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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.

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.

 

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

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:

 

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.

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.

Group Looks at Health Care for Children in PA

Pennsylvania Partnerships for Children has released a report detailing various aspects of the health of children in Pennsylvania.

Among the subjects addressed in the group’s report 2021 State of Children’s Health Care in Pennsylvania:  Health Insurance During the COVID-19 Pandemic are the increase in the number of insured children in the state as a result of the current public health emergency; the impact of the pandemic on children receiving their childhood immunizations; the major role Medicaid and the Children’s Health Insurance Program (CHIP) play in insuring children in the state; the implications of the end of the declared public health emergency; and more.

The report also looks at steps that could be taken to reduce health care disparities in Pennsylvania.

Learn more from this news release and Pennsylvania Partnerships for Children’s new report 2021 State of Children’s Health Care in Pennsylvania:  Health Insurance During the COVID-19 Pandemic.

2021-11-10T16:17:47+00:00November 9th, 2021|COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on Group Looks at Health Care for Children in PA

PA Health Policy Update for the Week of November 1-5

The following is an update of selected state health policy developments in Pennsylvania for the week of November 1-5, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration announced that “Pennie,” the state’s new health insurance exchange, has now begun operations as this year’s Affordable Care Act open enrollment period begins.  Find Pennie here.

General Assembly

  • The House and Senate will be in session next week on Monday (10/8), Tuesday (10/9), and Wednesday (10/10).  The following health care-related committee meetings have been scheduled:
    • The Senate Majority Policy Committee will hold an informational meeting on Monday, November 8 at 10:00 a.m. to examine COVID-19 vaccine mandates and their impact on the workforce.  The hearing will be live-streamed here.
    • The Senate Health & Human Services Committee will convene on Monday, November 8 at 12:30 p.m. to consider Senate Bill 471, which prohibits the mandatory vaccination of Pennsylvania residents by the state or as a condition of employment.  The committee will also consider House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment.
    • The Senate Aging & Youth Committee will meet on Tuesday, November 9 at 12:00 p.m. to consider, among other bills, 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.
  • The House of Representatives is planning to consider a few key behavioral health bills next week, including House Bill 1561 and House Bill 1563, which 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.  The House is also planning to consider House Bill 1308, which enables local communities and agencies to establish overdose fatality review teams.

Department of Human Services

This communication is intended for Department of Human Services (DHS) Sandata Electronic Visit Verification (EVV) and DHS Aggregator users for informational purposes regarding how the DHS Aggregator will be handling the end of Daylight Savings Time (DST) which is set to occur at 2:00 AM this Sunday, November 7, 2021.

For scheduled and completed visits that occur during or crossover the end of DST, the scheduling hours will appear to be short by an hour. This is expected behavior since DHS Aggregator times are calculated based on Coordinated Universal Time (UTC). Provider agencies and/or administrators should not adjust visit times related to DST. Visits during this event will continue to be calculated based on the actual visit times so there are no issues with billing requirements.  

Any questions related to this can be submitted to RA-PWEVVNOTICE@pa.gov

Department of Health

The Department of Health has rescinded a May 26, 2021 order that required skilled nursing facilities to make weekly reports of specified data on supplies and equipment.  The department has launched a new data dashboard with facility-level COVID-19 resident and staff cases, deaths, and vaccination rates that uses data that nursing homes are already required to report to the federal government.  The Survey 123 reporting requirement was eliminated effective October 29, 2021.

COVID-19:  By the Numbers

  • While there has been a modest downward trend in new COVID-19 cases in recent weeks, the past two days have seen the two highest single-day counts of new cases since mid-October.
  • Approximately 32,710 of the state’s total cases to date have been among health care workers.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly three times greater this year than in 2020.  Between October 27 and November 2, 2020 there were 1,683 COVID-19 cases in school-aged children compared to 4,918 cases in the same age group during the same week this year.
  • In licensed nursing and personal care homes there have been 79,250 resident cases of COVID-19 to date and 17,449 cases among employees for a total of 96,699 at 1,642 facilities in all 67 counties.
  • The number of new COVID-19-related deaths remains high but did not rise during the past week.
  • Sixty-six of Pennsylvania’s 67 counties currently are experiencing high rates of community transmission of COVID-19; Philadelphia County is experiencing “only” a substantial rate of community transmission.
  • The number of Pennsylvanians hospitalized, in hospital ICUs, and on ventilators because of COVID-19 has fallen slightly since the first of the month.
  • 72.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people.  38,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The state’s Independent Regulatory Review Commission has approved the Department of Drug and Alcohol Programs’ proposed regulations for drug and alcohol recovery house licensure.  See the approval in this Pennsylvania Bulletin notice.

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.

 

2021-11-05T21:56:42+00:00November 5th, 2021|Affordable Care Act, Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for the Week of November 1-5

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.

 

PA Health Policy Update for the Week of October 11-15

The following is an update of selected state health policy developments in Pennsylvania for the week of October 11-15, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced a new grant program to support community organizations conducting outreach on COVID-19 vaccines.  The $5 million COVID-19 Vaccine Outreach Grant Program is available to eligible organizations, including non-profits, child care, and educational institutions.  The program will provide grants from $10,000 up to $100,000 to support targeted outreach efforts such as sponsorship of vaccine-related community events, equipment rental to assist with setting vaccine appointments, local media buys, creation of outreach and training materials, and more.  Learn more about the program from this news release from the governor’s office and the program’s web page, which includes a link to application guidelines.  The deadline for the first round of grant applications is November 1.

General Assembly

The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Saving Community Hospitals:  Keeping Care Close.”  The informational hearing, held in Downingtown, focused heavily on Tower Health’s recent decision to sell Chestnut Hill Hospital and close Jennersville Hospital.  Labor issues, including clinical staffing levels, also were discussed.  Panelists included representatives from SEIU Healthcare, the Pennsylvania State Association of Staff Nurses and Allied Professionals (PASNAP), and first responders.  A press release issued following the hearing can be found here.  The same committee will hold another hearing in Stroudsburg on Monday, October 18 at 1:00 p.m. focused on consolidation in the health care sector.

Department of Human Services

Department of Health

The departments of Human Services and Health have announced that the Regional Congregate Care Assistance Teams (RCAT) will continue to provide COVID-19 prevention, preparation, and response support to long-term-care facilities from October 1, 2021 through December 31, 2021.  More information, including contact information for each regional lead, can be found here.

The Department of Health has developed a series of new vaccine hesitancy materials to assist long-term-care facilities with their vaccine outreach efforts.  These materials include:

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) will propose changes to modernize the confidentiality of substance use records in the state, the department informed stakeholders in a message delivered through its listserv.  Another message to stakeholders elaborates on the department’s intentions.

In preparation for this undertaking, DDAP surveyed stakeholders on the state’s substance use confidentiality policies and has posted the appendices to its summary report.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week and today it passed the 1.5 million mark since the pandemic began.  Approximately 31,780 of these cases have been among health care workers.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly six times greater this year than in 2020.  Between October 6 and October 12, 2020 there were 1101 COVID-19 cases in school-aged kids compared to 6433 cases in the same age group during the same week this year.
  • The number of new COVID-19-related deaths continues to rise slightly.  This week Pennsylvania passed 30,000 deaths from the disease since the pandemic began.
  • Every county in Pennsylvania continues to experience a high level of COVID-19 transmission.
  • 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.
  • 70.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – nearly 6.4 million people.  3000 Philadelphians and 77,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; the latter number represents a much larger weekly total than in recent months.

Stakeholder Events

Independent Regulatory Review Commission – Consideration of Department of Drug and Alcohol Regulation – October 21

Pennsylvania’s Independent Regulatory Review Commission will consider final-omitted rulemaking Standards for Drug and Alcohol Recovery House Licensure (#74-4).  The commission will be considering a revised version of a proposed regulation it rejected in July.  To review a history of the regulation and its latest version, go here.  To register to view the meeting virtually or offer testimony, send an email to irrchelp@irrc.state.pa.us.

Infant Hearing Screening Advisory Committee- October 21

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, October 21, 2021 at 1:00.  Go here for information on how to participate.

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:

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.

 

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