Pennsylvania Medicaid Archives - Page 22 of 26 - Safety-Net Association of Pennsylvania

COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logo The 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.

PA Safety Net Admin2020-03-18T16:53:47+00:00March 18th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

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

Included in this month’s edition are articles about:

Governor Wolf’s proposed FY 2021 Medicaid budget.
Challenges Pennsylvania Medicaid recipients have encountered obtaining services from their HealthChoices managed care plan and how to address them.
Implementation of the federal “public charge” regulation and whom it does – and does not – affect.

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

PA Safety Net Admin2020-03-05T06:00:11+00:00March 5th, 2020|Federal Medicaid issues, HealthChoices, Pennsylvania Medicaid, Pennsylvania proposed FY 2021 budget|Comments Off

HealthChoices MCO Seeks to Address Social Determinants of Health

A managed care plan that participates in Pennsylvania’s Medicaid program is slowly dipping its toe into an effort to address the social determinants of health in Philadelphia.

United Healthcare, with 57,000 Medicaid members in the city, has placed six homeless members with multiple health problems into apartments in the city – it plans to add four more – and is spending between $1200 and $1800 a month on rent and wrapround services. Its theory: with one percent of the population accounting for 22 percent of annual health care spending nation-wide, helping some of that one percent could improve lives while saving a great deal of money.

Pennsylvania’s Department of Human Services has awarded nearly $9 million in grants since 2016 to groups attempting to address the social determinants of health and to help the more than 300,000 Medicaid participants in north Philadelphia.

Learn more about what United Healthcare is doing and why it is doing it in the Philadelphia Inquirer article “United Healthcare tackles homelessness as a root cause of poor health, and Philly is a test case.”

PA Safety Net Admin2020-02-25T06:00:04+00:00February 25th, 2020|Pennsylvania Medicaid, social determinants of health|Comments Off

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company.

MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could

…reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone. States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications.

Bookshelf with law books Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that

Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities reliant on state funding, including local governments and providers. States would need to find revenue or cost savings, either in Medicaid or elsewhere, to offset reduced federal contributions.

Because Pennsylvania safety-net hospitals care for more Medicaid patients than the typical hospital, both proposed policy changes have a potentially greater impact on them.

Last month SNAP conveyed its opposition to the proposed MFAR regulation in a formal comment letter to the Centers for Medicare & Medicaid Services in response to the regulation’s publication late last year. Pennsylvania Governor Tom Wolf has already rejected the idea of using block grants in the state’s Medicaid program.

Learn more about the potential impact of the proposed Medicaid fiscal accountability regulation and Medicaid block grants in the Fitch Ratings analysis “Fitch Rtgs: Medicaid Changes Will Affect States, NFP Healthcare Providers.”

PA Safety Net Admin2020-02-20T06:00:08+00:00February 20th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Wolf Administration Proposes New Human Services Initiatives for FY 2021

New human services efforts to support vulnerable populations are a major part of Governor Tom Wolf’s proposed $36.06 billion FY 2021 budget for Pennsylvania.

The proposed budget, presented to the state legislature earlier this week, includes the following new initiatives:

creating pathways to success in the workforce for low-income Pennsylvanians
increasing the minimum wage to $15
increasing Department of Human Services staffing to support licensing and oversight
supporting adults in long-term-care facilities
legal services for vulnerable populations
direct care worker comprehensive training
commitment to performance-based metrics, accountability, and transparency in services and licensing
supporting vulnerable populations through home- and community-based services and reducing waiting lists
prevention services to support at-risk families
improving food security while supporting agriculture

Go here to see DHS’s presentation of these initiatives.

In addition, the Safety-Net Association of Pennsylvania has prepared a detailed memo describing the proposed FY 2021 budget’s implications for Pennsylvania safety-net hospitals and the state’s Medicaid program. For a copy of this memo, use the “contact us” link in the upper right-hand corner of this page.

PA Safety Net Admin2020-02-07T06:00:38+00:00February 7th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2021 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2020 newsletter.

Included in this month’s edition are articles about:

the transition to a new Medicaid prescription drug list (PDL);
the rollout of a new electronic visit verification system for Medicaid-paid home health services; and
progress in the state’s effort to introduce major changes in its Medical Assistance transportation program (MATP).

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

PA Safety Net Admin2020-02-05T06:00:12+00:00February 5th, 2020|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Says No to Medicaid Block Grants

Pennsylvania is not interested in pursuing the new Medicaid block grants being offered by the administration, leading state officials said last week.

In a news release, Governor Wolf said that

I expanded Medicaid in Pennsylvania to allow for more than 700,000 people to have reliable health care access. Pennsylvania will not go backwards. I will not risk jeopardizing our progress by going along with another short-sighted, insensitive plan to cut Medicaid…

Department of Human Services Secretary Teresa Miller, who oversees the Pennsylvania Medicaid program that serves approximately 2.8 million people, echoed this sentiment:

Changing any part of Medicaid to a block grant structure is the federal government permitting states to grow health inequities experienced by the poorest Americans. This cruel policy will directly target people who have the most opportunity to see their life and circumstances improved by consistent access to necessary health care and will keep people trapped in the cycle of poverty.

Learn more about why Pennsylvania will not pursue a Medicaid block grant in the Wolf administration news release “Pennsylvania Will Not Participate in Trump Administration Scheme to Cut Medicaid.”

PA Safety Net Admin2020-02-04T06:00:35+00:00February 4th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its November-December 2019 newsletter.

Included in this month’s edition are articles about:

Changes in care coordination in the Community HealthChoices program in southeastern Pennsylvania beginning on January 1.
Changes in the delivery of Medicaid-covered intensive behavioral health services in homes, schools, and the community for children and adolescents.
The switch from Medicaid to Medicare as primary payer for medication-assisted treatment for opioid use disorder for dually eligible (Medicare and Medicaid) patients.
Pennsylvania’s request for a delay in implementation of electronic visit verification for Medicaid-covered personal assistance services and home health aides.
The delay in implementation of the new public charge rule and its implications for taking advantage of Medicaid benefits among potentially affected individuals.

Read about these subjects and more in the Pennsylvania Health Law Project’s November-December newsletter.

PA Safety Net Admin2019-12-23T06:00:51+00:00December 23rd, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Medicaid DSH Cut Delayed

Scheduled cuts in Medicaid DSH payments to hospitals will be delayed until at least late May under new federal spending legislation.

The cuts in Medicaid disproportionate share allotments to the states, mandated by the Affordable Care Act and delayed several times by Congress – including twice in FY 2020 alone under continuing resolutions to fund the federal government – are among a number of so-called “extenders” included in spending bills passed by Congress this week and sent to the president for his signature.

Authorization for delaying the cut in allotments to the states, which would have resulted in reduced Medicaid DSH payments for many hospitals – including private safety-net hospitals – would expire on May 22. Congress is expected to address Medicaid DSH, along with surprise medical bills, the price of prescription drugs, and other health care matters, before that time.

SNAP has argued against Medicaid DSH cuts for a number of years, doing so most recently in an October 2019 message to members of Pennsylvania’s congressional delegation in which it wrote that

Should the Medicaid DSH cut take effect, Pennsylvania would lose 40 percent of its federal Medicaid DSH allotment in FY 2020 and 80 percent of its allotment each year from FY 2021 to FY 2025. Such devastating cuts could jeopardize access to care for the state’s uninsured and jeopardize the ability of the state’s safety-net hospitals to serve them. It is essential, for the sake of Pennsylvania’s health care safety net and the communities and patients that safety net serves, that the Medicaid DSH cut continue to be delayed.

Learn more about the delay in Medicaid DSH cuts and other aspects of this recent health care spending legislation in the Becker’s Hospital Review article “Congress unveils $1.3T spending deal: 5 healthcare takeaways.”

PA Safety Net Admin2019-12-19T06:00:58+00:00December 19th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid|Comments Off

DHS Unveils Strategic Plan

Pennsylvania’s Department of Human Services has a new strategic plan for 2019 through 2022.

While DHS’s area of endeavor is broad and goes beyond health care, Medicaid is an important aspect of its work and that importance is reflected in the plan, which includes descriptions of DHS’s ambitions in the following areas:

Provide every child with a strong foundation for physical and behavioral well-being
Bend the health care cost curve
Drive innovative whole-person care
Holistically assess needs and connect to resources
Address the social determinants of health
Expand health care beyond the doctor’s office and into the places people live, work, and play
Coordinate physical health care, behavioral health care, and long-term services and supports
Promote health equity
Lead the health care system toward value-based purchasing coordinated across payers
Serve more people in the community
Enhance access to health care and services that help Pennsylvanians lead healthy, productive lives
Coordinate services seamlessly across programs and agencies
Expand services and supports for individuals with mental illness
Expand services and supports for individuals with substance use disorder

Learn more about what Pennsylvania has in mind for its Medicaid program in the coming years, and for the Pennsylvania safety-net hospitals that serve so many participants in that program, by reading DHS’s new strategic plan for 2019 through 2022.

PA Safety Net Admin2019-11-14T06:00:50+00:00November 14th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

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