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PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023.  Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds.  Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds.  Proposed spending increases include:

  • rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
  • increased Supplemental Nutrition Assistance Program benefits
  • increased supplemental payments to personal care homes
  • increased county mental health funding
  • reducing the waiting list for intellectual disability services
  • expanding court-appointed child special advocates
  • expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced.  The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate.  Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease.  It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate.  Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies.  A press release issued by the governor’s office can be viewed here.

General Assembly

  • The state House and Senate convened for voting session this week.  The following is a selection of health-related bills that received consideration.
    • House Bill 1440 passed on third and final consideration by a vote of 132 to 67.  This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals.  It will now be sent to the Senate.
    • House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66.  The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.
  • The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
  • The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
  • The House Appropriations Committee will begin budget hearings next Tuesday, February 15.  The Senate Appropriations Committee will begin budget hearings the following week, on February 22.  The hearing schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program.  The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system.  Find the bulletin here.
  • DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19.  Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action.  Such comments are due within 30 days.
  • DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting.  Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic.  The update reflects a recent revision in the CDC’s guidance.  Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state.  Learn more in this DOH news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
  • To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
  • The number of new COVID-19-related deaths also remains very high but declined slightly over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
  • To date, more than 42,000 Pennsylvanians have died from COVID-19.
  • The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
  • The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
  • 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 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

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.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

 

2022-02-11T21:54:18+00:00February 11th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 7-11
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PA Health Policy Update for the Week of January 31-February 4

The following is an update of selected state health policy developments in Pennsylvania for the week of January 31-February 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

As part of a preview of the budget proposal Governor Wolf will deliver to the legislature on Tuesday, February 8, his office has issued a news release  announcing “…his $1.7 billion plan to help Pennsylvania fully recover from the pandemic and pave the way for a successful future with support for families and workers, small businesses, the healthcare system, and statewide community revitalization through the American Rescue Plan​ Act (ARPA).”  Included in that news release is the following:

Support for Pennsylvania’s Healthcare System, $325 million

This investment would recognize healthcare workers for their heroic dedication and hard work throughout the pandemic and give healthcare providers resources to recruit and retain a skilled workforce​:

    • $250 million for long-term care recruitment and retention incentives and workforce development initiatives to grow the critical healthcare workforce​;
    • $40 million for the behavioral health workforce to expand county mental health programs; and 
    • $35 million to expand the student loan forgiveness program at PHEAA to include additional critical healthcare workers.

Redistricting Update

This afternoon the Legislative Reapportionment Commission voted 4-1 to approve new state House and Senate legislative district maps.  The final maps can be viewed here.  Pennsylvanians who are “aggrieved” by the approved maps have one month to appeal them to the Supreme Court, which has the authority to send the maps back to the commission.  Earlier this week the state Supreme Court assumed responsibility for drawing the state’s congressional district map.

House Chamber of the State HouseGeneral Assembly

  • The General Assembly will be in session next Monday (2/7), Tuesday (2/8), and Wednesday (2/9).
  • The state House and Senate will convene for a joint session on Tuesday (2/8) for Governor Wolf’s final budget address.
  • The House of Representatives is planning to consider the following health-related bills on second and third consideration next week.  Please note that this list is subject to change.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 19, which creates professional licensure for behavior analysts.
    • Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The House Health Committee will convene on Monday, February 7 to consider House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat coronavirus infections, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that the Medical Assistance program will pay for FDA-authorized over-the-counter COVID-19 tests provided to Medical Assistance beneficiaries, effective with dates of service on and after August 30, 2021.  This bulletin applies to Medical Assistance-enrolled pharmacies that serve Medical Assistance beneficiaries.  Providers serving Medical Assistance beneficiaries in physical health HealthChoices or Community HealthChoices should address any billing and payment questions with the applicable managed care organization.  Learn more from this Medical Assistance Bulletin.
  • DHS has published notice of its final $255.556 million funding allocation for various FY 2022 disproportionate share hospital (DSH) payments.  DHS is not otherwise changing the qualifying criteria or payment methodology for any of these payments.  Learn more in this Pennsylvania Bulletin notice.
  • Thirty Pennsylvania counties have received nearly $28 million in federal funding to enhance their behavioral health programs.  Administered through DHS, this one-time funding consists of money granted to states through the federal Consolidated Appropriations Act of 2021 combined with funds from Pennsylvania’s annual Community Mental Health Services Block Grant award.  The grants will target specific state priorities, including mobile crisis mental health services, telehealth, student assistance programs, start-up funding for residential treatment services and assisted outpatient treatment, and additional crisis services projects.  These projects include walk-in and remote crisis supports, expanding crisis, respite, and residential care capacity, and enhanced collaboration with law enforcement to assist with crisis response.  Learn more about the services this funding will support and which counties received grants from this news release.
  • DHS has circulated a briefing document on pharmacy prior authorization for sedative hypnotics when prescribed for Medical Assistance beneficiaries and has invited stakeholder comment.  Comments are due by February 8 and should be sent in MS Word to c-bstarr@pa.gov.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its final annual case-mix per diem payment rates for FY 2022 for non-public and county nursing facilities that participate in the Medical Assistance program.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report,” which updates the report to include January 2022 enrollment data.

Department of Health

  • Leaders of the Pennsylvania Department of Health (DOH), Department of Military and Veterans Affairs, and Pennsylvania Emergency Management Agency (PEMA) announced that they would establish four long-term care regional support sites to relieve pressure on hospitals and skilled nursing facilities due to a high number of patients with COVID-19.  Each facility will receive clinical and non-clinical support staff to open up to 30 beds to allow for more rapid discharge of patients from hospitals, when clinically safe to do so, freeing additional acute care space to meet COVID-19 demands.  A staffing firm will provide clinical staff, including RNs, LPNs and CNAs; the Pennsylvania National Guard will provide non-clinical staffing to support the facilities’ existing staff; and PEMA will assist with coordination.  The four regional support sites will open at the following skilled nursing facilities:  Vincentian Home in Pittsburgh; Lutheran Home in Hollidaysburg, Blair County; Springs at the Watermark in Philadelphia; and Clarview Nursing Home and Rehabilitation in Sligo, Clarion County.  Learn more from this news release.
  • DOH this week established new COVID-19 testing sites in Clearfield, Fayette, Monroe, Somerset, and Venango counties, joining previous sites it opened in Berks, Blair, Centre, and Clinton counties.  Learn more about individual clinic locations and hours in this DOH news release.
  • DOH has posted information about two options for DHS-certified child care facilities to report positive COVID-19 cases.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 8512 cases day; a week ago (January 27) its seven-day average was 14,025 cases a day.
  • The number of new COVID-19-related deaths also remains very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 135 deaths a day; a week ago (January 27) its seven-day average was 166 deaths a day.
  • The Department of Health reports that the percent of available adult and pediatric ICU beds in the state rose to 18.9 percent and 14.4 percent, respectively; that in approximately 22.1 percent of all staffed adult ICU beds are COVID-19 patients; and that 30.6 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 25 percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators fell 21 percent over the past week and the number in ICUs fell 25 percent.

Stakeholder Events

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

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.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

2022-02-04T21:42:47+00:00February 4th, 2022|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 31-February 4
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PA Health Law Project Newsletter

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

Included in this month’s issue are articles about:

  • The implications of the federal extension of the COVID-19 public health emergency for the state’s Medicaid program.
  • Changes the state is planning for its HealthChoices program later this year.
  • The planned extension of Pennsylvania’s Medical Assistance for Workers with Disabilities Program.
  • An increase in the income limit for participation in the state’s PACENET program that provides financial assistance for prescription drug purchases for low-income seniors.

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

 

2022-01-31T18:58:51+00:00February 1st, 2022|Coronavirus, COVID-19, HealthChoices, 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 Law Project Newsletter
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PA Health Policy Update for the Week of January 24-28

The following is an update of selected state health policy developments in Pennsylvania for the week of January 24-28, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The General Assembly enacted House Bill 253 (Act 2), providing $225 million in federal American Rescue Plan funding to support health care professionals on the frontlines of the COVID-19 pandemic in hospitals and behavioral health care facilities.  The breakdown of the funding is as follows:
    • $100 million for one-time payments to hospitals for making retention and recruitment payments to qualified staff.
    • $110 million for one-time payments to behavioral health providers, critical access hospitals, and high Medical Assistance hospitals for making retention and recruitment payments to qualified staff.
    • $15 million to be used by the Pennsylvania Higher Education Assistance Agency (PHEAA) to fund the Pennsylvania Student Loan Relief for Nurses Program.

A press release issued by Republican leaders of the General Assembly that quotes several health systems can be found here.  A press released issued by Governor Wolf can be found here.

  • The Senate passed Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.  The bill was received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee.
  • The Senate Health and Human Services Committee convened this week and favorably reported 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 about 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 favorably reported the following bills this week.
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances.
    • 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 convened and favorably reported the following bills this week.
    • 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 (DHS) has mailed letters to hospitals potentially eligible for FY 2021-22 OB/NICU DSH payments requesting verification of their current licensure status.  Courtesy electronic notification also was sent to contacts on file on January 26.  To verify that they meet the criteria for inclusion in the payment program, hospitals must sign and return the attestation form to RA-pwdshpymt@pa.gov by Friday, 2/25/22.  Any Pennsylvania hospitals that are currently licensed to provide obstetric or neonatal services and did not receive a notification should contact DHS at RA-pwdshpymt@pa.gov.
  • DHS has issued a Medical Assistance Bulletin to inform pharmacies of the addition of procedure code S5001 to the Medical Assistance Program fee schedule for dispensing oral antiviral treatments with FDA emergency use authorization for the treatment of COVID-19
    and providing instructions for pharmacies on how to submit claims for dispensing these treatments.  Learn more in this Medical Assistance Bulletin.
  • DHS has announced that it will add Aduhelm (aducanumab) and complement inhibitors to the Medical Assistance Program’s list of services and items requiring prior authorization.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report.”  The new report includes the first look at October 2021 Medicaid managed care enrollment data.

Department of Health

  • The Department of Health (DOH) has posted a notice on its message board that it will provide direct access to COVID-19 therapeutics to residents of long-term-care facilities. With the recent approval of oral antiviral medications for COVID-19 (Pfizer’s Paxlovid and Merck’s molnupiravir), DOH is holding product in strategic reserve for residents of long-term-care facilities and others in congregate care settings.  Paxlovid and molnupiravir are authorized for use in individuals who test positive for COVID-19 and are at high-risk for severe disease progression.  Upon receipt of a request for medication, supply permitting, DOH will ship the product the same day or the next day to the requesting facility.  Due to the nature of the medications, this product is only appropriate for residents within five days of the onset of symptoms.  Go here to request these oral antiviral medications from DOH.
  • DOH has issued an update of its recommendations for return to work for health care workers with confirmed or suspected COVID-19.
  • DOH has updated its guidance on work restrictions for health care workers who have been exposed to COVID-19.
  • DOH has announced changes to hospitalization data reporting on its Corvena platform to align with federal reporting requirements.  The new data fields must be completed beginning February 2 and daily thereafter.  Click here to download a Word file announcing these changes and download the Corvena data dictionary here (Excel).
  • DOH has deployed the first state-directed health care strike team to Grand View Health in Bucks County.  The team includes 10 registered nurses provided through GHR Healthcare under a contract with the Department of Health.  Learn more about the strike team concept and how it works and what this group will do at Grand View Health in this Department of Health news release.
  • DOH has introduced two new resources to help skilled nursing facilities encourage their residents and staff to receive COVID-19 vaccines and boosters:  a document on best practices and a vaccine and booster fact sheet.
  • DOH has adopted the new federal CDC standard for blood lead reference value (BLRV) from 5 μg/dL to 3.5 μg/dL.  The department explains why it adopted this new standard and what it means in this health advisory notice.

COVID-19:  By the Numbers

Stakeholder Events

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.

Traumatic Brain Injury Advisory Board – February 4

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, February 4 at 10:00 a.m.  For information about the board, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

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.

2022-01-28T22:39:08+00:00January 28th, 2022|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, 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 January 24-28
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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 December 6-10

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

Harrisburg, PA capital buildingGeneral Assembly

The Senate Democratic Policy Committee held an informational hearing this week on substance use disorder treatment facilities.  The hearing was co-hosted by senators Schwank, Tartaglione, and Muth.  Panelists included individuals affected by the addiction crisis, treatment providers, and the Department of Drug and Alcohol Programs.  Testimony offered at the hearing and a video recording may be found here.

The state House and Senate will return to session next week.  The following are the relevant health committee hearings currently scheduled.

  • The House Health Committee has scheduled a hearing on Monday, December 13 at 9:00 a.m. to discuss COVID-19 treatment options.  Chairman Kathy Rapp has indicated the committee will examine House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat COVID-19.
  • The Senate Health & Human Services Committee is scheduled to convene on Tuesday, December 14 at 11:00 a.m. to consider, among other bills, 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; and 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.  The committee also will consider House Bill 118, which establishes requirements for the final disposition of fetal remains.
  • The House Human Services Committee has scheduled an information hearing on House Bill 1644 for next Thursday, December 16 at 9:30 a.m.  House Bill 1644 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 has scheduled an 11:00 a.m. hearing to examine community participation supports during COVID-19 pandemic.

Department of Human Services

  • The Department of Human Services (DHS) has updated its list of regulations that have been suspended to facilitate the state’s response to the COVID-19 emergency.  Find the updated list here.
  • The federal Centers for Medicare & Medicaid Services (CMS) has written to state Medicaid directors to encourage them to take advantage of a provision in the American Rescue Plan that authorizes their programs, beginning on April 1, 2022, to provide 12 months of postpartum Medicaid coverage to pregnant women enrolled in either their Medicaid or CHIP programs.  Learn more from the CMS letter to state Medicaid directors.  Pennsylvania announced in August that it would extend this coverage.
  • CMS has sent a letter to state Medicaid directors to help them understand provisions in the Consolidated Appropriations Act of 2021 that include new reporting requirements for non-disproportionate share hospitals (DSH) supplemental payments and a change in the methodology for calculating hospital-specific DSH limits.  See that letter here.
  • DHS has issued a news release elaborating on Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act.  This funding will support Medicaid’s home and community-based services system throughout the state.  Learn more from this DHS news release.

Department of Health

  • The Department of Health (DOH) has issued a seasonal influenza update urging providers to encourage their patients to receive flu vaccines, offering treatment recommendations, and reminding providers that they are required to report flu cases to the state.  Learn more in this department influenza update and reminder health alert.
  • DOH has updated two health alerts, PA-HAN-609 and PA-HAN-610, to clarify that the visitation guidance from the department applies only to skilled nursing facilities and that other types of facilities, such as personal care homes, assisted living facilities, and intermediate-care facilities, should seek guidance from their licensing agencies when it comes to COVID-19 visitation policies.
  • DOH has distributed communication that it received from the Centers for Medicare & Medicaid Services informing states that the federal government will not be enforcing the health care provider vaccination mandate while federal litigation is pending.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain near 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 also 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, in hospital ICUs because of COVID-19, and on ventilators because of the virus all rose sharply in the past week.
  • These numbers reflect the growing rate of occupancy in the state’s hospitals.  There currently are only 481 unoccupied adult ICU beds – 13.5 percent of the total of such beds in the state; 2019 unoccupied medical/surgical beds – 10 percent of such beds in the state; 29 pediatric ICU beds (7.7 percent); 234 pediatric beds (20.8 percent); and 919 airborne isolation beds (29.1).
  • Media reports confirm the challenges some communities and hospitals are facing, including this report on the situation at the nine hospitals that constitute Geisinger Health; this report on the situation in Allegheny County; this report on the situation in the Erie area; and this report on the situation throughout Pennsylvania.
  • The Department of Health reports that 6.7 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 nearly 170,000 boosters have been administered to city residents since August 13.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has established minimum qualifications for the positions of project director, facility director, clinical supervisor, counselor, and counselor assistant but these regulations permit persons to meet those qualifications with a degree in an “other related field.”  In Licensing Alert 03-2021 the department lists “other related fields” that meet qualifications and notes that this list is not necessarily all-inclusive and that the department will review those degrees on a case-by-case basis.  Find the licensing alert here.

The Department of Drug and Alcohol Programs has published its long-delayed, much discussed final standards for drug and alcohol recovery house licensure.  Find them in this Pennsylvania Bulletin notice.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published its annual report on the financial performance of the state’s non-general acute-care hospitals, including rehabilitation hospitals, psychiatric hospitals, long-term acute-care hospitals, and specialty hospitals.  Learn more from this PHC4 news release and the report itself.  PHC4 also offers download data from the report in Excel format.

2021-12-10T21:44:43+00:00December 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off on PA Health Policy Update for the Week of December 6-10
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PA Health Policy Update for the Week of November 8-12

The following is an update of selected state health policy developments in Pennsylvania for the week of November 8-12, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced his intention to return the decision on mask requirements in K-12 schools to local leaders on January 17, 2022.  It may not take that long, though:  as the Philadelphia Inquirer reports, Pennsylvania’s Commonwealth Court “…has struck down the state’s school mask mandate, ruling that acting Health Secretary Alison Beam didn’t have the authority to issue the requirement under the state’s Disease Control and Prevention Law.”  The Department of Health is appealing the court’s decision.

House Chamber of the State HouseGeneral Assembly

  • The House of Representatives passed House Bill 1561 and House Bill 1563 on third and final consideration this week.  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 more easily share patient mental health and substance use disorder treatment information.  Both bills were sent to the Senate and referred to its Health & Human Services Committee.
  • The Senate Majority Policy Committee held an informational meeting this week to examine COVID-19 vaccine mandates and their impact on the workforce.  Testimony offered at the hearing and a video recording may be viewed here.
  • The Senate Health & Human Services Committee met twice this week and favorably reported the following bills:
    • Senate Bill 471, which prohibits the implementation of COVID-19 vaccine mandates;
    • House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment; and
    • Senate Bill 938, 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.

Recordings of both committee meetings may be viewed here.

  • The Senate Aging & Youth Committee favorably reported House Bill 1260, which increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples.

Department of Human Services

The Department of Human Services has issued updated requirements on the information needed to evaluate prior authorization requests for certain medications, based on actions taken by its Pharmacy and Therapeutics Committee during its September 14 meeting:

Department of Health

The Department of Health (DOH) has issued a health advisory echoing the federal decision that a pediatric formulation of the Pfizer vaccine has been approved for children from the ages of five to 11.

DOH has announced that information on schools participating in a free and voluntary COVID-19 screening testing program, which is available through a partnership with the company Gingko Bioworks, is now available on its web site.  Go here for the DOH announcement and here for information about the program.

COVID-19:  By the Numbers

  • The general downward trend in new daily COVID-19 cases in Pennsylvania halted over the past week with several days of more than 5000 new cases.  The state’s total number of COVID-19 cases since the start of the pandemic surpassed 1.6 million this week – a figure that represents approximately 12 percent of the state’s population.
  • The number of new COVID-19-related deaths remains high.  196 new deaths were reported on Wednesday – the highest single-day figure since late January.  This week Pennsylvania surpassed 32,000 COVID-19-related deaths.
  • The number of Pennsylvanians hospitalized because of COVID-19 has fallen five percent since the beginning of November; the number in hospital ICUs has fallen nine percent; and the number on ventilators because of the virus has fallen 11 percent.
  • 72.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people.  70,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Stakeholder Events

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.

Health Research Advisory Committee – November 15

The Department of Health’s Health Research Advisory Committee will hold a virtual public meeting on Monday, November 15 at 1:00 p.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Pennsylvania Rural Health Redesign Center Authority Board – November 16

The Department of Health’s Pennsylvania Rural Health Redesign Center Authority Board, which is charged with administering the Pennsylvania Rural Health Model, will hold a virtual public meeting on Tuesday, November 16 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Newborn Screening and Follow-Up Technical Advisory Board – November 18

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Thursday, November 18 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

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.

2021-11-12T22:01:57+00:00November 12th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for the Week of November 8-12
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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