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PA Senate to Take Up Medicaid Work Requirement

Undeterred by past defeats, members of PA’s state senate are again attempting to advance Medicaid work requirement legislation.

This time, the proposal to impose a Medicaid work requirement will add new flexibility to such a requirement, offering exemptions for individuals deemed “medically frail” and enabling individuals who do volunteer work, attend college, or who are actively looking for work to continue qualifying for Medicaid benefits.

Harrisburg, PA capital buildingThe proposal will be considered by the Senate Health and Human Services Committee.

The legislature has passed two Medicaid work requirement bills in the past but Governor Tom Wolf has vetoed them.

Learn more about this latest effort to establish a Medicaid work requirement in Pennsylvania in the PA Post article “Wolf, Republicans resume tug-of-war over Medicaid work requirements.”

 

2019-09-17T06:00:13+00:00September 17th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Senate to Take Up Medicaid Work Requirement

PA Slams Brakes on Medicaid Transportation Program Overhaul

The plan to introduce major changes in Pennsylvania’s free medical transportation program for the Medicaid population has temporarily been halted.

As envisioned by the state, the current program, in which individual counties contract independently with transportation providers to serve their residents on Medicaid, was to be replaced by a regional approach in which the state contracts with three vendors to serve all of Pennsylvania.  Objections by members of the state legislature and county officials, however, led to legislation that requires the Department of Human Services, Department of Transportation, and Department of Aging to study the implications of such a change for patients and taxpayers and to report their preliminary findings to the legislature in September.

Learn more about Pennsylvania’s Medical Assistance Transportation Program, how it works now, how the state sought to change it, and what to expect in the near future in the Philadelphia Inquirer article “Overhaul of PA’s medical transport program on hold after counties raise concerns.”

 

2019-08-06T06:00:31+00:00August 6th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Slams Brakes on Medicaid Transportation Program Overhaul

Uninsured ED and Inpatient Visits Down Since ACA

Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act.

And Medicaid-covered admissions and ER visits are up, according to a new analysis.

Hospital buildingThe report, published on the JAMA Network Open, found that ER visits by uninsured patients fell from 16 percent to eight percent between 2006 and 2016, with most of this decline after 2014, while uninsured discharges fell from six percent to four percent.

The rate of uninsured ER visits declined, moreover, at a time when overall ER visits continued to rise.

While the Affordable Care Act is likely the cause of most of these changes, other contributing factors include the emergence of urgent care facilities, telemedicine, and free-standing ERs as well as new payment models and rules.

The study’s findings are especially good news for Pennsylvania safety-net hospitals because they care for so many more low-income patients than other hospitals and have benefited from the Affordable Care Act’s expansion of access to insurance, whether through Medicaid expansion or the private health insurance market.

Learn more in the JAMA Network Open article “US Emergency Department Visits and Hospital Discharges Among Uninsured Patients Before and After Implementation of the Affordable Care Act.”

 

2019-05-02T06:00:28+00:00May 2nd, 2019|Affordable Care Act, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off on Uninsured ED and Inpatient Visits Down Since ACA

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published the February 2019 edition of its newsletter.

Included in this edition are articles about:

  • Governor Wolf’s proposed FY 2020 Medicaid budget
  • Medicare Part D co-pay problems for some dual-eligibles
  • new Medicare Part D monitoring for prescription drug abuse
  • Community HealthChoices

Find these stories and others in the latest edition of the Pennsylvania Health Law Project’s Health Law PA News.

2019-03-04T06:00:14+00:00March 4th, 2019|Pennsylvania Medicaid, Pennsylvania proposed FY 2020 budget, Pennsylvania state budget issues|Comments Off on Pennsylvania Health Law Project Newsletter

Medicaid MCOs Skimping on Care?

Medicaid MCOs may be skimping on care, according to a recent Kaiser Health News report.

According to Kaiser, for-profit companies that sub-contract with Medicaid managed care organizations to review requests for services often deny care to Medicaid patients to save money for the MCOs that employ them and to benefit themselves financially.

The Kaiser article presents examples of companies that have been identified engaging in such practices, explains how they go about their work, and outlines the dangers to Medicaid recipients posed by such practices.

Because they serve so many more Medicaid patients than the typical hospital, Pennsylvania safety-net hospitals, their patients, and the communities they serve can be greatly affected by such practices.

Learn more in the Kaiser Health News article “Coverage Denied: Medicaid Patients Suffer As Layers Of Private Companies Profit.”

2019-01-09T15:54:59+00:00January 9th, 2019|Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off on Medicaid MCOs Skimping on Care?

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest Health Law News.
Included in this edition are articles about:

  • The January 1 introduction of Community HealthChoices, a mandatory program of managed long-term services and supports, in southwestern Pennsylvania
  • the January 1 implementation of the federal ordering, referring, or prescribing rule that requires that all such actions involving Pennsylvania Medicaid patients be undertaken by providers enrolled with the state to serve Medicaid patients
  • various Medicare issues

Find these stories here in the latest edition of Health Law News.

2017-12-26T06:00:24+00:00December 26th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest Health Law News.
Included in the November edition are articles about:

  • a proposal to impose a work requirement on Pennsylvania Medicaid recipients
  • the CHIP program
  • leadership changes in health care-related state agencies
  • the rollout of the Community HealthChoices program of managed long-term services and supports
  • HealthChoices managed care contracts
  • changes in several state waiver programs

Find these stories here in the latest edition of Health Law News.

2017-11-20T06:00:01+00:00November 20th, 2017|HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

CMS Guidance on MCO Payments is Good News for PA Hospitals

New guidance from the Centers for Medicare & Medicaid Services on the use of directing additional Medicaid resources to hospitals through Medicaid managed care organizations is good news for Pennsylvania safety-net hospitals.
Such payments have been routed through the state’s Medicaid managed care plans for several years, but as the state and hospital industry continue negotiating renewal of the state’s hospital tax – its “Quality Care Assessment” – it was not entirely clear whether the federal government would permit continued use of this mechanism.
An early November bulletin from CMS, however, clarifies that this approach is still permissible, which is good news for Pennsylvania safety-net hospitals and SNAP members hoping to benefit from the state’s hospital assessment.
Go here to see the CMS memo “Delivery System and Provider Payment Initiatives under Medicaid Managed Care Contracts.”

2017-11-16T14:19:15+00:00November 16th, 2017|HealthChoices, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on CMS Guidance on MCO Payments is Good News for PA Hospitals

Wolf Vetoes Medicaid Work Requirement

Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work.

 Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.

2017-10-23T10:00:53+00:00October 23rd, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Wolf Vetoes Medicaid Work Requirement

SNAP Joins Others in Letter to PA Senators

SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians.
Safety-Net Association of Pennsylvania logoAmong the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections.
See the complete letter here.

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