SNAPShots

SNAPShots

PA Health Policy Update for January 12

The following is an update of selected state health policy developments in Pennsylvania from January 8 – 12.  (Some of the language used below is taken directly from state documents). 

General Assembly 

  • The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that, effective February 1, 2024, doulas may enroll in the Medical Assistance (MA) Program, which will enable MA managed care organizations (MCOs) to enter into network agreements with doulas. The bulletin also contains information on provider enrollment.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through February 2024. Find the updated calendar here. 

Department of Health

DOH has requested input from stakeholders on what the state’s priorities should be for its Title V Maternal and Child Health Services Block Grant, which is intended to improve the health and wellbeing of mothers, infants, children, and youth, including children and youth with special health care needs, and their families. Interested stakeholders can find additional information and details on how to submit feedback here. 

Board of Nursing 

The State Board of Nursing, along with DHS and DOH, has issued a joint statement of policy to clarify nursing standards and qualifications in the commonwealth for licensed practical nurses (LPNs) and registered nurses (RNs) as it relates to the Nurse Licensure Compact (NLC). Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the establishment of a state-administered independent appeal process that allows Pennsylvanians to submit for an independent external review if they believe their insurer wrongly denied a claim for covering medical service, treatment, or other items. This is part of Act 146 of 2022, which reformed the state’s prior authorization and step therapy procedures. 

PID has also announced that Pennie’s open enrollment period for 2024 health care coverage will be extended until January 19. Pennie is Pennsylvania’s official health insurance marketplace. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced the Drug-Free Communities Program, which provides community coalitions with grant funding for substance use prevention efforts, will release its FY 2024 notice of funding opportunities on www.grants.gov in February 2024.   

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new report – COVID-19, The Impact on Health Care in Pennsylvania – examining how the coronavirus pandemic affected Pennsylvania and its health care system. Find additional information in this press release issued by PHC4. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here. 

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-01-12T23:48:27+00:00January 12th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 12
Read More

PA Health Policy Update for January 5

The following is an update of selected state health policy developments in Pennsylvania from December 21 – January 5.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The commonwealth’s Behavioral Health Council held its first meeting the week of December 18. Created by Executive Order 2023-20 in October, the council is tasked with developing and recommending a state-wide action plan to address deficiencies in access, affordability, or delivery of behavioral health services. Find additional information about the council’s first meeting and a list of council members in this press release. 

General Assembly 

  • The state House of Representatives and Senate briefly convened for session on Tuesday, January 2. Both chambers are now in recess until Tuesday, February 6 when they will convene for Governor Shapiro’s annual budget address.
  • Senator Kim Ward (R-Westmoreland) was reelected by her colleagues on Tuesday to serve as President Pro Tempore of the Senate.
  • The House and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that the department is providing coverage and payment for interprofessional consultation services in the Medical Assistance (MA) Program, beginning January 1, 2024.
  • DHS has also issued a Medical Assistance Bulletin to inform providers about the department’s coverage policy for routine patient care costs associated with qualifying clinical trials and the updated requirements.
  • DHS has published a Pennsylvania Bulleton notice announcing its intent to submit a state plan amendment to the Centers for Medicare & Medicaid Services to implement Act 15 of 2023, which increases ground ambulance rates for the MA fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate funds in FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to MA enrolled, qualifying acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has published its approved and required medications list for emergency medical service agencies and emergency medical service providers. Find additional information in this Pennsylvania Bulletin notice.
  • DOH has published a Pennsylvania Bulletin notice with the scope of practice for emergency medical responders, emergency medical technicians, advanced emergency medical technicians, paramedics, prehospital registered nurses, prehospital physician extenders, and prehospital physicians.

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs’ (DDAP) new training management system (TMS) is now live and DDAP has migrated all training records from the old TMS and TrainPA. Find more information and access the new TMS here. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.7 billion in General Fund revenue in December, which was $69.6 million, or 1.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $19.8 billion, which is $70.7 million, or 0.4 percent, below estimate. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – January 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, January 19 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the department’s programs related to care and treatment. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Medical Marijuana Advisory Board Meetings – 2024    

The Medical Marijuana Advisory Board has provided notice of its 2024 board meeting schedule. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice.

 

2024-01-05T20:38:40+00:00January 5th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for January 5
Read More

PA Health Policy Update for December 22

The following is an update of selected state health policy developments in Pennsylvania from December 18 – 21.  (Some of the language used below is taken directly from state documents). There will be no update the week of December 25. The next update will be Friday, January 5, 2024. 

Governor Shapiro 

The Shapiro administration has issued a press release highlighting its first-year public health accomplishments, including the expansion of maternal health services, support for emergency medical services, and more.  

General Assembly 

The state House of Representatives and Senate are in recess until 2024. The Senate is scheduled to return to voting session on January 16 and the House is scheduled to return to voting session March 18. Find the House’s current 2024 session schedule here and the Senate’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued two Medical Assistance (MA) bulletins regarding the submission of claims, including those claims outside the 180-day timeframe, for MA beneficiaries whose MA coverage has been reinstated.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through January 2024. Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin relating to prior authorization of pharmacy services for hypoglycemics, incretin mimetics/enhancers.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania – is open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, or during multiple advisory and stakeholder meetings. Those details can be found here. 

Department of Health 

  • The Department of Health (DOH) has posted a solicitation for proposals that seek to foster and encourage innovative research for treatment and rehabilitative techniques for the functional improvement of people with spinal cord injuries. Find the solicitation on eMarketplace here.
  • DOH has issued a Health Advisory (PAHAN – 731) to alert health care providers of low vaccination rates against influenza, COVID-19, and respiratory syncytial virus (RSV). DOH also advised health care providers that they should recommend and provide antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high-risk of progression to severe disease.
  • DOH has also issued a Health Advisory (PAHAN – 732) to notify health care providers of an increase in pertussis across Pennsylvania, primarily among high school students and their close contacts. Providers should have an increased suspicion of pertussis if patients have certain symptoms. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

2023-12-22T16:56:08+00:00December 22nd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for December 22
Read More

PA Health Policy Update for December 15

The following is an update of selected state health policy developments in Pennsylvania from December 11 – 15.  (Some of the language used below is taken directly from state documents.)

FY 2023-2024 Budget 

The General Assembly and Governor Shapiro enacted the remaining pieces of the FY 2023-2024 budget this week, including the Fiscal Code – House Bill 1300. The enactment of the Fiscal Code will enable approximately $1.1 billion that has been delayed since July to begin to be distributed. This includes $50 million for hospital financial relief, tobacco settlement funds, etc.  Find a summary of the various provisions in the Fiscal Code here. 

Governor Shapiro 

Governor Shapiro signed several bills into law this week. Following is a selection of health care-related laws enacted.

  • Senate Bill 414 (Act 59 of 2023) authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.
  • Senate Bill 683 (Act 43 of 2023) requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
  • Senate Bill 941 (Act 66 of 2023) enables certain flexibilities for addiction treatment providers.
  • House Bill 1131 (Act 50 of 2023) removes the requirement for counties to operate state health centers in counties establishing their own local health departments. 

General Assembly 

The state House of Representatives and Senate convened for their final voting session of 2023 this week. In addition to the bills noted above that were enacted by the General Assembly and the governor, following is an overview of selected health care-related legislative activity from this week.

  • The House of Representatives passed House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania, by a vote of 163-40. The bill will now be sent to the Seante for consideration.
  • The House of Representatives amended House Bill 181, known as the Family Medical Leave Act, on second consideration. The bill was subsequently referred to Appropriations and re-reported as amended. The bill still needs to be passed on third and final consideration before heading to the Senate.
  • The House Health Subcommittee on Health Care met on Wednesday, December 13 for an informational meeting on the “cannabis regulatory landscape.” Find a recording of the proceeding here. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of interprofessional consultation services to the Medical Assistance (MA) program fee schedule. These changes are effective for dates of services on and after January 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania – is open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.
  • DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Medical Assistance (MA) program fee schedule related to the administration of COVID-19 vaccines.

Department of Health

  • The Department of Health (DOH) has sent a message to long-term care facilities regarding the methodology for calculating staffing ratios for licensed practical nurses (LPNs) and nurse aides. The new methodology will go into effect January 1, 2024.
  • DOH has published an addendum to its solicitation for substance use disorder navigation services to increase emergency department capacity. Find the addendum and additional information regarding the solicitation here.
  • DOH has asked health care providers to report individuals with blood lead levels of 3.5 μg/dL or higher detected through venous, capillary or unspecified testing within three months after consuming a WanaBana, Schnucks, or Weis brand cinnamon applesauce or apple purée product containing cinnamon by securely emailing the following information to RA-DHBOE-RESPONSE@pa.gov or by fax: 717-772-6975. Find additional information in this Health Advisory issued by DOH. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its 2022 Hospital Performance Report. The report includes risk-adjusted, hospital-specific mortality and readmission ratings as well as volume of cases and average charges for patients discharged from Pennsylvania’s acute care hospitals between October 1, 2021, through September 30, 2022 

State Board of Medicine 

The State Board of Medicine has published proposed rulemaking submitted by the Board of Medicine effectuating Act 79 of 2021, which among other things, enables physician assistant written agreements to be effective upon being filed rather than approved. Find additional information in this Pennsylvania Bulletin notice. 

Department of Labor & Industry 

The Department of Labor & Industry has determined the maximum compensation payable under the Workers Compensation Act shall be $1,325 per week for injuries occurring on or after January 1, 2024. Find additional information in this Pennsylvania Bulleton notice. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2023-12-18T16:30:15+00:00December 16th, 2023|long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for December 15
Read More

PA Health Policy Update for December 1

The following is an update of selected state health policy developments in Pennsylvania from November 20 – December 1.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro 

On Tuesday, November 21 Governor Shapiro signed Senate Bill 500 and House Bill 507 into law. Senate Bill 500 (Act 32 of 2023) provides Medicaid coverage for pasteurized donor human milk. House Bill 507 (Act 31 of 2023) requires health care providers to obtain informed consent, both verbal and written, before performing a pelvic examination, a rectal examination, or a prostate examination while the patient is anesthetized or unconscious. 

Department of Human Services

  • The Department of Human Services (DHS) has made available for public review and comment its proposed 1115 waiver application. Entitled Bridges to Success: Keystones of Health for Pennsylvania, the application proposes Medicaid coverage for Health-Related Social Needs (HRSN), reentry supports, and multi-year continuous eligibility for young children. Find additional information, including a schedule of public hearings, in this Pennsylvania Bulletin notice. The state’s draft 1115 waiver application can be viewed here.
  • DHS has published notice of its intent to amend the current regulations to comply with the CMS’ final rule – ”Medicaid Program; Covered Outpatient Drugs.” The proposed rulemaking also makes technical changes to add diabetic supplies, opioid overdose agents, and immunizations to the list of services excluded from copayments. In addition, it recognizes the prescriptive and dispensing authority of certified nurse practitioners (CRNP) and midwives. Find additional information in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health (DOH) has updated its guidance on implementation of the interstate Nurse Licensure Compact. In accordance with an updated interpretation of applicable state law and regulations relating to registered nurses (RNs) and licensed practical nurses (LPNs), the Department will no longer require exceptions to regulations to allow health care facilities to employ or contract with RNs and LPNs holding an active multistate license. Read the updated guidance here.

DOH has notified providers that exceptions to perform Total Shoulder Replacement procedures in ambulatory surgery facilities are no longer required. Since the passage of Act 87, only procedures that are excluded from the CMS payment schedule require exceptions to 551.21 and CMS recently added Total Shoulder and Total Ankle procedures to that list. Letters rescinding currently held exceptions will be forthcoming, but effective immediately, exceptions and the associated reporting requirements are no longer in effect. 

Department of Drug & Alcohol Programs

The Drug and Alcohol Programs (DDAP) has announced its New Training Management System (TMS) will launch in January 2024. Additional information, including steps to prepare for the new TMS, can be viewed here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published proposed rulemaking submitted by the Board of Medicine effectuating Act 79 of 2021, which among other things, enables physician assistant written agreements to be effective upon being filed rather than approved. The proposed rulemaking can be viewed here. 

Office of the Attorney General 

The Office of Attorney General has issued a press release with information for Pennsylvania consumers, especially those who are pregnant or may become pregnant, when choosing reproductive health care providers and counselors.

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

Patient Safety Authority – December 7

The Patient Safety Authority will hold a public board meeting on Thursday, December 7 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-12-01T23:06:22+00:00December 1st, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for December 1
Read More

PA Health Policy Update for November 17

The following is an update of selected state health policy developments in Pennsylvania from November 13 – 17.  (Some of the language used below is taken directly from state documents.) 

General AssemblyHouse Chamber of the State House

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health-related legislative activity.

  • The House of Representatives unanimously passed Senate Bill 500, which provides Medicaid coverage for pasteurized donor human milk, as amended. The Senate subsequently concurred with the House amendments and sent it to the governor’s desk.
  • The Senate unanimously passed House Bill 507, which requires health care providers to obtain informed consent, both verbal and written, before performing a pelvic examination, a rectal examination, or a prostate examination while the patient is anesthetized or unconscious. The House subsequently concurred with the Senate amendments and sent it to the governor’s desk.
  • The Senate unanimously passed Senate Bill 668, which permits certified nurse aides to become certified medication aides (CMA) in long-term care facilities, assisted living residences, and personal care homes. Following Senate passage the bill was received in the House and referred to the Health Committee.
  • The House Human Services Committee held a meeting on Monday, November 15 and favorably reported House Bill 1650, which authorizes the establishment of a grant program for recovery houses, and House Bill 1690, which establishes a public awareness campaign about the growing threat of Xylazine.
  • The House Health Committee held a meeting on Wednesday, November 15 and favorably reported House Bill 1657, which eliminates exemptions in the state’s Clean Indoor Air Act and expands the definition of smoking to include e-cigarettes, and Senate Bill 414, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through December. Find the updated calendar here.
  • DHS has announced it will add sexually transmitted infection (STI) test kits for at-home specimen collection to the Medical Assistance (MA) Program fee schedule, effective with dates of services on and after December 1, 2023. Find additional information in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health is soliciting applications from hospitals and health systems for up to $325,000 in grant funding to support care navigators in emergency departments as part of the Pennsylvania Substance Use Navigation Program. One grantee will be selected in each of four regions, based on the location of the emergency department where care will be provided, and funds can be used to build and implement health system-wide clinical capacity to screen, diagnose, and support longitudinal care for opioid use disorder and stimulant use disorder and support recovery for adults and adolescents. The RFA closes on January 16, 2024.

In anticipation of the holiday season, DOH has issued vital safety tips to avoid holiday accidents. On behalf of DeBrunner & Associates, we hope you don’t burn the turkey and wish you a very happy Thanksgiving. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Patient Safety Authority – December 7

The Patient Safety Authority will hold a public board meeting on Thursday, December 7 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-11-17T21:07:32+00:00November 17th, 2023|Governments, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for November 17
Read More

PA Health Policy Update for November 10

The following is an update of selected state health policy developments in Pennsylvania from November 6 – 10.  (Some of the language used below is taken directly from state documents.) 

2023 General Election

Pennsylvania voters went to the polls this week to cast their ballots for a series of judicial, county, and municipal elections. Democrat Dan McCaffrey defeated Republican Carolyn Carluccio in a highly contested and expensive race to fill a vacancy on Pennsylvania’s Supreme Court. Democrats also won state-wide races for the superior and commonwealth courts. For detailed state and county election results, visit the Department of State’s website here. 

Governor Shapiro 

Governor Shapiro announced this week his administration will require all commercial insurers to “meet their obligations under Pennsylvania law” to provide coverage for autism benefits. Find additional information in this Pennsylvania Bulletin notice published by the Pennsylvania Insurance Department and this press release issued by the Shapiro administration. 

General Assembly

The state House of Representatives and Senate were in recess this week. Both chambers will return to Harrisburg next week and be in session Monday, November 13 through Wednesday, November 15.

Department of Human Services

The Department of Human Services (DHS) has issued several medical assistance bulletins relating to prior authorization for pharmacy services.

DHS has published final notice of the fee schedule rates for community participation support, Needs Group 5 Residential Habilitation and group music therapy, art therapy and equine assisted therapy services funded through the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers. Find additional information in this Pennsylvania Bulletin notice.

DHS is issued a Remittance Advice Alert notifying providers that a claims recovery was done to recoup monies paid in error due to date of death discrepancies uncovered in a recent audit.

DHS has published an updated Medicaid Managed Care Organization (MCO) Directory.  

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the beginning of the open enrollment period for Pennie, Pennsylvania’s official health insurance marketplace, for 2024 coverage. The enrollment period will last until December 15. Find additional information in this PID press release. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) held its Emerging Drug Trends Symposium this week. This annual event gathers key stakeholders to review current drug trends, innovative approaches to connect people who use drugs to treatment and other social services, identify gaps in services, and provide a venue for stakeholders to network. Find additional information in this DDAP press release. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – November 16

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 16 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-11-17T20:58:20+00:00November 10th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for November 10
Read More

PA Health Policy Update for November 3

The following is an update of selected state health policy developments in Pennsylvania from October 30 – November 3.  (Some of the language used below is taken directly from state documents.)  

Governor Shapiro 

Governor Shapiro was joined by legislators for a ceremonial signing of Senate Bill 262 this week. Senate Bill 262, which is now known as Act 5 of 2023, improves access to timely data on maternal health and maternal mortality in Pennsylvania. The increased access to data will enable researchers, doctors, and policymakers to make more informed medical care decisions. Find additional information in this press release.

The Shapiro administration has announced the launch of PAyback.pa.gov, an online money-back guarantee system that allows eligible residents, businesses, charities, and schools to request a refund of their permit, license, or certification application fee. This initiative is an outcome of Executive Order 2023-07, which directed state agencies to standardize timeframes for processing permits, licenses, and certifications. If those timeframes are not met, applicants may request their fee be refunded.  

General Assembly

  • The state House of Representatives convened in Harrisburg for session this week. The House is now in recess until Monday, November 13 when the Senate will return to session as well.
  • The House Health Committee met this week and favorably reported House Bill 1795, which removes state requirements that exceed federal statute related to source plasma donation centers. The committee also reported as amended Senate Bill 773, which makes certain changes to the state’s Medical Marijuana Act.
  • The House Health Committee’s Subcommittee on Health Care held an informational meeting this week on legalizing cannabis for adult use. Find a recording of the meeting here.

Department of Human Services

  • The Department of Human Services (DHS) has posted in the Pennsylvania Bulletin its annual list of each inpatient acute care general hospital, rehabilitation hospital, and private psychiatric hospital qualifying for a disproportionate share payment and their respective disproportionate share payment percentage. Find the full list here.
  • DHS published a notice with details on the implementation of the statewide hospital quality care assessment, which are consistent with Act 15 of 2023 passed by the General Assembly earlier this month. The Act set the assessment percentage rate for FY 2023-2024 as 3.54% of net inpatient revenue and 1.78% of net outpatient revenue. The department will use hospitals’ net inpatient and net outpatient revenue for state FY 2018-2019 to calculate the amount owed. Find the full notice here.
  • DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on October 26.
  • DHS has shared the following presentations used at the MAAC Consumer Subcommittee meeting on October 25.
  • DHS has published a Medical Assistance Bulletin, the purpose of which is to advise providers that the Department will provide coverage for sexually transmitted infection (STI) testing kits for at-home specimen collection, effective with dates of service on and after December 1, 2023.

Department of Health  

  • The Department of Health updated the staffing tool it offers to assist long-term care facilities with compliance with the new staffing ratio requirements. With this update, the sheets can now be printed on one page and the ratios are no longer calculated to two decimal places. Click here to access a direct download of the spreadsheet.
  • DOH cautioned providers about a recent consumer warning by the U.S. Federal Drug Administration related to eye drops from several major brands that have been linked to serious eye infections. See the full FDA warning here, which includes a list of the affected brands. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.2 billion in General Fund revenue in October, which was $119.8 million, or 3.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $13.1 billion, which is $47.5 million, or 0.4 percent, below estimate. 

Medicaid Continuous Coverage Unwinding

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOS – Board of Nursing – November 6

The Pennsylvania State Board of Nursing will hold a meeting on Monday, November 6. The meeting will be conducted in person and virtually. Find an agenda and additional details on how to participate here. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – November 16

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 16 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2023-11-03T20:12:52+00:00November 3rd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for November 3
Read More

PA Health Policy Update for October 13

The following is an update of selected state health policy developments in Pennsylvania from October 9 – 13.  (Some of the language used below is taken directly from state documents.) 

Governor Shapiro 

Governor Shapiro has announced that he signed Executive Order 2023-20 establishing the commonwealth’s first Behavioral Health Council. The 33-member council is tasked with developing a state-wide action plan to enhance and streamline the coordination and delivery of behavioral health care services and improve access to care. 

Governor Shapiro has signed House Bill 1209 and House Bill 1407 into law. These bills, now known as Act 11 and Act 9 of 2023, respectively, make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. 

General Assembly 

The state House of Representatives and Senate will convene for voting session next Monday, October 16 through Wednesday, October 18.

The House of Representatives’ Health Committee will meet on Wednesday, October 18 at 9:45 a.m. in Room G50 of the Irvis Office Building to consider the following bills.

  • House Bill 1417, which restores dental coverage for Medical Assistance recipients.
  • House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania.
  • House Bill 1694, which requires the Department of Drug & Alcohol Programs to create an annual report on the use of opioid settlement funds by state and county governments.
  • Senate Bill 500, which requires Medicaid coverage for medically prescribed pasteurized donor human milk. 

The Senate Appropriations Committee is scheduled to meet off the floor on Monday, October 16 to consider, among other bills, Senate Bill 941, which enables certain flexibilities for addiction treatment providers. 

Department of Human Services

The Department of Human Services (DHS) has published final notice of its intent to increase to the funding and change the payment methodology for a class of disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for Fiscal Year (FY) 2022-2023. These payments will provide financial relief to hospitals that provided access to acute care services for Medical Assistance (MA) beneficiaries during the COVID-19 pandemic. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced that PROMISe will have an extended maintenance window beginning 9:00 p.m. on October 20 to 2:00 p.m. on October 22.  During this window all PROMISe functions, including provider enrollment applications, will be unavailable.  For Pharmacy claims, DHS is directing pharmacies to dispense 5-day supplies of drugs and submit claims when the system is back online.

Auditor General  

Auditor General Tim DeFoor has announced the department will conduct a performance audit of state contracts and oversight of Pharmacy Benefit Managers (PBMs) used by the Department of Human Services’ HealthChoices Medicaid Program. 

Medicaid Continuous Coverage Unwinding 

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – October 20

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – November 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 2 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-10-13T19:39:11+00:00October 13th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for October 13
Read More

PA Health Policy Update for October 6

The following is an update of selected state health policy developments in Pennsylvania from October 2 – 6.  (Some of the language used below is taken directly from state documents.) 

FY 2023-20204 Budget Update 

The General Assembly continues to work on finalizing the FY 2023-2024 state budget. This week the state House of Representatives passed an amended version of the Fiscal Code (House Bill 1300) by a vote of 121-82 and sent it back to the Senate for consideration. The House of Representatives also passed an addendum to the General Appropriations Act (House Bill 1456) and a tax code (House Bill 1219) and sent them to the Senate for consideration. These pieces of legislation were not negotiated with Senate leadership in advance, so it is unclear how the Senate will proceed, or when the FY 2023-2024 budget process will be completed. 

General Assembly 

  • The state House of Representatives and Senate convened for session in Harrisburg this week. The following is an overview of selected health care focused legislative activity.
    • The House of Representatives adopted House Resolution 165, which directs the Legislative Budget and Finance Committee to examine the effect of workforce shortages on state-supported Medicaid home and community-based services waiver programs.
    • The Senate Health & Human Services Committee held an informational meeting on Tuesday to examine barriers to addiction treatment. Immediately following the information meeting, the committee held a voting meeting and favorably reported the following bills.
      • Senate Bill 941, which enables certain flexibilities for addiction treatment providers.
      • Senate Bill 721, which establishes the Women, Infants, and Children (WIC) advisory board.
      • House Bill 1351, which makes certain changes to the Rural Health Redesign Center Authority.

Find a recording of the hearing here.

    • The House Health Committee’s Subcommittee on Health Facilities held an informational meeting on Wednesday to examine the effects of hospital consolidation. Find a recording of the hearing here.
    • The House Human Services Committee and Aging & Older Adult Services Committee held a joint informational meeting Wednesday on personal care homes and assisted living facilities. Find a recording of the hearing here.
  • The state House of Representatives and Senate are now recessed until Monday, October 16. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to make one-time enhanced supplemental payments to eligible public and non-public Medical Assistance (MA) nursing facilities. Find additional information in this Pennsylvania Bulletin notice.
  • DHS Secretary Dr. Val Arkoosh has reminded Pennsylvanians who receive health care coverage through Medicaid or CHIP that the cost of COVID-19 vaccines, tests, and treatments are covered by the programs. Find additional information in this press release issued by DHS.
  • DHS has issued a Medical Assistance Bulletin announcing the addition of new procedure codes to the Medical Assistance (MA) program for vaccine administration.
  • DHS has issued a Medical Assistance Bulletin notifying providers about updates to the provision of Medicaid-covered services to beneficiaries experiencing homelessness when delivered in their lived environment, also known as “street medicine.”
  • DHS has published Provider Quick Tip #270 with important information for providers who are required to revalidate clinicians at multiple locations.
  • DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on September 28.

Department of Health 

The Department of Health (DOH) has invited stakeholders to participate in an information-gathering listening session regarding patient access to controlled substances in the commonwealth. The listening session will be held on Wednesday, October 11 from 10:00 – 11:30 a.m. Find additional information on how to register and participate here.

DOH has announced it will be implementing new regulatory requirements for all long-term care facilities beginning October 31. The new requirements include changes to the application for licensure, which will require additional information, documentation, and public disclosure. DOH has provided interpretive guidance for these changes on its website here.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.1 billion in General Fund revenue in September, which was $140.2 million, or 3.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $9.8 billion, which is $167.4 million, or 1.7 percent, below estimate. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – October 20

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-10-10T14:33:03+00:00October 6th, 2023|Financial, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 6
Read More

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

Go to Top