  • The Department of Health (DOH) has issued guidance on the implementation of Act 87 of 2022, which amends the Health Care Facilities Act by expanding what procedures may be performed in an ambulatory surgical facility without an exception; creating a time frame in which exception requests must be denied, approved, or determined to be incomplete; and requiring an explanation of the basis for a denied or incomplete request.  Find that guidance here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments, and shared the comments of stakeholders, in response to DOH’s proposed revision of state regulations governing long-term care nursing facilities.  Those comments include IRRC questions to DOH about selected aspects of its proposed revisions.  Find the IRRC’s comments and questions in this Pennsylvania Bulletin notice.
  • DOH has announced the creation of a new Women, Infants and Children Advisory Group that will focus on providing support to foster healthier pregnancies and better postpartum care.  Learn more about the advisory group and the 16 individuals appointed to serve on it from this news release.
  • DOH has updated its alcohol-based hand rub memo, seeking to promote use of alcohol-based hand rubs by addressing misconceptions regarding their safety, use, and efficacy in health care facilities.  Find that updated memo here.
  • DOH has sent an email to all long-term-care facilities with their annual Department of Health long-term-care questionnaire.  This questionnaire is mandatory for facilities and must be completed and returned to DOH by October 28.  Facilities that have not yet received this email from Thomas Gavrish should contact him at tgavrish@pa.gov or call 717-547-3660.

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases in Pennsylvania fell 21 percent over the past week and the number of COVID-related deaths fell 29 percent.
  • The number of people hospitalized with COVID-19 and on ventilators changed only slightly in the past week but the number in hospital ICUs because of the virus rose 21 percent.
  • Sixty-five of Pennsylvania’s 67 counties are currently experiencing a high rate of community transmission of COVID-19, down from 67 counties last week.  The other two counties, McKean and Warren, are experiencing a substantial rate of community transmission.
  • The Pennsylvania Health Care Cost Containment Council (PHC4) has released COVID-19 hospitalization data for the 21-month period March 1, 2020 through December 31, 2021.  The report covers number of hospitalizations by month; age, gender, and ethnicity of hospitalized patients; the socioeconomic status of the communities in which hospitalized patients reside; in-hospital mortality rates, including by age; length of stay; and frequency of ventilator use, including by age, patient ethnicity, and the socioeconomic status of the communities in which patients resided.  Learn more from this PHC4 news release; a summary of the report’s findings; county rates (this link opens a downloadable Excel file); and patient demographics (this link also opens a downloadable Excel file).

Monkeypox

The Department of Health has posted a monkeypox fact sheet that addresses what the virus is, its symptoms, how it is transmitted, how it is treated, and how vaccines are being used to prevent it among high-risk individuals.  Find the fact sheet here.

The CDC has posted an updated map showing the distribution of 7102 confirmed cases of monkeypox in the U.S. as of August 4, a 53 percent increase in the last week.  192 of those cases were in Pennsylvania, a 68 percent increase over a week ago.

As of August 1, eighty-two of those Pennsylvania monkeypox cases were in Philadelphia.  The city has responded in part by establishing a new digital monkeypox dashboard with case and vaccination data.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has released a licensing alert that gives providers information about its process for investigating complaints about licensed drug and alcohol treatment facilities.  Find that alert here.

Insurance Department

The Insurance Department has released the requested rate filings for health insurance plans for 2023 that plans are required to file with the state.  As filed, 2023 will see increased competition and more choices for consumers in some counties.  Insurers offering plans in the individual market filed plans requesting an average state-wide increase of 7.1 percent and those currently selling in Pennsylvania’s small group market filed plans requesting an average state-wide increase of 5.2 percent.  Learn more from this Insurance Department news release and find the rate filings here.

Stakeholder Events

Department of Health – State Child Death Review Team – August 10

The Department of Health’s State Child Death Review Team will hold a virtual public meeting on

Wednesday, August 10 at 1:00.  The state’s Child Death Review Program provides training and technical assistance to local child death review teams.  Learn more about the State Child Death Review Team and how to join the August 10 meeting from this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-08-05T19:18:57+00:00August 5th, 2022|COVID-19, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, August 5
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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its July 2022 newsletter.

Included in this month’s edition are articles about:

  • The need for some current Medicaid-covered HealthChoices participants to choose a new managed care plan by August 16.
  • The end of the freeze on the prior authorization requirement for Medicaid-covered pediatric shift nursing care as of November 1.

Read about these subjects and more in the July 2022 edition of Health Law News, the Pennsylvania Health Law Project’s newsletter.

2022-07-28T20:00:02+00:00August 2nd, 2022|HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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PA Health Policy Update for Friday, July 15

The following is an update of selected state health policy developments in Pennsylvania for the week of July 11-15, 2022.  (Some of the language used below is taken directly from state documents.)

Final FY 2023 Budget

Governor Wolf signed the Fiscal Code (House Bill 1421) into law on Monday, July 11. With the Fiscal Code’s signing, all the relevant budget-related bills for FY 2023 are enacted, including the budget bill (Senate Bill 1100) and the Tax Code (House Bill 1342).

Governor Wolf

Governor Wolf has signed several bills addressing health care issues.

  • House Bill 1421 increases Medicaid rates for skilled nursing facilities to help them meet upcoming Department of Health regulation updates that in part will increase staffing requirements.  The rate increase of nearly 20 percent increases Medicaid funding for skilled nursing care by almost $300 million a year.
  • House Bill 2097 amends Title 35 (Health and Safety), in emergency medical services system, further providing for basic life support ambulances.
  • House Bill 2419 amends the Outpatient Psychiatric Oversight Act by adding a definition of “telebehavioral health technology” and provisions regarding the use of the technology.
  • House Bill 2604 amends the employee photo identification provisions of the Health Care Facilities Act.
  • House Bill 2679 amends the Pharmacy Act to preserve three regulatory suspensions authorized under the COVID-19 disaster emergency declaration, including the ability of pharmacists to provide influenza and COVID-19 vaccines to children ages five and older.
  • Senate Bill 818 amends the Health Care Facilities Act for the purpose of allowing ambulatory surgical facilities to seek an exception or waiver from the Department of Health for certain surgical procedures and permits cardiac catheterization to be performed in ambulatory surgical facilities.
  • Senate Bill 1235 amends the Insurance Company Law, further providing for contracts and coverage packages in comprehensive health care for uninsured children.
  • House Bill 2032 amends the Sexual Assault Testing and Evidence Collection Act, providing that the failure to report injuries by firearm or criminal act does not constitute an offense if the submission of sexual assault evidence is an anonymous submission.

General Assembly

The state House and Senate are currently in recess. The House is scheduled to return to session on Monday, September 12 and the Senate is scheduled to return on Monday, September 19.

Department of Human Services

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases rose 17 percent over the past week, to 2850 new cases a day.
  • COVID-19-related deaths in the past week remained comparable to their level of recent weeks.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remained generally steady over the past week but the number in hospital ICUs rose 30 percent.
  • Fifty-two of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 62 counties last week.  Four counties experienced a moderate rate of community transmission and 11 a substantial rate.

Monkeypox

The Department of Health has issued a health alert advising providers about the current state of availability of testing for monkeypox and when providers should consider pursuing such testing for their patients.  Find that alert here.

The CDC has posted an updated map showing the distribution of 1053 confirmed cases of monkeypox in the U.S. as of July 13, 32 of them in Pennsylvania and more than half of those cases in Philadelphia.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – July 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, July 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – July 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, July 28 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – July 28

The Department of Health’s Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, July 28, 2022, from 10 a.m. to 12 p.m. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. Learn more about the meeting and how to register to participate in this notice.

 

2022-07-18T17:02:52+00:00July 18th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 15
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PA Health Policy Update for Friday, July 8

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-8, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

Governor Wolf and the General Assembly reached a final budget agreement for FY 2022-2023 this week.  In total the budget spends $45.3 billion, which is $1.3 billion more than the prior fiscal year’s budget.  The budget makes significant investments in education, housing, child tax credits, health care, and property tax and rent rebate programs.  It also allocates $2.1 billion to the state’s rainy day fund.  The following is an overview of budget-related bills and their status as of 2:00 p.m. on Friday, July 8.

  • Senate Bill 1100 is the General Appropriations bill.  The House passed the bill by a vote of 180-20 and the Senate subsequently concurred with House amendments by a vote of 47-3.  The bill has been presented to the governor for his signature.
  • The Fiscal Code bill is House Bill 1421, which is scheduled to be considered off the floor by the Senate Rules & Executive Nominations Committee Friday afternoon.
  • The Human Services Code bill is House Bill 1420.  It passed the House and Senate on Thursday but Governor Wolf vetoed the bill early Friday.  The Senate is expected to amend Human Services Code language, with the exception of the “Agency with Choice” delay, into the Fiscal Code later today and send it to the House for concurrence.
  • House Bill 1342 is the Tax Code bill.  The Senate and House both passed this yesterday.  It was presented to the governor and is currently awaiting his signature.

Governor Wolf

  • Governor Wolf signed House Bill 1561 and House Bill 1563 into law this week.  These bills, which are now Act 32 and 33 of 2022, amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • Governor Wolf signed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.

General Assembly

The state House and Senate remain in session while they work to finalize the FY 2023 budget and pass legislation before they recess and are not scheduled to return to Harrisburg until mid-September.  The following is an overview of action taken by the General Assembly as of Friday, July 8 at 2:00 p.m.

  • The Senate voted to concur with House amendments to Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS), and sent it to Governor Wolf for his signature.
  • The Senate passed House Bill 2679 on third and final consideration.  The bill, which is now on the governor’s desk, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
  • The Senate passed House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.  The bill is now on the governor’s desk.
  • The Senate passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill is now on the governor’s desk for his signature.
  • The Senate passed Senate Bill 106 and sent it to the House for concurrence.  Senate Bill 106 includes a number of constitutional amendments, including one establishing that the state constitution does not grant the right to taxpayer-funded abortion or any other rights relating to abortion.
  • The Senate passed House Bill 2419, which expands access to outpatient psychiatric care via telemedicine, and sent it to Governor Wolf for his signature.
  • The House passed Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.  The bill is now on the governor’s desk.

Department of Human Services

  • The Department of Human Services (DHS) has proposed amending the state’s Human Services Code to enable individuals who are 14 years of age or older but under 18 years of age who meet the admission requirements to gain access to psychiatric rehabilitation services; to amend the diagnoses that enable an individual to obtain those services without use of the exception process; and to revise outdated language and add definitions of ”serious mental illness” and ”serious emotional disturbance” that align with definitions currently used by the Federal Substance Abuse and Mental Health Services Administration.  Learn more about what DHS has proposed and why it has proposed it in this Pennsylvania Bulletin notice.
  • DHS has published a Medical Assistance Bulletin announcing the addition of procedure code A4928 to the Medical Assistance fee schedule for disposable surgical masks dispensed to Medical Assistance beneficiaries effective with dates of service on and after July 1, 2022.  This bulletin applies to Medical Assistance-enrolled certified registered nurse practitioners, physician assistants, physicians, podiatrists, and medical suppliers that prescribe or dispense disposable surgical masks to Medical Assistance beneficiaries in the fee-for-service and managed care delivery systems.  Find the bulletin here.
  • DHS has published a series of Medical Assistance Bulletins to issue updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of certain prescriptions.  These bulletins apply to all licensed pharmacies and prescribers enrolled in the Medical Assistance program.  The types of prescriptions covered by these bulletins are:
  • DHS has posted the minutes of the June 23 meeting of its Medical Assistance Advisory Committee meeting.  Find those minutes here.
  • DHS also has posted the minutes of the June 22 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.  Find those minutes here.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals in response to Act 30 of 2022, recently passed by the state legislature, which extends COVID-19-related waivers through October 31, 2022.  Among other things, this guidance addresses mandatory data reporting, suspension of services, alternative uses of hospital space, hospital-based laboratory analysis of COVID-19 tests, mandatory patient COVID-19 testing, and more.  For a complete review of the implications of Act 30 for hospitals, see this updated DOH guidance.
  • DOH has announced that its COVID-19 community-based testing sites will now offer three forms of free testing:  point-of-care tests where tests are performed and results are analyzed on-site; the distribution of at-home COVID-19 antigen tests; and continued administration of mid-nasal passage swab PCR testing.  The department currently operates testing locations in Berks, Blair, Centre, Clarion, Clinton, Erie, and Washington counties.  Learn more from this DOH announcement.
  • “COVID Alert PA,” DOH’s COVID-19 app that advises users of potential exposure to individuals diagnosed with COVID-19 and provides updated data on the state of the pandemic in Pennsylvania, has a new message informing users that “The current app will be discontinued on July 27, 2022.”

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases fell 10 percent over the past week, to 2440 cases a day.
  • COVID-19-related deaths in the past week were the same as they were the week before.
  • The number of Pennsylvanians hospitalized with COVID-19 remained generally steady over the past week, as did the number of COVID-19 patients in hospital intensive care units and on ventilators.
  • Sixty-two of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, up from 35 counties last week.  The remaining five counties (Clarion, Forest, Potter, Sullivan, and Tioga) experienced a substantial rate of community transmission.

State Board of Pharmacy

The State Board of Pharmacy has published a final rule in the Pennsylvania Bulletin related to the administration of injectable medications, biologicals, and immunizations.  The rule allows pharmacists to administer influenza immunizations by injectable or needle-free delivery methods to children nine years of age and older.  Additionally, qualified and authorized pharmacy interns are permitted to administer injectable medications, biologicals, and immunizations to persons 18 years of age or older and administer influenza immunizations by injectable or needle-free delivery methods to children ages nine years and older under certain conditions.  Find the bulletin here.

Stakeholder Events

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 14

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special populations webinar on “Filling the Day With Meaning:  Thinking Outside the Box.”  The webinar, to be held on Thursday, July 14 at 2:00, will seek to share with participants the benefits of meaningful engagement for residents living with dementia and is especially directed toward special population workers involved in recreational therapy, restorative team members, CNAs, and volunteers.  Learn about registration and how to join the webinar from this notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – July 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, July 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – July 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, July 28 at 10:00.  Go here to register to participate.

2022-07-08T20:28:06+00:00July 8th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 8
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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its June 2022 newsletter.

Included in this month’s edition are articles about:

  • Changes in HealthChoices managed care plans that take effect on September 1.
  • The July 1 transition to Tempus as the financial management services vendor for Community HealthChoices, which means Tempus will take over paying direct care workers hired by Community HealthChoices participants as part of that program’s self-directed care model.
  • A reduction of the deadline for requesting a fair hearing in response to Medicaid eligibility rejection or termination from the program from 90 days, which it has been since the start of the COVID-19 emergency, back to the 30 days it was before that time.  This change is retroactive to May.
  • A lifting of the pandemic-driven suspension of the need for prior authorization for shift nursing services for Medicaid beneficiaries under the age of 21, which will take effect on November 1.

Read about these subjects and more in the June 2022 edition of Health Law News, the Pennsylvania Health Law Project’s newsletter.

2022-07-06T21:19:51+00:00July 7th, 2022|COVID-19, HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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PA Health Policy Update for Friday, July 1

The following is an update of selected state health policy developments in Pennsylvania for the week of June 27 to July 1, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

As of 2:00 p.m. on Friday, July 1, Governor Wolf and the General Assembly continue to work on finalizing Pennsylvania’s FY 2023 budget.  Despite indications that a framework for a budget agreement has been reached, the state missed its June 30 deadline to enact a spending plan.  The General Assembly is scheduled to return to session next Tuesday, July 5 to continue its work. The short-term impact of not having a budget by July 1 will be minimal; the state is obligated to maintain essential operations and cover Medicaid expenditures, state employee payroll, and debt payments.

Harrisburg, PA capital buildingGeneral Assembly

The state House and Senate cancelled session this weekend and are schedule to return to session on Tuesday, July 5.  Depending on the outcome of budget negotiations and the progress of budget-related legislation, they may have to add additional session days next week.

  • The Senate passed House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • The Senate passed Senate Bill 225 on third and final consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.  The bill was sent to the House and referred to the Insurance Committee for consideration.
  • The House passed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.
  • The House passed Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers in Pennsylvania with those permitted by the federal Centers for Medicare & Medicaid Services (CMS), on third and final consideration.  Since the bill was amended, it was sent back to the Senate for concurrence.
  • The House passed House Bill 2679 on third and final consideration.  The bill, which was subsequently sent to the Senate for consideration, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five years of age and older.
  • The House unanimously voted to concur with Senate amendments to House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.  The bill will now be sent to the governor for his signature.
  • The House passed House Bill 2293 on third consideration and final passage and sent it to the Senate for consideration.  This bill requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.

Governor Wolf

Governor Wolf has signed into law House Bill 2401, which extends regulatory waivers that went into effect over the course of the COVID-19 pandemic.  This extension will permit many waivers to remain in place until October 31, 2022 unless the waivers are related to federal exemptions.  Waivers related to federal exemptions will remain in place until the last day of the federal public health emergency or the last day the federal exemptions are authorized, whichever is later.  House Bill 2401 also makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.  Learn more from this Wolf administration news release.

Governor Wolf has signed Senate Bill 709, which establishes the CMV Education and Newborn Screening Act and requires the Department of Health to make available on its website certain information regarding cytomegalovirus (CMV), one of the most common viral infections that infants are born with in this country.  Health care providers will be required to provide parents or guardians of newborns with information on CMV and to offer a screening or referral within 21 days if the newborn child fails the initial newborn hearing screening.  Learn more from this Wolf administration news release and Senate Bill 709 (now Act 29).

Department of Human Services

  • In response to the COVID-19 emergency, the federal Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in April of 2020 issued an exemption to opioid treatment programs from the requirement to perform an in-person physical evaluation for any patient who will be treated by such programs with buprenorphine if a program physician, primary care physician, or an authorized health care professional under the supervision of a program physician determines that an adequate evaluation of the patient can be accomplished via telehealth.  Based on positive response to this practice, SAMHSA is extending this flexibility for one year from the formal end of the COVID-19 public health emergency.  Learn more from SAMHSA’s guidance.
  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services has issued a bulletin to update its guidelines for payment of behavioral health services delivered using telehealth technology.  Find the bulletin here and attachments here and here.  The new guidelines take effect immediately.
  • DHS’s Breast & Cervical Cancer Prevention & Treatment Program provides eligible individuals treatment for confirmed cases of breast and cervical cancer or pre-cancerous conditions of the breast or cervix.  DHS has posted a notice to providers reminding them how to determine whether patients may be eligible for services under the program and, if they are, how they can enroll in the program.  Find that notice here.
  • DHS has issued a Medical Assistance Bulletin informing providers that as of November 1 it will reinstate the prior authorization requirements for shift care services provided to beneficiaries under the age of 21 in the Medical Assistance fee-for-service program.  Medical Assistance managed care organizations may reinstate the prior authorization requirements for these services provided to children under the age of 21.  Providers rendering services in the managed care delivery system should contact the appropriate managed care organization regarding any questions about prior authorization requirements.  Learn more from this Medical Assistance Bulletin.
  • DHS has announced a funding opportunity for home and community-based service (HCBS) providers to improve and strengthen HCBS programs and services to better serve HCBS participants.  Under the program DHS will provide up to $40,000 for each approved request to help HCBS providers implement a series of specific types of service improvement projects.  Funding is limited to providers of services through the Community HealthChoices and OBRA 1915(c) waivers for activities that supplement HCBS services rather than supplant existing services.  Learn more about the funding program and the specific types of projects DHS is interested in supporting from this DHS news release.  For more detailed information, see this DHS description of the program, the funding guidelines, and how to apply.  Applications will be accepted until December 31 or whenever the $38 million allocated for this purpose has been committed.  All awarded funds must be spent by July 1, 2023.
  • DHS is seeking partners to help it through the public health emergency unwinding process during which people will need to re-establish their eligibility for Medical Assistance benefits.  Specifically, it seeks individuals and organizations that will help guide current Medical Assistance beneficiaries through the eligibility renewal process or direct them to other resources for possible health care coverage.  Learn more about what DHS seeks and how to participate in this undertaking from this DHS message.
  • DHS has decreased from 90 to 30 days the period of time individuals have to request a hearing appealing a Medicaid termination or denial.  The time limit previously was 30 days, was extended to 90 days at the start of the COVID-19 public health emergency, and has now been restored to 30 days.  Find the notice in this DHS memo (on page 7, in red).
  • DHS and the Department of Transportation have been awarded a $750,000 grant from the Federal Transit Administration to expand its Find My Ride online tool, Pennsylvania’s “one-stop shop” for access to human services transportation.  The program was developed collaboratively with transit agencies and streamlines the application process for the five largest transportation assistance programs in the state, including the Senior Share Ride program, the Medical Assistance Transportation Program, ADA complementary paratransit, the Persons with Disabilities Program, and the Free Transit Program.  The program enables third parties, such as family members or health care providers, to apply for services on behalf of riders.  Learn more from this Wolf administration news release.

Insurance Department

The Insurance Department has received a federal grant as part of the State Flexibility to Stabilize the Market Grant Program Cycle II.  One of the proposed projects includes studying the availability of providers in various specialties and geographic areas.  The goal of this study is to understand areas of need based on the current availability of providers to accept new patients and the amount of time it takes to get an appointment with these providers and to assess network adequacy considerations based on the findings.  The Insurance Department is seeking public comment from organizations, consumer advocates, providers, and consumers about their experience with getting appointments or finding available specialists.  Learn more about the project and the areas of medical specialty the analysis may consider, and on which the department is interested in comments, in this Pennsylvania Bulletin notice.  Comments are due by August 5.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder.  Last year the program awarded $599,000 to 12 organizations and this year the Department of Drug and Alcohol Programs plans to award approximately three to five grants of up to $600,000 each to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.  Learn more about this funding opportunity from this department news release and a program overview that describes eligible applicants and outlines the application process.  Applications are due by July 29 for projects that begin on October 1 and end by September 30, 2023.

COVID-19:  By the Numbers

  • After four weeks of falling case counts the number of new reported COVID-19 cases rose over the past week.
  • During this past week, Pennsylvania’s total of COVID-19 cases since the beginning of the pandemic rose past three million.
  • COVID-19-related deaths rose slightly during the week.
  • The number of Pennsylvanians hospitalized with COVID-19 remained steady over the past week but the number in hospital intensive care units and on ventilators declined.
  • Thirty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 55 counties last week.  Four counties experienced a moderate rate of community transmission and the remaining 18 experienced a substantial rate.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 7

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar to help nursing facility staff recognize expressions of behavior among residents living with dementia.  The webinar will be held on Thursday, July 7 at 2:00.  Learn more about the webinar and how to participate from this notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

2022-07-01T20:16:07+00:00July 1st, 2022|COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 1
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PA Health Policy Update for Friday, June 24

The following is an update of selected state health policy developments in Pennsylvania for the week of June 20-24, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state House and Senate convened for voting session this week in Harrisburg.  Originally scheduled to be in session all week, the House and Senate cancelled session Thursday and Friday while legislative leaders and the governor continue to negotiate an FY 2023 spending plan.  Both chambers will back in session next week to attempt to finalize the budget by the state’s June 30 constitutionally-mandated deadline.
  • The Senate unanimously concurred with House amendments to Senate Bill 709 and sent it to Governor Wolf for his signature.  This bill establishes the CMV Education and Newborn Testing Act to create public awareness of cytomegalovirus and provide for CMV screening for certain newborns.
  • The Senate unanimously passed Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.  The bill now goes to the House for consideration.
  • The Senate adopted Senate Resolution 288, which authorizes the Joint State Government Commission to research the impact of the pandemic on the staffing needs of long-term-care facilities.
  • The House unanimously passed House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.  The bill was received in the Senate and referred to the Judiciary Committee for consideration.
  • The House unanimously passed House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by FDA.  The bill was received in the Senate and referred to the Judiciary Committee.
  • The House passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill was received in the Senate and referred to the Judiciary Committee.
  • The House Human Services Committee favorably reported House Bill 107, which would require Medicaid managed care organizations to enter into an agreement with the Department of Human Services to enable the department to recoup any Medicaid funds that were spent on “provider-preventable conditions,” and House Bill 109, which increases the penalties for making a false claim against the state’s Medicaid program.
  • The House Judiciary Committee favorably reported House Bill 2660, which is a proposed constitutional amendment that would establish the General Assembly’s sole authority to establish in statute the rules regarding venue in civil lawsuits.
  • The Senate Health & Human Services Committee favorably reported House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  The committee also unanimously reported House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.
  • The Senate Consumer Protection & Professional Licensure Committee reported Senate Bill 485, which seeks to improve access to physical therapy services, and Senate Bill 511, which authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
  • The Senate amended Senate Bill 225 on second consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.
  • Representative Wendy Thomas and Human Services Committee Chairman Frank Farry held a press conference to highlight House Bill 2686, which seeks to improve access to mental health care in Pennsylvania through the Behavioral Collaborative Care Model.  The legislation would provide grant funding to support the model’s implementation in physician practices.

Free COVID-19 Vaccines

Following the extension of authorization to administer COVID-19 vaccines to children six months of age and older, the federal Centers for Medicare & Medicaid Services (CMS) has announced that children ages six months to five years with Medicaid and CHIP coverage are eligible for COVID-19 vaccinations without cost-sharing.  Learn more about these free vaccines, and others who are eligible for free vaccines, from this CMS news release.

Department of Human Services

  • The Department of Human Services (DHS) has announced that the plan selection period for physical health HealthChoices will run from June 22 through August 16.  This selection period comes ahead of implementation of new physical health managed care agreements that will take effect on September 1.  The new agreements will result in some consumers having to choose a new physical health plan, and all consumers can review options and select a new health plan if they would like to make a change.  Notices are being mailed to all Medicaid recipients enrolled in a physical health managed care plan.  The letter explains whether or not a person’s current plan will continue to be available after September 1, all options for plans in their region, important dates, and how to choose or change their plan.  Approximately 500,000 current HealthChoices participants will have to select a new physical health plan by August 16 or be automatically assigned due to the agreement changes.  Learn more about the plan selection period and find links to additional resources from this DHS news release.
  • DHS has extended its calendar of remittance advice notifications, check mailings, and electronic funds transfers into early August.  Find the updated calendar here.
  • DHS has updated its list of drug companies that participate in the federal Medicaid drug rebate program.  For a drug product to be compensable through the Medical Assistance program the company that markets the product must participate in the Federal Medicaid Drug Rebate Program.
  • DHS’s Medical Assistance Advisory Committee met on Thursday, June 23.  Learn about the committee’s deliberations from presentations offered by:
  • DHS’s Medical Assistance Advisory Committee’s consumer subcommittee met on Wednesday, June 22.  Learn about the committee’s deliberations from presentations offered during the meeting by DHS’s Office of Medical Assistance Programs and its Office of Long-Term Living.
  • DHS has published a notice announcing the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2023.  Find that notice here.
  • DHS has announced its intent to amend Pennsylvania’s Title XIX State Plan to update the Medical Assistance payment methodology and standards for payment of Medical Assistance-covered nursing facility services in FY 2023 to authorize the continued use of a budget adjustment factor in setting payment rates for nursing facility services.  Learn more about this proposal in this Pennsylvania Bulletin notice.
  • DHS has published its proposed annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Find that notice here.

Department of Health

The Department of Health has issued a health alert updating its recommendations for identifying cases of monkeypox, testing for the disease, and counseling patients.  Find the updated guidance here.

The Department of Health has issued a health alert informing providers and public health officials that the first mosquito pools of the season to test positive for West Nile virus in Pennsylvania have been found in Montgomery, Philadelphia, Bucks, and Cumberland counties and that the risk of West Nile infection is likely to remain elevated over the next several months.  The alert reviews symptoms of West Nile virus and when and how to test for the virus.  Find the alert here.

Pennsylvania Rural Health Model

The Pennsylvania Rural Health Model is a federal program that seeks to test whether care delivery transformation in conjunction with hospital global budgets increase rural Pennsylvanians’ access to high-quality care and improve their health while also reducing the growth of hospital expenditures across payers, including Medicare, and improving the financial viability of rural Pennsylvania hospitals to improve health outcomes of and maintain continued access to care for Pennsylvania’s rural residents.  Eighteen Pennsylvania hospitals participate in this program.  CMS’s Center for Medicare and Medicaid Innovation has just published an evaluation of the program’s second year of operations.  Find that evaluation report here and go here for other information about the program, including a list of the participating hospitals.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the expansion of ATLAS, the Addiction Treatment Locator, Assessment, and Standards platform, to Pennsylvania.  ATLAS evaluates addiction treatment facilities’ use of evidence-based best practices and offers a dashboard that enables those seeking assistance to search for and compare facilities using various criteria.  Learn more about ATLAS’s expansion to Pennsylvania in this Department of Drug and Alcohol Programs new release and on the ATLAS web site.  The news release notes that in the fall of this year there will be an open enrollment period for facilities that missed the first deadline for inclusion in ATLAS.

COVID-19:  By the Numbers

  • For the fourth consecutive week COVID-19 case counts in Pennsylvania fell, declining from a seven-day average of 2897 on June 15 to 1761 on June 22, a 39 percent decline.
  • The seven-day average of COVID-19-related deaths fell by more than half, from 24 to 11, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units remained relatively unchanged over the past week.
  • Fifty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 56 counties last week.  Two counties experienced a moderate rate of community transmission and the remaining ten experienced a substantial rate.

Stakeholder Events

Department of Health – Public Health Advisory Council – June 27

The Department of Health’s Public Health Advisory Council will meet virtually on Monday, June 27 at 2:00.  The purpose of the meeting is to discuss the Preventive Health and Health Services Block Grant Federal Fiscal Year 2022 work plan.  For additional information about the meeting and how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

 

2022-06-24T20:48:16+00:00June 24th, 2022|COVID-19, Federal Medicaid issues, HealthChoices, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for Friday, June 24
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  • 2020 Safety-Net Association of Pennsylvania

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