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HealthChoices Procurement Again Mired in Litigation

For the past six years Pennsylvania has been trying to rebid its HealthChoices Medicaid managed care contracts but every time it does, the losing bidders sue the state and the procurement process grinds to a halt.

Three times since 2015 the state has issued requests for proposals from managed care companies and all three times at least one of the losing parties has responded to its defeat by filing a lawsuit.

This is happening, many believe, because the state’s Medicaid managed care contracts are so lucrative – a stark contrast with state Medicaid payments to providers, which are generally considered poor.

The matter is now in the state’s Commonwealth Court, and the stakes are great:  the contracts are for five years, with a possible option for another three.

The Philadelphia Inquirer has taken a look at the challenges that have prevented Pennsylvania from awarding new HealthChoices Medicaid managed care contracts in the article “Insurers want Pa.’s Medicaid business so badly they keep suing the state.”

 

2021-07-07T19:42:10+00:00July 7th, 2021|HealthChoices, Pennsylvania Medicaid|Comments Off on HealthChoices Procurement Again Mired in Litigation
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PA Health Policy Update for the Week of June 28-July 2

The following is an update of selected state health policy developments in Pennsylvania for the week of June 28-July 2, 2021.  (Some of the language used below is taken directly from state documents.)

FY 2021-2022 Budget

On Wednesday Governor Wolf signed into law Pennsylvania’s FY 2021-2022 General Fund appropriations bill and related code bills.  The governor partially vetoed Senate Bill 255, the General Appropriations Act, to remove the funds appropriated by the General Assembly for the establishment and operation of a new Bureau of Election Audits.  The full package of budget-related bills passed by the legislature and signed by the governor includes the FY 2022 General Appropriations Act – Senate Bill 255; the Fiscal Code – House Bill 1348; the Administrative Code – House Bill 336, and the Tax Code – House Bill 952.

House Chamber of the State HouseLegislative Update

The legislature has passed, and Governor Wolf has signed, the following health care-related bills:

  • House Bill 649 (Act 67) – requires the Department of Health, in consultation with the Department of Human Services, to establish protocols to permit an essential caregiver to provide in-person physical and emotional support to a congregate care facility resident during a declaration of disaster emergency.
  • House Bill 1024 (Act 44) – revises to the state’s Medical Marijuana Act, including caregiver, dispensing, and criminal background check provisions.
  • House Bill 1429 (Act 48) – adds a new section to the state Crimes Code providing for the offense of financial exploitation of an older adult or care-dependent person.  It also clarifies that district attorneys have the right to investigate and institute criminal proceedings for any violation of this new section.
  • House Bill 1431 (Act 49) – adds a new section to the Crimes Code that defines as abuse and establishes as a misdemeanor the use of social media by employees who post pictures of care-dependent individuals without permission.
  • Senate Bill 108 (Act 56) – provides for a $130 supplemental per diem payment for ventilator or tracheostomy care provided by qualified skilled nursing facilities that meet certain criteria based on the volume and proportion of Medicaid patients they serve.
  • Senate Bill 115 (Act 68) – establishes the Nurse Licensure Compact Act, which makes the state a party to the Nurse Licensure Compact with all other states that have joined the compact.
  • Senate Bill 416 (Act 60) – establishes the certified registered nurse anesthetist (CRNA) designation in the commonwealth.  The legislation grants an individual licensed to practice professional nursing and who meets the requirements of this act the right to use the CRNA designation.
  • Senate Bill 425 (Act 61) – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions or medications and devices.
  • Senate Bill 445 (Act 23) – permits a person renewing a driver’s license, identification card, or vehicle registration electronically through the Department of Transportation’s web site to contribute $5 to the Pennsylvania Breast Cancer Coalition for breast cancer research.
  • Senate Bill 484 (Act 63) – adds the chair of the State Veterans Commission or a designee to the Pennsylvania Long-term Care Council.

Governor Wolf vetoed Senate Bill 618, which would have prohibited the use of vaccine passports by government entities and prevented institutions of higher education from requiring proof of vaccination against COVID-19.  The bill also sought to restrict the Secretary of Health’s ability to implement certain disease control measures. See the governor’s veto message here.

The General Assembly has now adjourned until September.

Department of Human Services

Department of Health

  • The departments of Health and Human Services have extended to September 30 the period during which the Regional Congregate Care Assistance Teams (RCAT) will remain available to help long-term-care facilities prevent and respond to COVID-19.  See the announcement here and updated call center information here.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline and the number of COVID-19 deaths continues to decline significantly.
  • For the week from June 18 through June 24 the state’s overall COVID-19 test positivity rate was 1.2 percent, down from 1.4 percent last week and 1.9 percent the week before.
  • Sixty-five counties had a positivity rate lower than five percent, up from 64 last week, and no counties had a positivity rate greater than 20 percent for the ninth consecutive week.
  • Fifty-five counties are currently experiencing low levels of community transmission of COVID-19, up from 37 last week; the remaining 12 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
  • On July 1 the number of Pennsylvanians hospitalized with COVID-19 was less than one-third of what it was on June 1; the number on ventilators was 30 percent of what it was on June 1; and the number in hospital ICUs was 25 percent of what it was on June 1.
  • 5.4 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard.  Growth in this number has slowed significantly over the past month, with fewer than 100,000 new, complete vaccinations reported in the past week. Another 760,000 people have been vaccinated in Philadelphia.  According to the state, 60.3 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.9 percent of the entire population has now received at least the first dose of a vaccine.

Department of Drug and Alcohol Programs

Around the State

  • While Pennsylvania is among the nation’s leaders in the percentage of its residents receiving their first dose of a COVID-19 vaccine it is the fifth-worst state when it comes to getting those first shot recipients their second dose.  The Philadelphia Inquirer lays out the situation and explores why.
  • Following a 2018 fire at the U.S. Steel Clairton Coke Works site the number of asthma-related visits to doctors’ offices and hospital emergency departments nearly doubled, according to a new study.  WESA Pittsburgh tells the story.
  • According to the Philadelphia Business Journal, “A partnership involving an Allentown-based health system and a recently formed hospital turnaround company has emerged as a bidder for the financially struggling Tower Health.”  Learn more here.
  • After today Lancaster County closes its COVID-19 mass vaccination site.  Lancaster Online recounts some of the site’s accomplishments and experiences.
  • With people spending more time at home, HIV testing at non-health care sites in Philadelphia fell 75 percent in 2020, according to the Pennsylvania Capital-Star.

Stakeholder Events

  • Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar.  Public comments will be taken after each presentation and questions can be entered in the chat box.  Interested parties can participate in the following ways:

    • Webinar registration – go here
    • Dial in:  1-914-614-3221, access code 716-025-613
    • Remote captioning and streaming link – go here
  • Health Research Advisory Committee Meeting

July 12 at 10:00 a.m.

The public meeting will be held virtually by means of Microsoft Teams at (267) 332-8737 with Conference ID: 689 378 043#.

  • Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting.  The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

  • Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728#   United States, Pittsburgh

(866) 588-4789,,785376728#   United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Financial Management Services Meeting – June 28

At the most recent Financial Management Services stakeholder meeting on June 28, 2021the Community HealthChoices managed care organizations announced that Tempus Unlimited, Inc. will be the new statewide Vendor Fiscal/Employer Agent, with HHA eXchange as the software solution, supporting FMS in the Community HealthChoices program.

Stakeholder Events Materials

DHS has shared materials presented at the June 28 meeting of its Financial Management Services stakeholder meeting.  This public meeting discussed the upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations participated in the meeting.  Those presentations are:

 

 

2021-07-06T03:16:48+00:00July 6th, 2021|Coronavirus, COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania proposed FY 2022 budget|Comments Off on PA Health Policy Update for the Week of June 28-July 2
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Pennsylvania Health Policy Update for the Week of June 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of June 14-18, 2021.  (Some of the language used below is taken directly from state documents.)

Pennsylvania’s COVID-19 Disaster Declaration

With the certification of November’s election results, Governor Wolf’s COVID-19 emergency disaster declaration has officially ended but most of the regulatory waivers issued during the emergency will remain in effect until the end of September.  Learn more here.

Update on State FY 2021-2022 Budget

The General Assembly continues to work toward a final budget agreement, with both the House and Senate beginning to position bills that could ultimately serve as vehicles for a final budget agreement by June 30.  The Senate sent a General Fund appropriations bill (Senate Bill 255) to the House earlier this week and scheduled a Finance Committee meeting on Monday, June 21 to consider a fiscal code bill (House Bill 1348).  We will continue to keep you apprised of any relevant budget updates.

House Chamber of the State HouseLegislative Update

The following are health care bills that received third and final consideration in the state House and/or Senate during the week of June 14.  We are tracking other health care bills as they move through the legislative process as well.

  • House Bill 1082 requires the Department of Health to establish and maintain an Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder toolkit.  The toolkit, among other things, shall include best practice and cognitive assessment tools, primary care workforce education resources, and materials on the importance and value of early detection and timely diagnosis.  The House passed the bill 201-1 and sent it to the Senate for consideration.
  • House Bill 1428 permits a resident, or their guardian, to authorize the installation and use of video surveillance devices in long-term-care nursing facilities provided certain conditions are met.  The House passed the bill 160-42 and sent it to the Senate for consideration.
  • House Bill 1429 adds a new section to the state Crimes Code providing for the offense of financial exploitation of an older adult or care-dependent person.  It also clarifies that district attorneys have the right to investigate and institute criminal proceedings for any violation of this new section.  The House unanimously passed the bill and sent it to the Senate for consideration.
  • House Bill 1431 adds a new section to the Crimes Code that defines as abuse and establishes as a misdemeanor the use of social media by employees who post pictures of care-dependent individuals without permission.  The House passed the bill 198-4 and sent the bill to the Senate for consideration.
  • Senate Bill 445 permits a person renewing a driver’s license, identification card, or vehicle registration electronically through the Department of Transportation’s web site to contribute $5 to the Pennsylvania Breast Cancer Coalition for breast cancer research.  The House passed the bill unanimously and sent the bill to the governor for his consideration.
  • Senate Bill 416 establishes the certified registered nurse anesthetist (CRNA) designation in the commonwealth.  The legislation grants an individual licensed to practice professional nursing and who meets the requirements of this act the right to use the CRNA designation exclusively.  The Senate passed the bill unanimously and sent it to the House for consideration.
  • House Bill 649 requires the Department of Health, in consultation with the Department of Human Services, to establish protocols to permit an essential caregiver to provide in-person physical and emotional support to a congregate care facility resident during a declaration of disaster emergency.  The Senate passed the bill 32-18 and sent it to the governor.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline.  With 277 new COVID-19 cases reported, yesterday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
  • The number of COVID-19 deaths continues to decline significantly.
  • For the week from June 4 through June 10 the state’s overall COVID-19 test positivity rate was 1.9 percent, down from 2.9 percent last week and 3.8 percent the week before.
  • Sixty-two counties had a positivity rate lower than five percent, up from 55 last week, and no counties had a positivity rate greater than 20 percent for the seventh consecutive week.
  • Twenty-two counties are currently experiencing low levels of community transmission of COVID-19, up from 13 last week; 53 counties are experiencing moderate levels of community transmission; and only one county (Potter) is currently experiencing a substantial level of community transmission, the same number as last week.
  • In just 17 days since June 1 (as of Thursday, June 17), the number of Pennsylvanians hospitalized with COVID-19 has fallen 54 percent; the number on a ventilator has fallen 44 percent; and the number in hospital intensive care units has fallen 54 percent.
  • 5.2 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard.  Growth in this number has slowed significantly over the past three weeks. Another 760,000 have been vaccinated in Philadelphia.  According to the state, 58.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 61.1 percent of the entire population has now received at least the first dose of a vaccine.

Department of Human Services

The American Rescue Plan offers a temporary 10 percent increase in federal Medicaid matching fund for certain state Medicaid expenditures for home and community-based services (HCBS).  DHS has submitted a preliminary spending plan to the federal Centers for Medicare & Medicaid Services (CMS) as part of the process of seeking approval for this additional funding and has invited stakeholder comment on its proposal.  Comments are due July 6.  Go here to see DHS’s announcement of this endeavor; go here to see a Wolf administration news release on the subject; and go here to see DHS’s preliminary spending plan.

DHS has updated its list of mailing dates for the most current four Remittance Advices and corresponding checks.

Department of Drug and Alcohol Programs

In response to the COVID-19 pandemic, the Department of Drug and Alcohol Programs suspended three of its regulations governing narcotic treatment programs:  one limiting the supply of medicine  those programs can dispense at one time to their patients; another requiring those programs to meet patients in person before prescribing buprenorphine; and the third requiring them to have a physician on the premises.  While the governor’s declaration of a disaster emergency has been terminated, the department has advised all stakeholders that these three regulations will remain suspended until September 30.  Go here for more information.

The Department of Drug and Alcohol Programs has issued an alert clarifying the requirements that licensed providers must meet to use certain medications, including methadone, buprenorphine, and naltrexone.

Around the State

  • Of the more than 600,000 residents of Allegheny County who are fully vaccinated, according to county health officials, only 420 have contracted COVID-19 – so-called breakthrough cases; only 11 of the 420 required hospitalization.  The Pittsburgh Tribune-Review provides the details.
  • Demand for COVID-19 vaccinations is falling in the Lehigh Valley and throughout Pennsylvania and the Allentown Morning Call offers the numbers to prove it.
  • While COVID-19-related hospitalizations have declined state-wide they are rising in Erie and Crawford County.  GoErie looks into why.
  • Cumberland County has made masks optional for staff and visitors at any county facility except the Claremont Nursing and Rehabilitation Center and Cumberland County Prison, according to the Carlisle Sentinel.
  • The city of Pittsburgh has announced plans for its workforce to return to city offices, the Pittsburgh Business Times reports.
  • “The company responsible for administering Pennsylvania’s contact tracing program has called on current and former employees to help it locate and secure documents online that might still contain the personal information of those who were contacted, “ according to Spotlight PA, which added that “…a lawyer for Insight Global asked them to contact the company’s information security team if they had any paper or electronic records, internet links and files, or Google Drive documents related to the program.”  The company was fired because of data leaks.
  • Black maternal morbidity rates in Philadelphia are among the highest in the country, the Pennsylvania Capital-Star reports.
  • “Medical marijuana sales in Pennsylvania topped more than $900 million over one year during the COVID-19 pandemic, and could soon see $3 billion in total sales with just a few operating years under its belt,” the Delaware County Daily Times writes, adding that “According to figures provided by the Pennsylvania Department of Health, sales from growers/producers to dispensaries have reached almost $1.2 billion and sales from dispensaries to patients have crested $1.7 billion.”

Pennsylvania Bulletin

The latest issue of the Pennsylvania Bulletin is now available.  It includes new items from the Department of Human Services, Department of Health, the General Assembly, and others.  Find it here.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar.  Public comments will be taken after each presentation and questions can be entered in the chat box.  Interested parties can participate in the following ways:

Webinar registration – go here

Dial in:  1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

2021-06-18T19:18:59+00:00June 18th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2022 budget|Comments Off on Pennsylvania Health Policy Update for the Week of June 14-18
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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May 2021 newsletter.

Included in this month’s edition are articles about:

  • Medicaid eligibility changes permitted for people with Medicare during the COVID-19 emergency.
  • Changes in the Medical Assistance work supports program.
  • The introduction of changes in the process for enrolling in the state’s Living Independence for the Elderly Program (LIFE).
  • The simplification of the dental benefit limits exceptions process.
  • A listening session during which Community HealthChoices participants expressed dissatisfaction with receiving their benefits through managed care.
  • Actions to terminate some participants from state home and community-based Medicaid programs because their health status has not been reassessed.

Read about these subjects and more in the Pennsylvania Health Law Project’s May 2021 newsletter.

2021-06-07T18:26:31+00:00June 9th, 2021|HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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Medicaid Enrollment in PA Continues to Rise – But Not as Much as Elsewhere

Medicaid enrollment in Pennsylvania rose 14.7 percent from February 2020 to March 2021.

That’s a lot, but Medicaid enrollment in 36 states examined as part of a recent analysis rose 17.7 percent from February 2020 to March 2021.  Leading the way were two Medicaid expansion states, Utah and Nebraska, which saw their Medicaid enrollment increase 37.6 percent and 30.9 percent, respectively.

Other states with major increases in Medicaid enrollment were Missouri (26.5 percent), Illinois (26.3 percent), and Indiana (25.7 percent).  The increases appear to have been driven by pandemic-related job losses and the accompanying economic downturn.

Learn more about where and why Medicaid enrollment is rising and where Pennsylvania fits among them from the article “What is Happening With Medicaid Enrollment in Q1 of 2021?” on the web site of the Georgetown University Health Policy Institute.

 

2021-06-07T17:20:52+00:00June 8th, 2021|Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on Medicaid Enrollment in PA Continues to Rise – But Not as Much as Elsewhere
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PA Health Policy Update for the Week of June 1

Safety-Net Association of Pennsylvania logoBeginning today, SNAP is expanding its regular COVID-19 updates to encompass a broader scope of Pennsylvania state health policy endeavors.  As efforts to address COVID-19 prove more effective and the state moves from focusing almost exclusively on the public health emergency back to its usual, much broader array of health policy concerns, we hope this update will be a useful resource on matters of importance to the hospital community.  Please feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is an update of selected state health policy developments in Pennsylvania for the week of June 1-4, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has issued a reminder to Pennsylvanians that all businesses, events, and venues can return to 100 percent capacity with the lifting of COVID-19 mitigation orders starting Monday, May 31 at 12:01 a.m.  The current order requiring masks for unvaccinated and partially vaccinated individuals will remain in place until June 28 or when 70 percent of Pennsylvanians age 18 and older get their second dose of Pfizer or Moderna vaccine or the single-dose Johnson & Johnson vaccine, whichever comes first.  Individuals are still required to wear masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs, such as airports and stations.  Individuals should still follow guidance at workplaces, local businesses, long-term-care facilities, hospitals, prisons, and homeless shelters.  See the reminder here.

State Finances

  • The Department of Revenue announced that state General Fund collections for May totaled $3.9 billion, which was $1.6 billion, or 65.4 percent, more than projected. This significant increase is attributed to the one-month delay for personal income tax collections.  Personal income tax revenue in May was $1 billion above estimate.  So far this year the state has collected $2.9 billion, or 8.5 percent, more than anticipated.
  • Last week the state Independent Fiscal Office (IFO) released its updated FY 2021-2022 revenue estimate. In contrast to FY 2020-2021, which is ending on a strong note, the IFO projects that FY 2021-2022 will be more challenging once all of the COVID-19 federal funds are exhausted.  The IFO projects that the state’s economy and revenues generated from various sources will revert to the path they were on prior to COVID-19.  The IFO forecast estimates that Pennsylvania will collect $37.96 billion, a decline of $2.152 billion from FY 2020-2021.  Learn more from the presentation given by Matthew Knittel, the IFO’s director.

House Chamber of the State HouseIn the Legislature

  • A bill already passed by the state Senate and currently before the House would give parents the option of having their children repeat their current grade in school because of the challenges children have faced learning remotely. The Johnstown Tribune-Democrat tells the story.
  • A bill has been introduced in the Senate that would permit young people 14 years of age and older to receive COVID-19 vaccines without the consent of their parents. KDKA provides further information.
  • For a comprehensive summary of health care legislation currently under consideration in the Pennsylvania General Assembly, contact SNAP at info@pasafetynet.org.

Department of Health

  • The Department of Health has issued an advisory with information and reporting requirements about patients presenting with myocarditis and pericarditis after receiving Pfizer or Moderna COVID-19 vaccines.
  • The Department of Health circulated a reminder to long-term-care facilities with information on CMS’s requirement to report to the federal government on COVID-19 vaccinations and therapeutic treatments they provide.  Facilities also are required to educate staff and residents on the importance of getting vaccinated.
  • The Department of Health issued a health advisory on COVID-19 treatment options that incorporates updated guidance from the FDA on monoclonal antibody treatments and combination therapies.
  • The Department of Health revised its order regarding skilled nursing facility data reporting requirements to require weekly rather than daily reporting. While facilities will be required to complete data surveys on a weekly basis, the data they submit will be cumulative.  See the Department of Health announcement here and the full amended order here.
  • The Department of Health revised its interim guidance for skilled nursing facilities during COVID-19 to incorporate changes in data reporting requirements and other recently issued federal and state guidance.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline and has been in three digits for seven days in a row.
  • The number of COVID-19 deaths is declining but not as swiftly as the number of cases.
  • For the week from May 21 through May 27 the state’s overall COVID-19 test positivity rate was 3.8 percent, down from 4.5 percent last week and 5.5 percent the week before.
  • Twenty-eight counties had a positivity rate lower than five percent, up from 12 last week, and no counties had a positivity rate greater than 20 percent for the fifth consecutive week.
  • Ten counties (Cameron, Clarion, Elk, Forest, Fulton, Montour, Potter, Snyder, Sullivan, and Warren) are currently experiencing low levels of community transmission of COVID-19, up from four last week; 56 counties are experiencing moderate levels of community transmission, down from 58 last week and but up from 41 two weeks ago; and only one county (Wyoming) is currently experiencing a substantial level of community transmission, down from five counties last week and 22 the week before.
  • The numbers of Pennsylvanians hospitalized with COVID-19 fell 55 percent from May 1 to June 1; the number on a ventilator fell 47 percent from May 1 to June 1; and the number in hospital intensive care units fell 49 percent from May 1 to June 1.
  • 4.8 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number slowed significantly over the past week. Another 709,000 have been vaccinated in Philadelphia.  According to the state, 54.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 58.7 percent of the entire population has now received at least the first dose of a vaccine.
  • Governor Wolf has stated that Pennsylvania needs to reach 70 percent of adults vaccinated before he will lift the state’s remaining mask mandates.

Department of Human Services

  • On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal CARES Act to assist providers with COVID-19-related costs they incurred between March 1, 2020 and November 30, 2020. Providers that accepted Act 24 funding agreed to provide documentation to DHS and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021.  With this in mind, DHS’s Office of Long-Term Living (OLTL) has asked providers to take the following actions:
    • Review the list of providers. OLTL has compiled a list of providers that received Act 24 funding but for which it has no record of submission of a cost report or the return of funds.  Organizations on this list should complete an Act 24 cost report and submit it to RA-PWOLTLCOVID-19@pa.gov no later than Friday, June 11, 2021.  The applicable cost reports can be found here.  Those that believe they submitted an Act 24 report yet are on this list should forward a screenshot of their submission to RA-PWOLTLCOVID-19@pa.gov.
    • Return Unused Funding. Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating that the check is for the return of CARES Act 24 funding they did not use.  Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg PA 17105-8025, Attn: Daniel Sharar.  Providers should include their EIN on the memo line of the check to ensure that refunds are traceable to the correct provider.

Providers that fail to submit a cost report or return their funding by the deadline will be deemed to have no COVID-related expenses and the state will proceed to recoup the Act 24 funding that was distributed to them.

  • DHS’s Office of Medical Assistance Programs has issued a notice advising all county administrators, brokers, and all contracted Medical Assistance Transportation Program (MATP) agencies of updated guidance to ensure the safe provision of non-emergency medical transportation services to Medical Assistance beneficiaries during the COVID-19 public health emergency.  The announcement directs the affected parties to federal CDC guidance for further information. See the DHS announcement here.
  • The Office of Medical Assistance Programs has posted a notice informing individuals who are eligible to participate in the Medical Assistance Transportation Program but who can provide or arrange for transportation assistance on their own that it has temporarily increased the mileage rate for the remainder of the COVID-19 pandemic. See the notice here.

Pennsylvania Health Care Cost Containment Council

PHC4 has published its annual report on the financial performance of the state’s acute-care hospitals.  Among the highlights (taken directly from a PHC4 news release):

  • Uncompensated Care: The statewide percentage of uncompensated care to net patient revenue increased from 1.72% in FY19 to 1.73% in FY20. The foregone dollar value for statewide uncompensated care has decreased from $820 million in FY19 to $809 million in FY20.
  • Net Patient Revenue: The revenue hospitals received for patient care decreased 2.0% during FY20. Statewide net patient revenue was $46.8 billion during FY20, making up 91% of statewide hospital total operating revenue.
  • Operating Margin: Statewide operating income decreased from $2.8 billion in FY19 to $1.9 billion in FY20. As a result, the statewide average operating margin decreased from 5.61% in FY19 to 3.73% in FY20. Total operating revenue increased to $51.5 billion and operating expenses increased to $49.6 billion in FY20.
  • Total Margin: The statewide total margin realized by the hospitals decreased by 2.70 percentage points, from 6.63% in FY19 to 3.93% in FY20.

To learn more, go here for links to the PHC4 news release about the report, downloadable data, and the report itself.

Around the State

  • Philadelphia has added COVID-19 to its list of vaccines for which children do not need parental consent under a new Philadelphia Board of Health regulation.
  • In the face of declining COVID-19 cases, Philadelphia lifted most of its COVID-19 restrictions, including density limits, maximum capacity limits, and distancing rules, on Wednesday, June 2.
  • The city’s indoor mask mandate and 11 p.m. last call for dining orders will continue to be enforced until its Department of Public Health reviews the state of the pandemic and may drop those restrictions on Friday, June 11, according to a city news release. It was previously announced that the city would lift restrictions on Friday, June 11.
  • Berks County has the third highest rate in the state for children suffering from lead poisoning. It is particularly a problem in the city of Reading and in communities of color.  Local officials and doctors are coming together to try to do something about it.  WFMZ tells the story.
  • Penn State is offering incentives to students and staff to get vaccinated: cash prizes, book store gift certificates, and a football signed by coach James Franklin.  The Centre County Times offers the details.
  • The Delaware County Council met in person for the first time in 14 months, the Delaware County Daily Times reports.
  • Erie’s city hall has reopened after a year, according to GoErie.
  • The number of flu cases in Pennsylvania fell 97 percent from last year. The AP offers the facts and figures.
  • Eighteen Pennsylvania colleges and universities (so far) are requiring students and staff to have COVID-19 vaccines for the fall semester. Scroll down this link to find the list.
  • Most hospitals, on the other hand, are holding off on imposing such requirements, PennLive reports.

Stakeholder Events

  • Medical Assistance Advisory Committee – Managed Care Delivery Systems Subcommittee Meeting

June 10 at 10:00 a.m.

Join Meeting

Meeting number (access code):  132 168 3592

Meeting password:  Managed

Join by phone:  +1-408-418-9388 United States (Toll)

  • Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

  • Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

  • DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholde

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

 

 

 

 

2021-06-04T20:20:09+00:00June 4th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Uncategorized|Comments Off on PA Health Policy Update for the Week of June 1
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Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2021 newsletter.

Included in this month’s edition are articles about:

  • The impact of the American Rescue Plan on health insurance eligibility.
  • The impact of the American Rescue Plan on “Pennie,” Pennsylvania’s health insurance marketplace.
  • Federal updates on nursing home visitation.
  • Medicare coverage of COVID-19 testing and vaccines.
  • Using the Medical Assistance Transportation program to get the COVID-19 vaccine.
  • Advancing maternal health care coverage in Pennsylvania.

Read about these subjects and more in the Pennsylvania Health Law Project’s April 2021 newsletter.

2021-05-06T11:13:13+00:00May 6th, 2021|Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter
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Medicaid Enrollment Up in PA

Medicaid enrollment in Pennsylvania has risen 13.7 percent in the past year, according to the state’s Department of Human Services, which administers the program.

Nearly 400,000 people have joined Pennsylvania’s Medicaid rolls in the past year, raising the total number of participants to 3.2 million.

Participation in the state’s Supplemental Nutrition Assistance Program (SNAP), cash assistance program, and Low-Income Home Energy Assistance Program (LIHEAP) have risen as well during the past year.

Learn more from this Department of Human Services news release.

2021-04-07T06:00:11+00:00April 7th, 2021|Pennsylvania Medicaid|Comments Off on Medicaid Enrollment Up in PA
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Change Atop PA’s Department of Human Services

Teresa Miller is out and Meg Snead will be in as Pennsylvania’s new Secretary of the Department of Human Services.

In separate news releases the Wolf administration announced that Miller, who has led DHS since 2015, “will be moving on to a new opportunity outside Pennsylvania” and leave her job at the end of April and that she will be replaced by Meg Snead, who currently serves as the governor’s Secretary of Policy and Planning.

Snead’s nomination is subject to confirmation by the state Senate.

The Secretary of the Department of Human Services is important to SNAP members and Pennsylvania safety-net hospitals because the state’s Medicaid program is administered by that department’s Office of Medical Assistance Programs.

Learn more about Miller’s departure here and about Snead’s nomination here.

2021-03-25T06:00:37+00:00March 25th, 2021|Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on Change Atop PA’s Department of Human Services
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COVID Drives Major Increase in PA Medicaid Enrollment

Medicaid enrollment in Pennsylvania has risen nearly 14 percent in the past year as rising unemployment resulting from COVID-19 drives people to turn to the state for health insurance.

As a result, Pennsylvania has added nearly 400,000 people to its Medicaid rolls in the past year.  Today, 3.2 million Pennsylvanians are enrolled in the state’s program, although among them are approximately 250,000 who would have been dropped from the program except for a federal requirement that the state not drop people from the program in exchange for a major increase in federal aid for the state’s program.

As a result of the increase, the state’s Department of Human Services, which runs its Medicaid program, has asked the legislature for nearly $1 billion in supplemental funding to help finance its services for this expanded enrollment through the rest of the state’s FY 2021 year.

Learn more about the past year’s increase in Medicaid enrollment, who the new enrollees are, and how the state is accommodating them in the Philadelphia Inquirer article “A huge spike in Medicaid enrollment in Pa. shows how devastating the coronavirus has been.”

2021-03-24T06:00:57+00:00March 24th, 2021|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off on COVID Drives Major Increase in PA Medicaid Enrollment
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 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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