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Medicaid and CHIP Enrollment Rising in Pandemic

Medicaid enrollment rose 6.2 percent and CHIP enrollment 0.5 percent during the first four months of the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services reports.

The enrollment increase can be traced to rising unemployment, with many people losing their employer-sponsored health insurance.  The new figures cover five months, from February through June, the latter four of which marked the beginning of the COVID-19 pandemic.

Pennsylvania safety-net hospitals already serve significant numbers of Medicaid and CHIP patients; an increase in their rolls will prove financially challenging to them.

The information comes from CMS’s first monthly “Medicaid and CHIP Enrollment Trends Snapshot.”  Go here for CMS’s news release explaining its new initiative and here to see the trends snapshot itself, which includes figures for Pennsylvania.

2020-10-06T06:00:16+00:00October 6th, 2020|Pennsylvania Medicaid, Uncategorized|Comments Off on Medicaid and CHIP Enrollment Rising in Pandemic
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Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency.

Or so reports the organization Families USA in a new study.

Pennsylvania State MapAccording to the study,

Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%.

But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss,

Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health Management Associates projects that up to 27 million people will lose their job-based insurance this year and that Medicaid will see an increase in enrollment of up to 18 million people by the end of 2020, depending on the severity of the economic downturn.

The effects of COVID-19 job loss and accompanying loss of insurance already appears to be visible in Pennsylvania, where Medicaid enrollment rose from 2.84 million in March of 2020 to 2.89 million in April, 2.94 million in May, and 2.977 million in June.  Growing Medicaid enrollment poses a challenge for Pennsylvania’s safety-net hospitals because they care for so many low-income patients and payments from the state’s Medicaid program often do not cover the cost of the care they provide.

Learn more about the nation-wide trend in the Families USA report “Rapid Increases in Medicaid Enrollment: A Review of Data from Six Months.”

 

2020-09-16T06:00:58+00:00September 16th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals|Comments Off on Medicaid Enrollment on the Rise
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Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders.

Safety-Net Association of Pennsylvania logoThe cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to the delegation, SNAP wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with COVID-19. When these people are sick or injured, most will turn to the state’s 41 private safety-net hospitals for care. These hospitals depend heavily on their Medicaid DSH payments to underwrite the cost of care for their uninsured patients, so they have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never permitted those cuts to go into effect. The most recent delay expires after November 30..

Because they serve so many uninsured and underinsured patients, Medicaid DSH payments from the state are especially important for Pennsylvania’s safety-net hospitals.

Learn more from SNAP’s Medicaid DSH letter to Pennsylvania’s congressional delegation.

2020-09-15T06:00:16+00:00September 15th, 2020|Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation
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CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.

In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy.

In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its Office of Medical Assistance Programs have not yet indicated how they will respond to the options CMS has presented.

Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”

2020-08-31T19:55:39+00:00August 27th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on CMS Provides Guidance on Medicaid DSH Calculations
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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its August 2020 newsletter Health Law News.

Included in this month’s edition are articles about:

  • The Department of Human Services’ selection of new managed care plans to serve Pennsylvania Medicaid’s Community HealthChoices program.
  • The end of ensured continuity of long-term services and supports for participants in the Community HealthChoices program in northeastern Pennsylvania.
  • The availability of navigators to help connect people to COVID-19 testing and treatment.

Read about these subjects and more in the Pennsylvania Health Law Project’s August 2020 newsletter.

2020-08-05T06:00:27+00:00August 5th, 2020|HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Law Project Newsletter
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COVID-19 Update: March 27, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 4:30 p.m. on March 27.

Pennsylvania Updates

Governor Wolf

  • Today Governor Wolf expanded his ‘Stay at Home’ order to include nine more counties to mitigate the spread of the virus:  Berks, Butler, Lackawanna, Lancaster, Luzerne, Pike, Wayne, Westmoreland, and York counties.  The governor’s amended order, the secretary of health’s amended order, and the stay at home guidance are available online.  The order takes effect for these nine counties tonight at 8:00 p.m. and will continue for all of the affected counties until April 6.
  • Today Governor Wolf approved and signed several bills into law to provide emergency relief to schools (SB 751), unemployment compensation rules (HB 68), delaying the primary election (SB 422), and the $50 million in immediate funding for health care supplies via HB 1232.  We do not yet know how this funding will be distributed but are monitoring it closely.  According to the enabling legislation and a press release Governor Wolf issued yesterday, “The $50 million in funding will be deposited into a restricted account under the governor’s jurisdiction and funds will be used if there are insufficient funds available from the disaster proclamation ‘to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand. Health care entities include hospitals, nursing facilities and emergency medical services’.”

Department of Human Services

  • The Department of Human Services (DHS) has published a reminder that Governor Wolf has signed an executive order prohibiting elective medical and surgical procedures for the duration of the COVID-19 crisis.
  • Pennsylvania has been granted a section 1135 Medicaid waiver by the federal government. Key elements of the waiver address:
    • Temporarily suspending Medicaid fee-for-service prior authorization requirements.
    • Extending pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.
    • Suspending Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days.
    • State Fair Hearing Requests and Appeal Timelines.
    • Provider Enrollment.
    • Provision of Services in Alternative Settings.

These waivers will remain in effect until the current health crisis ends.  See the letter from CMS to the state that explains all of these aspects of the waiver in greater detail.

Department of Health

  • During her daily briefing today, Secretary Levine reported that the number of new COVID-19 cases in Pennsylvania yesterday declined slightly from the day before, although she dismissed this decline as “not statistically significant.”  There are now COVID-19 cases in 50 of Pennsylvania’s 67 counties.  While the number of hospitalizations, ICU cases, and patients put on ventilators remain low, she said those numbers remain in line with trends elsewhere in the country and her department’s own projections.
  • The department has revised its guidance prohibiting the provision of dental treatment except for urgent and emergency services.

Department of State

The Department of State requested, and Governor Wolf granted, an extension for 90 days of certain license renewal deadlines that fall between April 30, 2020, and June 30, 2020.  Affected boards include the State Board of Medicine, State Board of Nursing, and State Board of Examiners of Nursing Home Administrators.  Any associated regulations that establish these dates are temporarily suspended.  While the department will provide guidance encouraging licensees to renew on time, if possible, this waiver ensures that if they miss the deadline their licenses will remain valid and they will have an additional 90 days to renew them.

Federal Updates

Congress

The House of Representatives passed the $2 trillion Coronavirus Aid, Relief, and Economic Security Act passed by the Senate late Wednesday.  It now goes to the president for his signature and he has indicated he will sign it.

President Trump

President Trump sent a letter to governors thanking them for their efforts in fighting the COVID-19 emergency, outlining upcoming federal efforts, and expressing hope for the future.

Department of Health and Human Services

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

Food and Drug Administration

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

 

2020-03-27T17:25:53+00:00March 27th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off on COVID-19 Update: March 27, 2020
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COVID-19 Update: March 25, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 5:15 on March 25.

State Legislature

Today the Senate passed House Bill 1232, as amended, which includes up to $50 million of additional funding to be made available for the state’s COVID-19 response efforts.  The legislation stipulates that funding shall only be used to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand.  It also requires available federal funding and any funding made available through the governor’s disaster proclamation to be used before these funds.  The authority to transfer funds expires on September 30, 2020.

Senate leadership noted that this is the first phase in its crisis response and recognizes that additional funds will likely be needed.  The House is expected to pass the bill as amended today.  The bill will then be signed in both chambers and sent to the governor for consideration and he is expected to sign it.  It would take effect immediately.

The Administration

Governor Wolf

Today the governor added Lehigh and Northampton counties to his stay-at-home order.

Department of Health

Secretary Levine today issued an order requiring hospitals to make daily report of specified data regarding hospital facilities, beds, supplies, equipment, and staffing.  Among the measures hospitals will be required to report daily are available beds, psychiatric beds, number of other beds in facilities, current emergency department capacity, number of COVID-19 patients, expected number of days remaining N-95 masks will last, expected number of days remaining until other personal protective equipment supplies will exhausted, supply of remaining NP specimen collection supplies in days, number of ventilators in facility and in use, and number of employees available for work.  See the secretary’s order here.

Department of Human Services – Office of Medical Assistance Programs

  • The Office of Medical Assistance Programs has issued billing guidance to CHIP managed care organizations on the subject of alternative screening sites related to COVID-19. Find that two-page document here.
  • It issued another policy clarification to CHIP managed care organizations with directions to bypass the prior authorization requirements for chest CT scans for COVID-19 payments. See that policy clarification document here.

Another notice announces a new ICD-10 code for COVID-10 that takes effect on April 1. Find it here.

  • The Office of Medical Assistance Programs has posted an FAQ on Medicaid program coverage of COVID-19 testing and related services. It includes information about what Pennsylvania Medicaid will pay for COVID-19 testing, the services it will cover, and more.  Find it here.

Department of Human Services – Office of Long Term Living

  • The Office of Long Term Living (OLTL) has published guidance on conducting pre-admission screening and resident reviews for applicants to and residents of Medicaid-certified nursing facilities. This includes an explanation of performing such screens by phone or video conference.  See the guidance here.
  • OLTL also has sent a memo to nursing home transition coordination agencies about a new, COVID-19-motivated nursing home transition tenant-based rental assistance process. Find that memo here.
  • OLTL also communicated via its listserv that it is delaying the implementation deadline for electronic visit verification (EVV) until October 1, 2020.

Department of Drug and Alcohol Programs

  • The Department of Drug and Alcohol Programs (DDAP) has issued a document clarifying the state’s response to federal guidance on the disclosure of patients’ substance abuse disorder records during the telehealth process. See that policy clarification here.
  • DDAP has issued a policy bulletin addressing telehealth services for gambling treatment. Find that bulletin here.

Department of State

The Pennsylvania Department of State, which is responsible for licensing many health care providers, has announced new guidelines and processes for reactivating the licenses of retired health care professionals such as doctors, nurses, nurse practitioners, pharmacists, and others.  This new policy supplements previous announcements the department has made on this subject.  Find this updated information here.

Pennsylvania Health Centers Awarded Federal Funds

The federal Health Resources and Services Administration has awarded $100 million in grants to 1381 health centers across the country.  Among them are 43 health centers in Pennsylvania that will share $12.9 million in federal funds.  See a list of those grant recipients here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

 

 

 

2020-03-26T06:00:31+00:00March 26th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on COVID-19 Update: March 25, 2020
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COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020.

Pennsylvania Administration

Since yesterday, the Department of Human Services has issued the following four new guidance documents:

We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information.

  • Any business that would like to seek a waiver to the mandate to close can send a request to this email address:  RA-dcexemption@pa.gov
  • In addition, questions about whether or not your specific business needs to close can be directed to: ra-dcedcs@pa.gov

At the Secretary of Health’s daily update she noted that the number of diagnosed COVID-19 cases in the state doubled in the past two days.

Safety-Net Association of Pennsylvania logoFederal

Administration

CMS approved Washington state’s 1135 waiver request.  The approval letter can be found here.

In addition, CMS released two telehealth toolkits:  one for general practitioners that is available here and another for end-stage renal disease providers available here.

Congress

Congress is preparing a combination bill to both combat the spread of the coronavirus and also provide economic stimulus to counteract the negative effects of the state of emergency.  As Congress deliberates, SNAP weighed in today with Pennsylvania’s congressional delegation, asking for immediate financial support for hospitals, the elimination of the Affordable Care Act Medicaid DSH cuts, and a moratorium on new regulatory requirements on hospitals.  Find a summary of the bill here and SNAP’s letter to the delegation here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

 

2020-03-23T06:00:11+00:00March 23rd, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off on COVID-19 Update: March 20, 2020
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COVID-19 Update: March 19, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania for March 19, 2020 as of 6:30 p.m.

Pennsylvania Administration

Governor’s Order Closing State Businesses

Early in the evening, Governor Tom Wolf announced that he was ordering the immediate closing of what he called “non-life-sustaining businesses in Pennsylvania.”  See his news release on the order here, the order itself here, and a list of types of businesses and whether they are or are not “life-sustaining” here.

Pennsylvania Department of State Licensure Exceptions and Fast Track

The Pennsylvania Department of State Bureau of Professional and Occupational Affairs, in conjunction with Governor Wolf, issued a press release announcing that the governor had granted the department’s request for a suspension to permit licensed practitioners in other states to provide services to Pennsylvanians without obtaining a Pennsylvania license during the emergency.  The announcement also makes clear that “no Pennsylvania law prohibits the practice of telemedicine.”  Under the exception, out-of-state practitioners must:

  • Be licensed and in good standing in their home state, territory or country.
  • Provide the Pennsylvania board from which they would normally seek licensure with the following information prior to practicing telemedicine with Pennsylvanians:
  • their full name, home or work mailing address, telephone number, and email address; and
  • their license type, license number or other identifying information that is unique to that practitioner’s license, and the state or other governmental body that issued the license.

The full text of the document can be found here.

Pennsylvania Department of Drug and Alcohol Programs Authorizing Additional Take-home Opioid Treatment Medicine

On March 16, the federal Substance Abuse and Mental Health Services Administration provided additional guidance to Opioid Treatment Programs.  Today, Pennsylvania’s Department of Drug and Alcohol Programs issued a licensing alert taking advantage of that guidance to suspend the prohibition on patients receiving a greater-than-two-week supply of medication to take home.  The full text of the document can be found here.

Pennsylvania Department of Human Services Shares COVID Response Overview

On Tuesday, March 17 Pennsylvania’s Department of Human Services (DHS) hosted an invitation-only call to provider DHS stakeholders with an overview of its actions related to COVID-19.  Last night DHS issued a summary of that presentation.  Please find that summary attached.

Pennsylvania Department of Health Daily Update

  • The Secretary stated that the Department of Health (DOH) is working with hospitals to evaluate whether elective procedures are necessary and to delay them as appropriate.
  • DOH has directed hospitals to update their emergency plans to include COVID-19 and to implement those plans as of 11:59 tonight.
  • Although the number of diagnoses continues to rise, hospitalizations in Pennsylvania are on par with nationwide statistics at roughly 10 percent of the diagnosed population.
  • The Secretary is urging small businesses to comply with the social distancing protocols and called on small business owners to contact the Department of Community and Economic Development to identify financial resources to assist them through this period.
  • She reminded citizens that limiting individual exposure does not require a mask, stating that the limited personal protective equipment supplies are best used by frontline responders.

Pennsylvania Legislature

House Chamber of the State HouseThe following summary of PA legislative actions was compiled by Cynthia Fernandez of Spotlight PA and Gillian McGoldrick of Lancaster Online.

Limiting Disaster Powers

When Gov. Tom Wolf declared a disaster emergency on March 6, he was able to  claim expansive powers. Rep. Russ Diamond (R., Lebanon) plans to issue a  resolution to terminate  Wolf’s COVID-19 emergency declaration “if the need arises.”

Privacy

Sen. Doug Mastriano (R., Franklin) is drafting a   resolution   that would call on the federal government to suspend privacy regulations for people who have tested positive for COVID-19. There should be “full disclosure of anyone who came within immediate contact of any contaminated citizen,” Mastriano said in a statement, “until the COVID-19 crisis passes.”

Pa. Coronavirus Cases

As of March 18, 2020, the Pa. Department of Health reports that there are 133 positive cases of COVID-19 in Pennsylvania.

Total cases/Deaths

VIEW THE INTERACTIVE MAP HERE:  https://www.pennlive.com/news/2020/03/evictions-student-loans-pssas-and-more-what-pa-lawmakers-are-proposing-in-response-to-the-coronavirus.html

Rent

Lawmakers are  drafting a bill  to limit landlords’ right to evict tenants when a governor declares a state of emergency. The measure, from Rep. Mary Isaacson (D., Philadelphia) and Rep. Summer Lee (D., Allegheny), would “provide an exemption from eviction for workers who are unemployed, separated from their employment, or unable to find employment.”

Schools

Sen. Andy Dinniman (D., Chester) and Sen. Scott Martin (R., Lancaster) are drafting a bill that would   cancel the state PSSA and Keystone exams  for the remainder of this school year. The measure would also require the state Department of Education to waive federal testing requirements.

Dinniman is also drafting  a measure  that would give school districts authority to deliver online instruction until the end of the academic year.

Martin has  proposed a bill  that would require colleges and universities closed because of COVID-19 to refund all fees paid in advance, including room and board. The prorated refund would only apply from the date the institution shuttered through the end of the semester.

Sick Leave

Rep. Joe Hohenstein (D., Philadelphia) and Sen. Larry Farnese (D., Philadelphia)   want to require  paid sick leave for any workers left out by a federal bill on its way to President Donald Trump’s desk, which is limited to workers who need to care for their children. The legislation could leave 19.3 million workers without any sick pay, the Washington Post  reported.

The state legislation would also require employers to reinstate workers when they return from leave.

Small Businesses

To lessen the impact on small businesses,  Sen. Tom Killion (R., Chester) plans to introduce legislation  that would direct table game revenue to the Department of Community and Economic Development to create zero-interest loans.

Reps. Valerie Gaydos (R., Allegheny) and Jared Solomon (D., Philadelphia)  also plan to introduce legislation  to create low-to-no interest loans to help small businesses survive. The bill will outline two types of loans: one will be short-term funding to meet payroll and overhead expenses; the other will be for “long-term resiliency” to help businesses recover over time.

Student Loans

A measure by Rep. Malcolm Kenyatta (D., Philadelphia) would allow a   60-day grace period  for repayment of student loans issued by the Pennsylvania Higher Education Assistance Agency.

Taxes and Filing

Rep. David Rowe (R., Union) and Rep. Frank Ryan (R., Lebanon) are   writing a measure  that would suspend sales and personal income tax collection until the disaster declaration is lifted.

The IRS will keep its tax-filing deadline as April 15, but the U.S. Treasury announced Tuesday it will waive interest and penalties for 90 days after that date. Rep. Joe Ciresi (D., Montgomery)  plans to introduce legislation   that would apply a 60-day extension for Pennsylvanians to file state income taxes when the state is under a disaster declaration.

Voting

All Pennsylvanians are now eligible to vote by mail. Rep. Kevin Boyle (D., Philadelphia) wants to  encourage  that by mailing all voters that kind of ballot ahead of the April 28 primary.

Rep. Dan Williams (D., Chester) plans to introduce legislation to allow elections officials to   open votes submitted by mail  before the polls close. House Majority Leader Bryan Cutler (R., Lancaster)  previously said  this is a part of discussions with Gov. Tom Wolf to “clean-up” a comprehensive voting reform bill passed last year.

Workers’ Rights

A proposed state Senate bill would support workers while quarantined or in isolation during a public health emergency. Sen. Steve Santarsiero (D., Bucks) said in a  memo  to his colleagues that Pennsylvania does not have a law that addresses whether an employer can fire a worker under these conditions during a state of emergency.

A measure by Rep. Ed Neilson (D., Philadelphia) would provide  unemployment compensation for people who have been ordered to quarantine or isolate because of the coronavirus. His bill would not offer extended benefits to people who used paid time off or paid sick days during quarantine or isolation.

Federal

CMS Catastrophic Plan Coverage Guidance

Catastrophic coverage plans are generally prohibited from covering essential health benefits until a covered individual has met its deductible.  The U.S. Department of Health and Human Services has issued a notice informing plans that it will not enforce this provision as it relates to insurers amending their plans to provide pre-deductible coverage for services related to the diagnosis and treatment of COVID-19.  The full notice is available here.

CMS Medicaid and CHIP FAQ Released

The guidance describes the authority states have generally to respond to emergencies but has also been updated as of March 18 to include additional guidance specific to the response to COVID-19.  The updates generally provide additional clarity around telehealth.

There are also new sections on managed care flexibilities and 1115 waiver flexibilities, again generally focused on limiting the spread of person-to-person contact through the use of telehealth, remote monitoring, etc.  It is worth mentioning that this is federal guidance for state Medicaid programs so it describes what is possible but does not describe the actual conditions in any particular state.

The FAQ document is available here.

CMS Elective Surgery Guidance

CMS released guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures, in an effort to conserve critical resources such as ventilators and Personal Protective Equipment (PPE).  Decisions remain the responsibility of local health care delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients.  To help with that decision-making, CMS offered a tiered framework of procedures that should be considered for postponement, taking into account the location (outpatient department, ambulatory surgery center, or hospital), the hospital’s COVID-19 patient census, the patient’s acuity, and more.  Click here to read the full guidance.  Click here to read the CMS press release.

HRSA Data Collection Activities

The Health Resources and Services Administration (HRSA) will not be going through notice and comment periods for data collection activities for the remainder of the emergency.  Under this authority, HRSA launched an information collection effort to support the Trump administration’s response to the COVID-19 pandemic, surveying HRSA-funded health centers on their involvement in the COVID-19 response, including whether they are offering diagnostic tests.  The agency will have to comply with relevant provisions within 30 days of the end of the emergency declaration.  The announcement is available here.

CDC Alters Timeline to Implement New ICD-10 Code for Coronavirus (see attached)

The Centers for Disease Prevention and Control (CDC) is taking the unprecedented step of invoking the National Emergencies Act to supersede the schedule for updating the ICD coding set defined within HIPAA.  Under this authority, CDC is establishing an effective date of April 1, 2020 for the new code as opposed October 1 date that would have been required under the normal statutory update schedule.  The full text of the announcement is available here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

2020-03-20T09:54:40+00:00March 20th, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off on COVID-19 Update: March 19, 2020
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COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logoThe following is a summary of the major COVID-19-related developments in Pennsylvania today.

Telemedicine

The Office of Medical Assistance Programs has issued guidance for providers on the use of telemedicine  services for Medicaid patients – those covered both by managed care plans and on a fee-for-service basis. Learn more from the newly posted telemedicine guidelines and a separate memo to the HealthChoices managed care plans from the state.

In addition, CMS issued a waiver for certain restrictions on the provision of telemedicine services under the Medicare program.  The details of the wavier are described in a Fact Sheet and FAQ.

New Guidance From the State

Today the state published a number of COVID-19-related resources:

Letter from Department of Health Secretary

Attached to this memo, please find a letter and its attachment issued by the PA Department of Health providing additional hospital guidance on implementing your emergency preparedness plans.

PA Insurance Department Public Notice

You can find a preview copy of a pending public notice from the insurance department related to COVID-19 at this link.

PA General Assembly Update

Both the House and Senate are currently in recess with a 12-hour call of their respective chairs.  Neither chamber is expected to be in Harrisburg through the remainder of this week and we will likely receive an update on next week’s session schedule over the weekend.

The House passed temporary rules during session yesterday to allow its members to work and vote remotely should the need arise in the coming weeks/months.  This temporary rule still requires majority and minority leadership to be at the Capitol for bill movement and to tally votes.  The same is required of Committee Chairs should they call voting meetings during this time away from Harrisburg.

Daily State Briefing

  • Department of Health Secretary Levine reported that the state is now receiving more COVID-19 test results from commercial and hospital laboratories, which are now doing most of the testing.  As that number rises, the ability of officials to trace the origin of the disease is expected to decrease.
  • Mass testing sites for Philadelphia and Montgomery County are still being explored.  They would perform drive-through testing and would only be for people showing symptoms.
  • With state liquor stores about to close, state officials are planning to meet later today to discuss possible resources for alcohol-dependent individuals who suffer withdrawal problems.
  • The state will be providing guidance to dentists, who are considered very high risk, later this week.
  • No hospitals are reporting to the state that they are overtaxed by COVID-19 patients at this time.

Secretary Miller’s Briefing

DHS Secretary Teresa Miller is holding an invitation-only briefing later today.  If anything urgent arises we will let you know immediately.  Otherwise, we will report on it tomorrow.

Resources to Consult

 Pennsylvania Department of Human Services

Pennsylvania Department of Health

Centers for Disease Control and Prevention Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

 

 

 

2020-03-18T16:53:47+00:00March 18th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on COVID-19 Update: March 17, 2020
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  • 2020 Safety-Net Association of Pennsylvania

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

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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