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PA Health Policy Update for the Week of January 17-21

The following is an update of selected state health policy developments in Pennsylvania for the week of January 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The Senate held voting sessions on Tuesday (1/18) and Wednesday (1/19) this week and passed, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS) and eliminates the need for facilities to request an exception, and Senate Bill 861, which enters Pennsylvania into the EMS interstate compact.  Both bills will now be sent to the state House.
  • The Senate Health and Human Services Committee convened on Tuesday and favorably reported Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Health and Human Services Committee will convene again next week on Tuesday, January 25 to consider the following bills:
    • Senate Bill 152, which provides direction to the Department of Human Services on how to distribute funding intended for women’s health and family planning services.
    • Senate Bill 956, a constitutional amendment that clarifies that there is not a right to an abortion or abortion funding in the state constitution.
    • House Bill 1420, which directs the Department of Human Services to establish a public awareness campaign to provide information regarding the programs and services available for first responders, health care workers, and other frontline workers suffering from mental health issues related to the COVID-19 pandemic.
  • The Senate Aging and Youth Committee meeting previously scheduled for Tuesday, January 18 has been rescheduled for Monday, January 24 at 12:30 to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Human Services and Health to establish protocols to permit residents of long-term-care facilities to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.
  • The House Professional Licensure Committee will convene on Monday, January 24 at 10:30 a.m. to consider the following bills:
    • House Bill 19, which establishes professional licensure for behavioral analysts.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 1862, which preserves the COVID-19 regulatory waiver that authorizes physicians with an institutional license in a teaching hospital to serve patients at more than just two facilities in a health system.

Department of Human Services

The Department of Human Services has updated its schedule of Remittance Advice (RA) mailing dates and electronic RA delivery dates.  The schedule now extends into early March.

DHS has published final notice of the assessment amount, assessment methodology, and estimated aggregate impact on nursing facilities that will be subject to an assessment under the Nursing Facility Assessment Program for FY 2022.  Find that information in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a health alert outlining options for treating patients with the COVID-19 omicron variant.

DOH continues to establish new sites for COVID-19 testing, adding sites this week in Greene and Pike counties.  Find information about these and other state-sponsored sites in this department news release; about plans for a new high-volume site in Hershey; and about another high-volume site in Delaware County.

DOH reports that the state has had 28,475 laboratory-confirmed flu cases and that such cases have been found in all 67 counties.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (January 20) was 20,958 cases a day; a week ago (January 13) its seven-day average was 26,224 cases a day.
  • The number of new COVID-19-related deaths also remains very high but it, too, declined over the past week.  Pennsylvania’s seven-day average yesterday (January 20) was 127 deaths a day; a week ago (January 13) its seven-day average was 120 deaths a day.
  • The Department of Health reports that from January 1, 2021 to January 4, 2022, 78 percent of reported COVID-19 cases were in unvaccinated or not fully vaccinated people; 85 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 84 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.
  • The Department of Health also reports that 31.8 percent of all staffed adult ICU beds are COVID-19 patients and 32.4 percent of all ventilators state-wide are in use.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a seven percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators and in ICUs because of the disease held steady over the past week after two months of steeply increasing numbers.
  • As a result of the decline in hospitalizations, there are a slightly more unoccupied adult ICU and medical/surgical beds in the state this week.  While the occupation rate of pediatric ICU beds increased just slightly, occupancy of pediatric and airborne isolation rates rose 7.6 percent and two percent, respectively, over the past week.  There are still only 33 unoccupied pediatric ICU beds and 501 unoccupied adult ICU beds in the state.
  • On January 18 the Department of Health elaborated on some of these figures, reporting that 31.8 percent of all staffed adult ICU beds are occupied by COVID-19 patients and 32.4 percent of all ventilators state-wide are currently in use.  Both numbers are almost identical to the previous week’s totals.
  • Media reports are mixed but suggest reason for optimism.  Around the state,
    • New cases are declining in Lancaster County but the decline in hospitalizations is more modest.
    • The new case rate is falling significantly in the Lehigh Valley but hospitalizations are down only slightly.  Even so, the city of Easton closed its city hall because of COVID-19 cases and exposures.
    • Erie County hospitals have more COVID-19 patients than at any time since the pandemic began but fewer of them are dying and fewer of them are being treated in ICU beds.  County health officials are concerned that many cases are not reflected in official counts.
    • New case figures are stabilizing in Allegheny County but the number of infants and children hospitalized is rising.
    • Both cases and hospitalizations are declining in Philadelphia and its surrounding suburban counties.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued a legislatively mandated report on the effects of the COVID-19 emergency on the state’s hospitals and health care facilities.  The report notes that “Pennsylvania hospitals and health systems reported $214,055,540 in COVID-19 related expenses and revenue losses for the period July 2021 – September 2021. These expenses and revenue losses were attributable to coronavirus and used to prevent, prepare for, and respond to the coronavirus pandemic.  Total COVID-19 related expenses and lost revenue reported by Pennsylvania hospitals and health systems through September 2021 (Jan 2020-September 2021) were $6,925,269,148.”  The report does not reflect any offsetting state and federal funding intended to help providers with these expenses and losses.  Find the report here.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m.  Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m.  This meeting will be broadcast live through Commonwealth Media Services.  Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27 at 10 a.m.  To participate, call 412-648-8888 or 866-588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Organ Donation Advisory Committee – February 3

The Organ Donation Advisory Committee will hold a virtual public meeting on Thursday, February 3 from 10 a.m. to 1:30 p.m.  The purpose of this meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the acting secretary on matters relating to the administration of this fund.  Learn more about the meeting and how to participate in this Pennsylvania Bulletin notice.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                      Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

2022-01-21T22:25:57+00:00January 21st, 2022|Coronavirus, COVID-19, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 17-21
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PA Health Policy Update for the Week of January 10-14

The following is an update of selected state health policy developments in Pennsylvania for the week of January 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has announced the creation of the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment program, or LTC RISE, which seeks to give long-term-care facilities “…the support they need to battle COVID-19, recover, and rebuild.”  Under the program, long-term-care facilities can pursue improvement projects in the areas of infection prevention and control and emergency preparedness; building a sustainable outbreak response operation; and promoting professional development and a resilient long-term-care facility workforce.  The program is funded by a federal grant and replaces the state’s Regional Congregate Care Assistance Teams program, which expired at the end of 2021.  Learn more about LTC RISE from this Wolf administration news release and from the LTC RISE web page.

General Assembly

  • The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act.  This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.  The bill was received in the Senate and referred to the Health and Human Services Committee.
  • The House Health Committee convened on Tuesday, January 11 and favorably reported House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.  The committee also reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
  • The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m.  The hearing will take place at the University of Pittsburgh at Bradford.
  • The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
  • The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
  •  The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

  • Various Department of Human Services (DHS) regulations were suspended to facilitate the state’s response to the COVID-19 pandemic.  Some of those suspensions have been lifted, so some of the temporarily suspended regulations are being enforced again.  For an updated list of regulations and their current status, organized by offices within DHS and with the most recent changes highlighted, go here.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of booster doses of COVID-19 vaccines.  To find those new codes and the rates to be paid, see this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of the Pfizer pediatric COVID-19 vaccine.  Find the procedure codes, rates, and more in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin informing providers of changes in billing procedures for certified registered nurse practitioners and physician assistants serving fee-for-service patients.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that the fee-for-service program will require prior authorization for prescribing Aduhelm (aducanumab), the new drug to treat Alzheimer’s disease.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that it has issued updated handbook pages presenting the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Xyrem (sodium oxybate)/Xywav (calcium, magnesium, potassium, and sodium oxybates) for fee-for-service patients.  Find the notice here.
  • DHS announced that it intends to continue making Medical Assistance Day One Incentive payments to qualified non-public nursing facilities in FY 2022.   These payments seek to give incentives to non-public nursing facilities to serve individuals who are Medical Assistance-eligible on the day of admission.  Learn more about how and when the payments will be made and how they will be calculated in this Pennsylvania Bulletin notice.
  • DHS is making available for public review and comment its proposed renewal application for extension of the Section 1115 Medicaid demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration.”  The effective dates of the current approved demonstration are October 1, 2017 through September 30, 2022.  The extension requested will be for an additional five years, through September 30, 2027.  Learn more about the program and the state’s planned request from this Pennsylvania Bulletin notice.
  • DHS’s Office of Child Development and Early Learning has updated its FAQ on its guidance for tuberculin skin testing and COVID-19 vaccinations for providers participating in its licensed programs.  Find that FAQ here.

Department of Health

In the past week the Department of Health announced the opening of a new COVID-19 testing site in Cambria County to go along with other recently opened testing sites in Berks, Blair, Centre, Clinton, Delaware, Luzerne and Mifflin counties.  In addition, the state has announced that a new high-volume and high-throughput COVID-19 testing site will be opening soon in Delaware County at Mercy Fitzgerald Hospital.  This site will be staffed by U.S. Department of Health and Human Services contractors with additional support from the host location, the costs for which will be eligible for reimbursement by FEMA.  The Department of Health continues to talk to federal officials about the possibility of opening an additional high-volume testing site in the south-central part of the state.

The Department of Health has announced that Credentia will serve as its new contractor to operate the Pennsylvania nurse aide registry previously operated by Pearson Vue.  Go here for the nurse aide registry search.  The Pearson Vue link no longer works as of January 3.

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

The Pennsylvania Rural Health Redesign Center Authority Board will hold its next virtual meeting on Tuesday, January 18 at 10:00 a.m.  The meeting will provide updates on a variety of topics, including model status updates, federal grant deliverables, global budget methodology, and more.  It also will address current and upcoming activities.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Infant Hearing Screening Advisory Committee – January 20

The Infant Hearing Screening Advisory Committee will hold a public meeting both in person and virtually on Thursday, January 20 at 1:00 p.m.  Agenda items will include reports by the cytomegalovirus and audiology subcommittees, an assessment of audiology training currently in development, and a review of upcoming program activities.  For information about how to join the meeting, either virtually or in person, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m.  Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m.  This meeting will be broadcast live through Commonwealth Media Services.  Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27 at 10 a.m.  To participate, call 412-648-8888 or 866-588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                     Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

 

2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 10-14
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PA Health Policy Update for the Week of December 27-30

The following is an update of selected state health policy developments in Pennsylvania for the week of December 27-30, 2021.  (Some of the language used below is taken directly from state documents.)

Centers for Medicare & Medicaid Services

CMS directed state survey agencies in certain states, including Pennsylvania, to begin surveying for compliance with the agency’s November 5, 2021 final rule requiring vaccination of health care staff. Click here to read the guidance to states and find provider-specific guidance documents.  CMS has authorized state surveyors to find facilities out of compliance with the rule within 30 days of the issuance of this guidance if less than 100 percent of all staff have received at least one dose of a COVID-19 vaccine.

Department of Health

  • The Department of Health (DOH) and the Pennsylvania Emergency Management Agency announced that the federal Department of Health and Human Services will be sending “strike teams” to Scranton Regional Hospital and Wellspan York to increase acute care capacity. In addition, EMS “strike teams” will be deployed in those regions to support the increased capacity.
  • DOH, in partnership, with the Department of Human Services, announced it will be transitioning its Regional Congregate Care Teams (RCATs) to the new LTC RISE (Long-term Care Resiliency, Infrastructure Supports, and Empowerment) program, effective January 1, 2022. This program will continue to provide long-term-care facilities with COVID-19 outbreak response support.  Additional information on the LTC RISE program may be found here.
  • DOH issued updated guidance to providers on COVID-19 treatment options with direction to limit the use of sotrovimab because of a current nationwide supply shortage.  This particular monoclonal antibody should be reserved for eligible outpatients at the highest risk who are diagnosed with the omicron variant of COVID-19 or exposed to local settings where omicron is prevalent.
  • DOH updated its recommendations for when health care personnel with COVID-19 infection could return to work and its contingency and crisis strategies for providers mitigating staff shortages.
  • DOH updated its guidance on isolation and quarantine periods for COVID-19 for the general population.

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of community-based care management services to the Medical Assistance fee schedule and its intent to seek CMS approval to add to the Medicaid state plan community-based care management services provided by Centers of Excellence for opioid use disorders.  See details in the Pennsylvania Bulletin notice here.
  • DHS has issued a Medical Assistance Bulletin to add to the MA fee schedule procedures codes for the administration of  booster doses of the Janssen and Moderna COVID-19 vaccines.
  • DHS has issued a Medical Assistance Bulletin with information on two CPT codes added to the MA fee schedule for the administration of Pfizer’s pediatric COVID-19 vaccine.
  • DHS has issued a Medical Assistance Bulletin about reimbursement of licensed pharmacists administering vaccines to Medicaid fee-for-service beneficiaries.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.9 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • Nearly all Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 remains high.  There currently are only 533 unoccupied adult ICU beds – 15.1 percent of the total of such beds in the state; 2369 unoccupied medical/surgical beds – 11.9 percent of such beds in the state; 40 pediatric ICU beds (10.7 percent); 234 pediatric beds (23.4 percent); and 991 airborne isolation beds (31.0 percent).
  • DOH reports that 6.9 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than 1.05 million people fully vaccinated and that 224,000 boosters have been administered to city residents since August 13.

 

2022-01-03T16:31:32+00:00January 3rd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 27-30
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PA Health Policy Update for the Week of December 13-17

The following is an update of selected state health policy developments in Pennsylvania for the week of December 13-17, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration requested support from the Federal Emergency Management Agency (FEMA) for Pennsylvania’s health care system in its continued battle against COVID-19.  In particular, it has asked for staffing support for clinical and non-clinical professionals and continued pandemic response support.  Learn more from this Wolf administration news release.

General Assembly

  • The Senate unanimously passed House Bill 1260, which expands eligibility for the PACENET prescription program from $27,500 to $33,500 for single individuals and from $35,500 to $41,500 for married couples.  The bill has been sent to the governor.
  • The House Health Committee held an informational hearing on Monday to discuss the various COVID-19 treatment options available.  House Bill 1741, which provides for prescribing and dispensing to treat COVID-19 off-label drugs approved by the FDA for other purposes, received a considerable amount of attention during the hearing.  Chairman Kathy Rapp indicated the committee may move the bill in early 2022.  You can view a recording of the hearing here.
  • The Senate Health & Human Services Committee convened on Tuesday and favorably reported the following bills:
    • Senate Bill 200, which expands early intervention services for infants and mothers;
    • Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health;
    • Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning;
    • Senate Bill 848, which creates a chief nursing officer position in the Department of Health;
    • Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board;
    • Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception; and,
    • House Bill 118, which establishes requirements for the final disposition of fetal remains.

You can view the committee’s agenda and a video recording here.

  • The House Human Services Committee held an informational hearing on House Bill 1644 on Thursday.  The bill directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.  The Human Services Committee also held an informational hearing on community participation supports during COVID-19 pandemic.  You can view a recording of the hearing here.
  • The state House and Senate appropriations committees released their FY 2023 budget hearing schedules.  The schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has updated its schedule for Remittance Advices, adding January dates and pay dates that go into early February.  Find it here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its intention to allocate funds in FY 2021-2022 for several classes of Medicaid inpatient disproportionate share hospital (Medicaid DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  The department does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  The allocations include:
    • $1.057 million in total funds for DSH payments to qualifying acute-care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue, and are located in an area of the state with a disproportionate need for Medicaid services
    • $1.585 million for DSH payments to qualifying acute-care general hospitals to promote access to acute-care services for Medicaid-eligible persons in less urban areas
    • $18.293 million for DSH payments to Medicaid-enrolled acute-care general hospitals that qualify as a trauma center
    • $111.585 million for DSH payments to qualifying Medicaid-enrolled acute-care hospitals that promote access to comprehensive inpatient services for Medicaid-eligible persons by providing an adequate supply of health care professionals who have been trained in high-volume Medicaid-enrolled hospital settings
    • $9.377 million for DSH payments to qualifying acute-care general hospital burn centers
    • $14.119 million for DSH payments to qualifying acute-care general hospitals providing obstetrical and neonatal services
    • $0.500 million for DSH payments to qualifying teaching hospitals that provide psychiatric services to Medicaid beneficiaries
    • $34.356 million for DSH payments to critical access and qualifying rural hospitals
    • $0.695 million for DSH payments to qualifying acute-care general hospitals that provide surgical services to patients with cleft palate and craniofacial abnormalities
    • $0.737 million for DSH payments made to qualifying Medicaid-enrolled acute-care general hospitals that provide a high volume of inpatient services to Medicaid-eligible and low-income populations
    • $4.333 million for DSH payments to qualifying acute-care general hospitals that qualify as academic medical centers
    • $23.946 million for DSH payments to qualifying acute-care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals
    • $7.397 million for DSH payments to qualifying acute-care general hospitals that participate in an academic medical program
    • $5.290 million for supplemental payments to qualifying acute-care general hospitals that provide medical and surgical ocular services to Medicaid beneficiaries
    • $0.900 million for supplemental payments to qualifying acute-care general hospitals that provide a substantial portion of their inpatient services to Medicaid beneficiaries

Learn more from this Pennsylvania Bulletin notice.

  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization.  Find the bulletin here.

Department of Health

  • Department of Health (DOH) acting secretary Alison Beam will leave that job at the end of the year.  She will be replaced by department deputy secretary Keara Klinepeter.  Learn more from this Wolf administration news release.
  • DOH announced that the state is opening free outdoor drive-up COVID-19 testing sites in Berks, Blair, Centre, Clinton, Jefferson, Luzerne and McKean counties.  For locations and hours, see this department news release (and this separate notice for the site in Blair County).
  • DOH has introduced a new “post-vaccination data” web page on which it will provide data on so-called breakthrough cases of COVID-19:  cases, hospitalizations, and deaths.  The web page reports that from January 1 through December 6, 2021, 85 percent of reported COVID-19 cases in Pennsylvania were in unvaccinated or not fully vaccinated people; 87 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 86 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.  For additional information and a more detailed breakdown of these and other numbers, see the department’s new post-vaccination data web page.
  • DOH has posted a notice on its message board about the transition from the Regional Congregate Care Teams to a new program that will support response operations at long-term-care facilities that experience COVID-19 outbreaks.  Find that message here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments on DOH’s proposed amendments of regulations governing long-term-care facilities.  In addition to specific comments, the IRRC stated its agreement with many others in the regulated community that have urged DOH to reevaluate its approach of promulgating several packages of proposed regulations and instead consider submitting a comprehensive regulatory update regarding long-term care.  Find the IRRC comments in this Pennsylvania Bulletin notice.
  • DOH has issued its monthly report detailing its nursing home inspection and sanction activities.  Learn more from this department news release and the department’s November report.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 has risen 18 percent since December 1; the number in hospital ICUs because of COVID-19 has risen 13 percent; and the number on ventilators because of the virus has risen 16 percent since the start of the month.
  • This situation is reflected in the high rate of occupancy in the state’s hospitals.  There currently are only 484 unoccupied adult ICU beds – 13.7 percent of the total of such beds in the state; 2106 unoccupied medical/surgical beds – 10.5 percent of such beds in the state; 34 pediatric ICU beds (9.0 percent); 191 pediatric beds (16.8 percent); and 938 airborne isolation beds (29.6).
  • Media reports confirm the challenges some communities and hospitals are facing, including this story in the Philadelphia Inquirer; a situation that the director of the 911 call center in Westmoreland County calls “desperate;” and reported capacity and hospital discharge problems in western and rural Pennsylvania.
  • DOH reports that 6.8 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that 186,000 boosters have been administered to city residents since August 13.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published Hospital Performance Report – 2020 Data, which presents volume and outcome information about a variety of medical conditions and surgical procedures performed by the state’s  general acute-care hospitals.  Learn more from the following resources:

 

2021-12-17T22:37:32+00:00December 17th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 13-17
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PA Health Policy Update for the Week of November 29-December 3

The following is an update of selected state health policy developments in Pennsylvania for the week of November 29 to December 3, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced a plan to spend approximately $1.2 billion in American Rescue Plan Act federal funding to support Medicaid’s home and community-based services (HCBS) system, giving more Pennsylvanians access to critical services in their communities.  This temporary funding enhancement will be directed toward Medicaid-funded essential care services to seniors, adults with intellectual and physical disabilities, adults with behavioral health needs such as substance use disorder or mental illness, and children with chronic complex medical needs.  The American Rescue Plan Act provides states with a temporary, one-year, 10 percent increase in the rate at which the federal government matches state spending for certain Medicaid-covered home and community-based services.  To learn more about how Pennsylvania plans to spend this money, see this Wolf administration news release.  For more on Pennsylvania’s plan, go here.  A week after this announcement, the federal government approved the state’s plan for using this money, as the Department of Human Services reported to stakeholders.

General Assembly

The House Republican Policy Committee held a hearing this week examining the health care staffing crisis.  Representatives from the Hospital & Healthsystem Association of Pennsylvania (HAP), Penn State Health, Geisinger, the Pennsylvania Health Care Association (PHCA), SEIU Healthcare, and the Pennsylvania State Nurses Association testified.  Hearing testimony and a video recording may be viewed here.

Two members of the General Assembly – House majority leader Kerry Benninghoff (R-Mifflin) and Representative Mark Gillen (R-Berks) – have tested positive for COVID-19.

Financial paperworkState Revenue Update

Revenue collections continue to exceed estimates. The Department of Revenue reported this week that Pennsylvania collected $6.6 billion in General Fund revenue in November, which was $217.9 million, or 3.4 percent, more than anticipated.  For the year to date Pennsylvania has collected $18.7 billion in General Fund revenue, which is $1.0 billion, or 5.7 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin explaining that it intends to allocate $106.130 million in total funds for disproportionate share hospital payments (Medicaid DSH payments) to qualifying acute-care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the state and $88.994 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms.  Go here to see the Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin updating its dental fee schedule.  The update is effective as of August 23, 2021.

Department of Health

The state Supreme Court has temporarily restored the Department of Health’s (DOH) order requiring students, teachers, and staff to wear masks in Pennsylvania school districts.  Read the court’s ruling here.  The ruling only put a hold on Commonwealth Court’s decision to issue a stay of the order; the Supreme Court will still need to consider the governor’s appeal of the Commonwealth Court decision.

DOH has established new walk-in COVID-19 testing sites in Berks, Centre, Clinton, Crawford, Jefferson, and Susquehanna counties.  Learn more from this news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts are on the rise in Pennsylvania.  Wednesday’s 7606 new cases and Thursday’s 9143 new cases are the highest single-day totals in the state since the second week of January.  To date, more than 1.75 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.  To date, more than 33,000 Pennsylvanians have died from COVID-19.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which declined during the first two weeks of November, rose significantly during the last two weeks of the month.  As the month came to a close, COVID-19 related hospitalizations were up 43 percent over the beginning of the month, ventilator cases were up 32 percent, and COVID-19 patients in hospital ICUs also were up 32 percent.
  • 231,000 Pennsylvanians were recorded as completing a vaccine regimen during the month of November.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs released Policy Bulletin 21-05, which documents modifications to the Standard General Terms & Conditions, Fiscal and Operations Manual, and Substance Abuse Prevention and Treatment Block Grant (SAPTBG) provisions.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, December 8 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m.  Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m.  Go here for information about registering and participating.

2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 29-December 3
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PA Health Policy Update for the Week of November 15-19

The following is an update of selected state health policy developments in Pennsylvania for the week of November 15-19, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf, the Department of Human Services, and the Department of Community and Economic Development announced a plan to spend nearly $300,000 on the state’s Pre-Apprentice and Apprenticeship Program to expand its nurse residency apprenticeship program.  Go here to read the announcement and here to learn more about the state’s apprenticeship programs.

General Assembly

  • The House of Representatives passed House Bill 1995 by a vote of 115-85 this week.  This legislation clarifies the Department of Drug and Alcohol Programs’ authority to promulgate regulations that affect licensed drug and alcohol treatment providers and subjects those regulations to the formal regulatory review process, including publication, notice, and comment.
  • The House Health Committee met on Tuesday, November 16 and favorably reported the following bills:
    • House Bill 1005 adds information to the prescription drug monitoring program (ABC-MAP) when Narcan/Naloxone is used to combat an overdose by emergency responders or medical professionals.
    • House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.
    • House Bill 1959 authorizes the clinical study of the efficacy and cost/benefit optimization of psilocybin-assisted therapy in the treatment of post-traumatic stress disorder, traumatic brain injury, and various mental health conditions.
    • House Bill 2013 adds language to the state constitution establishing an individual’s right to refuse any medical procedure, treatment, injection, or vaccine.
    • House Bill 2033 extends the reporting requirement on the status of COVID-19 testing at the state laboratory until December 31, 2022.
    • House Bill 2077 creates certain exceptions to the COVID-19 vaccine requirement.
  • The House Human Services Committee held an informational hearing on reimbursement rates for drug and alcohol, mental health, and intellectual disability treatment.  A recording of the hearing may be viewed here.

Department of Human Services

Department of Health

  • The Department of Health shared updated guidance from the Centers for Medicare & Medicaid Services about visitation in nursing homes during the pandemic.
  • The Department of Health has produced a neonatal abstinence syndrome family guide toolkit in partnership with the Northwestern Pennsylvania Neonatal Abstinence Syndrome Coalition and the Ohio Perinatal Quality Collaborative to help educate families on the symptoms of neonatal abstinence syndrome and treatment resources.
  • The Department of Health has posted a notice on its message board explaining that its Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities that they are not required to call 1-877-PA-HEALTH or email Bureau of Epidemiology staff with each new case of COVID-19 identified in staff and residents.  Facilities should continue to call 1-877-PA-HEALTH only to report new outbreaks within their building.  Bureau of Epidemiology staff may request line lists or updates about the status of an outbreak during specific situations.  Facilities should continue to follow all other reporting mandates, including reporting to ERS, CMS, NHSN, or PA-NEDSS.

COVID-19:  By the Numbers

  • The general downward trend in new daily COVID-19 cases in Pennsylvania has ended.  The new case totals for Wednesday, November 16 and Thursday, November 17 were the highest the state has experienced since mid-April.
  • The number of new COVID-19-related deaths remains high.
  • “About nine in ten COVID-19 hospitalizations and deaths in Pennsylvania have involved people who are less than fully vaccinated against the virus, according to new data from the state health department,” PennLive reports.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which had declined during the first two week of November, are now higher than they were on the first of the month.
  • 73.3 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people.  49,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $10 million in grant funding for stabilization payments to substance use disorder treatment providers to assist with pandemic-related expenses.  Learn more about the program and how to apply for funding in this department news release.  The deadline for funding applications is noon on December 8,

The Department of Drug and Alcohol Programs is in the process of implementing the ATLAS® (Addiction Treatment Locator, Analysis, and Standards) platform in Pennsylvania in the coming months.  Affected providers previously were asked to complete a survey for this purpose.  Find that survey here.  The following resources are available for those seeking assistance completing the survey:

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume two of its annual ambulatory surgery centers financial analysis for 2020.  Its analysis found that the average total margin for ambulatory surgery centers decreased 1.66 percentage points, from 25.04 percent in FY 2019 to 23.38 percent in FY 2020, with the state-wide average operating margin decreasing 2.88 percentage points, from 25.13 percent in FY 2019 to 22.25 percent in FY 2020.  Go here (under “Ambulatory Surgery Centers Volume Two”) for the agency’s news release about the report, the report itself, and a link to downloadable data from the report.

Pennsylvania Higher Education Assistance Agency (PHEAA)

“Pennsylvania-licensed nurses could soon have some of their student loan debt paid off for them,” reports PennLive, explaining that “A one-time student loan forgiveness program will provide up to $7,500 in debt reduction under a program that the Pennsylvania Higher Education Assistance Agency’s board authorized on Thursday.”  Learn more about the PHEAA board action here and about the PA Student Loan Relief for Nurses Program here.

Stakeholder Events

Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee Meeting – December 2

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will hold a virtual public meeting on Thursday, December 2 at 10:00 a.m.  To register to participate, go here.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m.  Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m.  Go here for information about registering and participating.

2021-11-19T22:17:34+00:00November 19th, 2021|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 15-19
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PA Health Policy Update for the Week of October 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of October 18-22, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed an executive order calling on the state’s Department of Labor & Industry to “study the feasibility of implementing Occupational Safety and Health Administration (OSHA) standards” in state offices and requiring that for profit entities that do business with the state pay “…a minimum wage that meets or exceeds” the state’s minimum wage and offer paid sick leave to their employees.  Go here to see that executive order and here to see a Wolf administration news release about it.

House Chamber of the State HouseGeneral Assembly

  • The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Navigating Healthcare Consolidation.”  Co-hosted by chairman Ryan Bizarro and northeast delegation chair Rep. Maureen Madden, the hearing focused on the market dynamics that contribute to health care consolidation and the effect consolidation has on communities, patients, and employees.  Representatives from the hospital community, organized labor, and patient advocacy groups testified.  A press release issued following the hearing may be viewed here and testimony offered at the hearing may be viewed here.
  • The House and Senate will be in session next Monday (10/25), Tuesday (10/26), and Wednesday (10/27).  As of October 22, the following health care-related committee meetings have been scheduled for next week:
    • The House Aging & Older Adult Services Committee will meet on Tuesday, October 26 to consider, among other bills, House Bill 1356, which amends the Human Services Code to increase the reimbursement rate for guardians of older adults.
    • The House Human Services Committee will meet on Tuesday, October 26 to consider House Bill 1561 and House Bill 1563.  These bills, which amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, seek to align them with HIPAA and give providers, facilities, and insurers the ability to more easily share patient mental health and substance use disorder treatment information.  The committee also will consider House Bill 1308, which enables local communities and agencies in Pennsylvania to establish overdose fatality review teams.  Finally, the committee will consider House Bill 1995, which clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.

Department of Human Services

  • The Department of Human Services (DHS) has added November dates to its calendar of when it will be issuing Remittance Advices (RAs) and corresponding checks.  Find the updated calendar here.
  • DHS has updated its information about provider enrollment and revalidation changes during the COVID-19 emergency.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin advising providers of updates of certain error status codes for personal care services subject to electronic visit verification, effective for claims received on or after October 22, 2021.  The bulletin also gives providers an updated Provider Assistance Center contact e-mail address for their use.  Go here to find this Medical Assistance Bulletin.
  • DHS’s Office of Mental Health and Substance Abuse Services has informed providers that certain regulatory requirements for on-site inspections have been reinstated as of October 18, 2021.  This includes visitation requirements, the right to enter and inspect, and the requirement to undergo an annual inspection.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) of the procedure for submitting claims to DHS for a take-home supply of naloxone distributed to Medical Assistance beneficiaries.  Find that bulletin here.
  • The federal Centers for Medicare & Medicaid Services (CMS) has issued guidance on coordinating care provided by out-of-state providers for children with medically complex conditions, including a description of best practices and other implementation considerations related to coordination of care from out-of-state providers for children with medically complex conditions.  Go here to see CMS’s guidance memo to state Medicaid programs.

Department of Health

The Department of Health has published an update on point-of-care COVID-19 antigen tests and the interpretation of test results.  The updated guidance replaces previous department guidance.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases declined slightly this week.
  • The number of new COVID-19-related deaths remains high but did not rise during the past week.
  • The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
  • 71.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people.  3000 Philadelphians and 58,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first evaluation of its Pennsylvania Rural Health Model, a federally approved program that seeks “…to improve population health outcomes, increase access to high-quality care, and improve the financial viability of acute care hospitals in rural Pennsylvania.  Designed to reduce the risk of rural hospital closures, the Model seeks to stabilize participating hospitals’ finances by providing a predictable revenue stream through global budgets.”  Go here and scroll down for information about the model and links to additional resources.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – October 28

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

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m.  To participate:

Health Care Cost Containment Council – November 4

The Health Care Cost Containment Council will meet via teleconference on Thursday, November 4 at 10:00 a.m.  The public is invited to participate.  See this Pennsylvania Bulletin notice about how to join the meeting.

Organ Donation Advisory Committee Meeting – November 4

The Organ Donation Advisory Committee will hold a virtual meeting on Thursday, November 4 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Traumatic Brain Injury Advisory Board – November 5

The Traumatic Brain Injury Advisory Board will hold a virtual meeting on Friday, November 5 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m.  To participate virtually or by phone, go here for further information.

 

2021-10-22T21:03:04+00:00October 22nd, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of October 18-22
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PA Health Policy Update for the Week of September 20-24

The following is an update of selected state health policy developments in Pennsylvania for the week of September 20-24, 2021.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • House Republican leadership held a press conference on Monday to discuss their legislative agenda for the fall.  In addition to addressing the Wolf administration’s mask mandate for K-12 schools, they plan to work on legislation to address the opioid and addiction crises and COVID-19 regulatory waivers and flexibilities.  View the news conference here.
  • The House of Representatives sent House Bill 1861 to the Senate, where it was referred to the Health & Human Services Committee.  This bill will likely serve as the legislative vehicle for an extension of the health-related COVID-19 regulatory waivers and flexibilities set to expire on September 30, 2021.
  • The House of Representatives unanimously approved House Bill 1774, which amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP).  Specifically, the bill extends the sunset date to December 31, 2028 and grants the Department of Labor & Industry access to the prescription monitoring program.
  • Senate Bill 397 and Senate Bill 398 were reported as amended by the House Professional Licensure Committee on Monday.  These two bills would modernize Pennsylvania law on physician assistants and their oversight.
  • The House and Senate will be in session again next week on Monday (9/27), Tuesday (9/28), and Wednesday (9/29).  The following health care-related committee meetings have been scheduled:
    • The House State Government Committee will convene on Monday (9/27) to consider, among other bills, House Bill 1893, which amends the Disease Control and Prevention Act of 1955 to make disease information under this act subject to the Right-to-Know Law.  The committee also will consider Senate Bill 533, which prohibits certain regulatory and administrative actions during a disaster emergency.
    • The Senate Health & Human Services Committee will convene on Monday, September 27 at 12:00 p.m. to consider House Bill 1861 (COVID-19 regulatory waiver and flexibility extension); House Bill 1774 (Achieving Better Care by Monitoring All Prescriptions Program); Senate Bill 782 (payment for FDA-approved anti-obesity drugs); Senate Bill 815 (pelvic exam consent requirement); and Senate Bill 818 (allowable ambulatory surgical center procedures).

Department of Human Services

Department of Health

  • The Department of Health has updated its interim infection prevention and control recommendations for health care settings to add new options for fully vaccinated individuals working in facilities in counties with low to moderate rates of community transmission of COVID-19.
  • The Department of Health, Department of Drug and Alcohol Programs, and the Pennsylvania Commission on Crime and Delinquency have written to Pennsylvania hospital officials advising them on how they can secure a supply of Narcan to support hospital- and community-based naloxone distribution efforts to help in the fight against overdose-related deaths.  See their letter here.
  • Acting Secretary of Health Alison Beam has signed an order to ensure that vaccine providers are prepared to start COVID-19 booster shots as soon as the CDC issues federal guidance to do so.  The order requires vaccine providers, as possible, to provide online scheduling for vaccination appointments; provide a telephone number to assist with scheduling appointments; offer walk-in appointments; and work with local Area Agencies on Aging and Medicaid managed care plans to help schedule appointments for eligible adults and people who cannot leave their homes to get vaccinated.  Learn more from the Department of Health’s announcement about the order and the order itself.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week.  Today the number of Pennsylvanians who have contracted COVID-19 surpassed 1.4 million.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is 12.2 times greater this year than in 2020.  Between September 15 and September 21, 2020 there were a total of 650 COVID-19 cases in school-aged kids compared to 7,928 cases in the same age group during the same week in 2021.
  • According to Pennsylvania’s COVID-19 dashboard, only 41 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
  • The number of new COVID-19-related deaths also remains high.  Yesterday the number of Pennsylvanians who have died from COVID-19 rose past 29,000.
  • For the third consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
  • The number of Pennsylvanians hospitalized because of COVID-19 rose 13 percent in the past week and has risen 44 percent since the first of the month; the number on ventilators has risen 14 percent in the past week and 38 percent since the first of the month; and the number in hospital intensive care units has risen 12 percent in the past week and 37 percent since the beginning of September.
  • 68.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.1 million people – up from 67.5 percent last week.  10,000 Philadelphians and 74,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; some of the 74,000 were added to the ranks of the vaccinated as the result of a Department of Health adjustment of its vaccination data.

Around the State

  • “Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again,” reports Spotlight PA, which takes a closer look at some of the waivers that have been in place in Pennsylvania, what they do, and what the stakes might be if they are not renewed.
  • Emergency department volume at Children’s Hospital of Pittsburgh and Excel Health Frick Hospital has risen so much that the hospitals have erected tents to help them handle growing numbers of patients, according to the Pittsburgh Tribune-Review.
  • Mobile clinics operated by the organization Latino Connection are making a special effort to provide COVID-19 vaccines to Hispanic communities around the state, the Allentown Morning Call reports.
  • Black Doctors COVID-19 Consortium, a group launched to ensure access to COVID-19 vaccines for Philadelphia’s African-American community, will extend its scope of endeavor and open a primary care clinic to help address health disparities and inequities.  The Philadelphia Inquirer explains the group’s evolution.
  • “A new study from Penn State shows Pennsylvania could avoid billions of dollars in health damages by joining a regional cap and trade program targeting power plant emissions… The team at Penn State used four types of damage estimates to find that the commonwealth could reduce health impacts caused by power plant pollution by between $18 and 40 billion dollars over the next nine years by joining the Regional Greenhouse Gas Initiative (RGGI).”  StateImpact Pennsylvania explains.
  • Spotlight PA has posted an update on its reporting on what it calls the “…growing dementia care crisis in one of the nation’s most rapidly aging states…”  Read it here.
  • “Mental health agencies in Bucks, Dauphin, Carbon, Monroe and Pike counties are using new grant funding to test out a program designed to help people who live with serious mental illness and are at risk of ending up in jail.”  Learn more from this WITF story.
  • An EMS organization serving parts of Lancaster County is encountering funding problems – a situation found in other parts of the state as well, according to the Pennsylvania Capital-Star.

 

2021-09-24T20:29:14+00:00September 24th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 20-24
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PA Health Policy Update for the Week of September 6

The following is an update of selected state health policy developments in Pennsylvania for the week of September 6-10, 2021.  (Some of the language used below is taken directly from state documents.)

General Assembly

The House of Representatives announced it will return to session a week early to address the Wolf administration’s implementation of a mask mandate for K-12 schools and child care facilities.  The House, which was originally scheduled to return on September 27, has added September 20, 21, and 22 as voting session days.

Department of Health

Department of Human Services

  • The Department of Human Services has issued a Medical Assistance Bulletin announcing the addition of CPT codes 0003A and 0013A to the Medical Assistance Program Fee Schedule for the administration of a third dose of the Pfizer and Moderna COVID-19 vaccines.  See the notice here.
  • The Department of Human Services has posted a notice announcing FY 2022 rates for selected services provided by the state’s Office of Mental Health and Substance Abuse Services (OMHSAS).
  • The Department of Human Services has announced that it will allocate $255.556 million in total funds in FY 2022 for inpatient disproportionate share hospital (Medicaid DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals, outpatient supplemental payments to qualifying inpatient acute-care general hospitals, and direct medical education payments to qualifying inpatient acute-care general hospitals.  The department is not changing the state plan provisions addressing the qualifying criteria or payment methodology for these payments.  Learn more from this Pennsylvania Bulletin notice.
  • The Department of Human Services has announced its intention to make COVID-19-related Medicaid DSH payments to qualified hospitals and how much it will pay hospitals based on their Medical Assistance days and their degree of Medicaid dependence.  See the Pennsylvania Bulletin notice here.
  • The Department of Human Services is adding and end-dating procedure codes as a result of implementing the 2021 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS).  The department also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance Program Fee Schedule, including fee adjustments.  Learn more from this Pennsylvania Bulletin notice.
  • The Department of Human Services has published its latest monthly physical health managed care enrollment report.  Find it here.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first report on the performance of its Pennsylvania Rural Health Model.  Find that report here and go here for further information about the program.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained high this week, including the first day (today) with more than 5000 new cases since mid-April.
  • The number of new COVID-19-related deaths increased over the past week.
  • For the week ending September 9 in Pennsylvania, every county in the state is experiencing a high level of COVID-19 transmission.  The CDC classifies transmission as follows:
    • Low:  0-10 new cases per 100,000 residents over the past week or 0-5% positivity rate
    • Moderate: 15-50 new cases per 100,000 residents over the past week or 5-8% positivity rate
    • Substantial:  50-100 new cases per 100,000 residents over the past week or 8-10% positivity rate
    • High: 100+ new cases per 100,000 residents over the past week or 10%+ positivity rate
  • The number of Pennsylvanians hospitalized because of COVID-19 has risen 17 percent since the beginning of the month, the number on ventilators has risen 14 percent, and the number in hospital intensive care units has risen 11 percent.
  • According to the state’s revised figures, 66.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.0 million people – up from 66.0 percent last week.  Only 11,000 Philadelphians and 65,000 other Pennsylvanians (fewer than last week) completed a vaccine regimen in the past week.

Around the State

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has rejected regulations proposed by the state’s Department of Drug and Alcohol Programs for the licensure or certification of drug and alcohol recovery houses that receive funds or referrals from the department or a federal, state, or other county agency to ensure that a drug and alcohol recovery house provides a safe environment for residents.  See the commission’s explanation of its decision in this Pennsylvania Bulletin notice.

Stakeholder Events

  • The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm.  Go here to register to participate remotely.
  • The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am.  Go here to register to participate remotely.
  • The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.
2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 6
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PA Health Policy Update for the Week of August 16-20

The following is an update of selected state health policy developments in Pennsylvania for the week of August 16-20, 2021.  (Some of the language used below is taken directly from state documents.)

The Wolf Administration

The Wolf administration has directed vaccine providers to support COVID-19 vaccination clinics and has introduced a free COVID-19 testing program for schools across the state.  Learn more from this news release and from a Department of Health order in support of the governor’s directive.

General Assembly

The Senate Aging & Youth Committee held a hearing this week to examine proposed revisions of the state’s Child Protective Services Law.  Testimony presented to the committee and a video transcript may be found here.

Next week the Senate Health & Human Services and Aging & Youth committees will hold a joint hearing with the House Aging & Older Adult Services and Human Services committees to “discuss the Department of Human Services’ intent to contract with Maximus as its independent enrollment broker (IEB) and the impact this will have on seniors and adults with disabilities.”  The hearing will take place on Monday, August 23 at 12:30 p.m.  Livestream the hearing here.

Department of Health

  • Effective August 18, the Department of Health’s order regarding daily hospital data reporting through the Corvena system is amended to add new data fields related to the vaccination status of hospital patients.  View details in the amended order here.
  • The Department of Health has issued an advisory to health care facilities and providers caring for people whose immune systems are moderately to severely compromised about the CDC’s recommendation that such individuals may benefit from an additional dose of mRNA COVID-19 vaccine to ensure they have enough protection against COVID-19.  Find the advisory here.
  • The Department of Health has informed health care facilities and providers of the CDC’s recommendation that pregnant people should be vaccinated against COVID-19.  Learn more from a department health advisory.
  • In July the Department of Health’s nursing home surveyors conducted 466 inspections, including 289 complaint investigations, of 329 separate nursing homes.  Of these inspections, 30 were COVID-19-specific investigations.  There were five new sanctions finalized against nursing care facilities in the past month resulting in a total of $40,150 in fines.  Learn more from this department news release.

Department of Human Services

  • DHS has added September dates to its calendar of MA remittance advice delivery dates.  Find the updated list here.
  • DHS has published a Medical Assistance Bulletin announcing changes in the Medical Assistance program fee schedule, including changes resulting from the implementation of the 2021 Healthcare Common Procedure Coding System procedure codes updates.  In addition, DHS also is adding other procedure codes and making changes to procedure codes currently in the MA program fee schedule, including fee adjustments, as well as setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 23, 2021.  Find this Medical Assistance Bulletin here.
  • Officials from DHS and the Department of Health have introduced the PA Health Equity Analysis Tool (HEAT), an interactive map that synthesizes Medical Assistance and population health data to show opportunities for intervention to promote better health and promote health equity.   PA HEAT provides state, county, zip code, and census track-level data on a number of population health measures and social determinants of health and how they affect local communities and Pennsylvania as a whole.  Results can also be displayed according to environmental justice areas, which are calculated based on concentrations of people living at or below the federal poverty line, based on resident demographics.  Learn more about PA HEAT from this DHS announcement and from the PA HEAT web site.
  • DHS has released quarterly licensing and enforcement activity data for its five licensing offices that oversee providers of long-term care, child care, behavioral health care, day activity programs, and residential care for individuals with intellectual disabilities and autism.  Find a summary of the report in this DHS announcement.
  • A notice in the Pennsylvania Bulletin announces that documents are now available on DHS’s web site about proposed annual case-mix per diem rates for state fiscal year 2021-2022 for non-public and county nursing facilities and the budget adjustment factor that will be applied to non-public and county nursing facilities.  Find the Pennsylvania Bulletin notice here and the DHS web site with the nursing facility rates here.

COVID-19:  By the Number

  • The daily number of new COVID-19 cases continued to rise during the past week.  The 3451 new cases reported on Thursday was the highest single-day total since April 30.
  • The number of deaths, while slightly higher during the past week, remains far lower than when comparable numbers of new cases were being reported in the spring.
  • For the week of August 6-12 the state’s overall COVID-19 test positivity rate was 6.0 percent, up from 5.4 percent last week and the fifth consecutive week with an increase.
  • In Pennsylvania, only Sullivan County is classified as having a low rate of COVID-19 transmission this week; three counties – Forest, Tioga, and Warren – have a moderate rate of transmission; 25 counties are currently experiencing a substantial rate of transmission; and 38 currently show a high rate of transmission, including nine of the ten most populous counties in the state:  Philadelphia, Allegheny, Delaware, Bucks, Montgomery, York, Lehigh, Berks, and Lancaster.
  • The number of Pennsylvanians hospitalized because of COVID-19 has more than doubled since the beginning of the month; the number on ventilators because of the virus is two-and-half times greater than it was at the beginning of the month; and the number in hospital intensive care units has more than tripled since the beginning of the month.
  • According to the state’s COVID-19 Dashboard, only 57 pediatric ICU beds in the state are not currently occupied.  That figure represents 14.7 percent of the total of such beds in Pennsylvania.
  • According to the state’s revised figures, 64.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 5.86 million people – up from 62.8 percent last week.  Only 54,000 Pennsylvanians completed a vaccine regimen in the past week and only 134,000 have done so since the beginning of August.

Around the State

  • Governor Wolf is “…reinstating a mask mandate for all state employees and contracted staff working under his jurisdiction regardless of their vaccination status, starting on Monday,” PennLive reports.
  • A shortage of nurses in the Philadelphia area has led hospitals to offer signing and retention bonuses of as much as $20,000 to experienced nurses.  The Philadelphia Inquirer offers the details.
  • “Overburdened health care systems from Texas to Florida are pleading with Western Pennsylvania hospitals to take on transfer patients at record-high rates as beds and ventilators reach capacity in covid-19 hot spots across the country,” the Pittsburgh Tribune-Review reports.
  • “While nearly a third of deer tested in Pennsylvania carried antibodies indicating they were exposed to COVID-19, the Pennsylvania Game Commission noted there is no evidence that deer can transmit the virus to humans and advised hunters to ‘take usual precautions when handling their harvests.’”  The Bradford Era explains what this means.
  • WTAE TV in Pittsburgh has published on its web site an interactive map showing the COVID-19 transmission rate for every county in the state.  Find the map here (scroll down to see it).
  • The Wolf administration plans to engage at least 100 people to perform COVID-19 contact tracing, Spotlight PA reports.

Stakeholder Event

The Department of Health’s Health Research Advisory Committee will hold a public meeting on Monday, August 23, from 10:00 a.m. to 11:30 a.m.  The meeting will be held virtually via Microsoft Teams at +1 267-332-8737 with Conference ID: 545 844 262#.  The purpose of the meeting is to review the work of the committee and plan future health research priorities.  Find the meeting agenda here.

2021-08-20T21:33:37+00:00August 20th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, social determinants of health|Comments Off on PA Health Policy Update for the Week of August 16-20
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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