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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
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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
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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
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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
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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
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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
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PA Health Policy Update for September 15

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

Governor Shapiro 

The Shapiro administration announced on Monday, September 11 that the Department of Human Services will begin reviewing and updating the data used to set rates for home and community-based services for Pennsylvanians with intellectual disabilities and autism. Find additional information in the administration’s press release here. 

General Assembly 

  • The House Health Committee will hold a public hearing on Wednesday, September 20 at 9:30am on House Bill 1657, which amends the Clean Indoor Air Act. The legislation clarifies the definition of a workplace, expands the definition of smoking to include e-cigarettes, and gives all localities the ability to enact smoke-free ordinances that exceed minimum state standards. The hearing will be held in Room 523 of the Irvis Office Building and will be livestreamed here.
  • The state Senate will convene for voting session Monday, September 18 through Wednesday, September 20. The state House of Representatives will remain in recess next week. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers of the expansion of childhood nutrition and weight management services for Medical Assistance (MA) beneficiaries under 21 years of age. The expansion includes pharmacotherapy as a result of changes to coverage of obesity drugs and updated guidance from the American Academy of Pediatrics, as well as coding changes stemming from the 2023 Healthcare Common Procedure Coding System updates.
  • DHS has issued a Medical Assistance Bulletin advising providers of procedure code updates to the MA program fee schedule for the provision of pediatric shift care services provided by home health aides through home health agencies to MA beneficiaries under 21 years of age. The changes are effective with dates of service on and after October 1, 2023.
  • DHS has published Provider Quick Tip #269 to remind providers that they may bill for, and prescribers may order, certain incontinence products.
  • DHS has issued a Remittance Advice (RA) Alert notifying community support service providers of the Federal Financial Participation rate change for the new federal fiscal year, which begins on October 1, 2023.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 717) with important information for providers regarding severe Vibrio vulnificus (V. vulnificus) infections in the United States associated with exposure to coastal waters. Since May 2023, there have been three Pennsylvania residents with V. vulnificus infections, all of whom were exposed to coastal water in the days leading up to disease onset.

Department of Aging 

The Department of Aging has released a Master Plan for Older Adults White Paper, which is intended to serve as a reference guide for aging stakeholders and interested individuals as they formulate and submit comments for the state’s master plan for older adults. Additional information about the development of the state’s master plan for older adults and how to comment may be found here. 

Board of Nursing 

The State Board of Nursing has published proposed rulemaking regarding opioid prescribing and organ donation education for certified registered nurse practitioners (CRNPs). Find additional information in this Pennsylvania Bulletin notice. 

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 – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

2023-09-15T20:01:07+00:00September 15th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for September 15
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PA Health Policy Update for August 11

The following is an update of selected state health policy developments in Pennsylvania from August 7 – 11.  (Some of the language used below is taken directly from state documents.) 

General Assembly

The House Professional Licensure Committee held a public hearing Monday, August 7 on HB 1000, which seeks to provide prescription authority to psychologists who complete specialized training. A recording of the hearing can be viewed here. 

Department of Human Services

The Department of Human Services (DHS) has issued Provider Quick Tip #263 with updated information regarding the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS), Office of Long-Term Living (OLTL), and long-term care 180-day exception requests requiring documentation.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has reminded stakeholders that its application is still open for qualified entities to request funding to invest in technology and training for behavioral health telehealth providers. Organizations with 51 or more employees are ineligible. The application deadline is December 31, 2023. Learn more about this funding opportunity here. 

Department of Health 

The Department of Health (DOH) and the Department of Drug and Alcohol Programs (DDAP) have requested that organizations who plan to request fentanyl and xylazine test strips complete “pre-order” information here. DOH, DDAP, and the Commission on Crime and Delinquency are working to establish a new program that can provide organizations with a supply of test strips at no cost. Organizations that make a request through the pre-order form will be contacted when orders can be filled.

DOH has issued a Health Advisory (PAHAN – 714) notifying clinicians of recently identified variant influenza viruses (A H1N2v and A H3v) in the U.S. The advisory also contains diagnosis and reporting guidance for clinicians.  

Department of Aging

The Department of Aging has announced the state’s 52 Area Agencies on Aging (AAAs) will be hosting in-person listening sessions in all 67 counties to gather input on Pennsylvania’s Master Plan for Older Adults – a 10-year strategic plan designed to transform infrastructure and coordination of services for older Pennsylvanians.

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.

2023-08-11T18:45:22+00:00August 11th, 2023|long-term care, Medicaid Eligibility Redetermination , Pennsylvania Medicaid|Comments Off on PA Health Policy Update for August 11
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PA Health Policy Update for August 4

The following is an update of selected state health policy developments in Pennsylvania from July 31 – August 4.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update

Governor Shapiro signed House Bill 611 – the FY 2023-2024 General Appropriations Act – into law yesterday shortly after it was formally signed in the Senate and sent to his desk. The enactment of House Bill 611 will enable funding to be disbursed to, among other entities, county governments and school districts. The Governor and the General Assembly still need to finalize enabling legislation (i.e., code bills) in order for the budget to be fully enacted. Read more in this press release issued by the Governor’s office. 

General Assembly

The Center for Rural Pennsylvania held a public hearing on rural hospital and healthcare sustainability to explore difficulties facing rural hospitals and health systems. Details from the hearing, including the agenda and testimony, may be viewed here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin updating guidelines for the delivery of physical health services via telehealth. The bulletin applies to all providers enrolled in the Medical Assistance (MA) Fee-for-Service program.
  • DHS has issued Provider Quick Tip # 85 with information about the department’s Breast & Cervical Cancer Prevention & Treatment Program.
  • DHS has shared the following information from the Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting on August 2.

Centers for Medicare and Medicaid Services

CMS has issued new guidance to state Medicaid programs as they work to return to normal operations after the end of COVID-19 flexibilities. Specifically, this guidance announces an update of CMS’s policy regarding the end date for flexibilities approved in states’ section 1915(c) Home and Community-Based Services waiver Appendix K amendments.  Under CMS’s prior policy, these flexibilities were set to expire six months after the expiration of the COVID-19 public health emergency, but in this letter CMS explains that these flexibilities may remain in effect for a longer period of time.  

Department of Health 

The Department of Health (DOH) has recently issued two Health Advisories (PAHAN – 713 & PAHAN –711) alerting providers of possible measles exposure in Blair, Clearfield, and Montgomery Counties.

DOH has issued a Health Advisory (PAHAN – 712) notifying providers of a nationwide shortage of Penicillin G benzathine (Bicillin L-A®). 

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Counsel (PHC4) has announced it launched a new website. The new website, which is aimed at increasing consumer engagement, may be found here. 

Revenue Collection Update 

The Department of Revenue announced Pennsylvania collected $2.9 billion in General Fund revenue in July, the first month of the 2023-2024 fiscal year. Note, the July collection data does not include a comparison against anticipated amounts because the official estimate for the 2023-2024 fiscal year has not been certified. 

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.

2023-08-04T18:51:26+00:00August 4th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for August 4
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PA Health Policy Update for July 7

The following is an update of selected state health policy developments in Pennsylvania from July 3 – 7.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update 

The Fiscal Year (FY) 2023-2024 budget remains in flux. Earlier this week the House of Representatives voted to concur with the Senate-passed General Appropriations bill (House Bill 611) by a vote of 117-86. The vote occurred after Governor Shapiro issued a statement announcing his intent to line-item veto the full $100 million intended for the Pennsylvania Award for Student Success (or PASS) voucher program – an initiative adamantly opposed by House Democrats and among the chief points of contention leading to the budget impasse. House Bill 611 was subsequently signed in the House and is awaiting signature in the Senate before it can be sent to the governor.

It is unclear when the Senate will return to Harrisburg or when a final agreement between the various parties will be reached. Senate Republican leadership released a statement criticizing Governor Shapiro and indicating they will “continue to await legislative action by the House on the remaining budgetary components.” 

Governor Shapiro

Governor Shapiro held a press conference touting House Bill 611’s $45.5 billion spending plan and its critical investments in mental health, education, and law enforcement. The governor implored the Senate to return to Harrisburg and sign the bill so it can be sent to his desk. Governor Shapiro also urged the Senate Republicans and House Democrats to meaningfully engage and enact enabling legislation (Fiscal Code, etc.) that would allow the budget to be fully implemented.

Governor Shapiro signed SB 262 into law on Thursday July, 6, which is now known as Act 5 of 2023. Act 5 amends the Maternal Mortality Review Act to require the Maternal Mortality Review Committee to annually publish severe maternal mortality data. 

General AssemblyHouse Chamber of the State House

The House returned to Harrisburg this week for voting session and adjourned to the call of the chair, noting that they do not anticipate returning for voting session in the immediate future. The following are selected health-related proceedings.

  • The House Human Services Committee held a voting meeting July 5 to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The bill was reported as committed. A recording of the meeting can be viewed here.
  • The House passed HB 1515 to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments and HB 1218 which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bills now go to the Senate for consideration.
  • The House Aging and Older Adult Services Committee previously scheduled a voting meeting Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting was not held.

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. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin announcing its intent to reimburse health care providers for services rendered to Medicaid beneficiaries experiencing homelessness. Eligible services include but are not limited to, “primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder, and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.” DHS has updated the MA Program Fee Schedule accordingly. Find additional information in the department’s press release announcing the policy change.

  • DHS has announced it will require prior authorization of all prescriptions for Amyloid-Targeted Monoclonal Antibodies and certain drugs not included on the Statewide Preferred Drug List (PDL). These prior authorization requirements will apply to prescriptions dispensed on or after July 10, 2023.
  • DHS has provided final notice of its funding allocation for FY 2022-2023 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to general acute care hospitals. The department is not otherwise changing the qualifying criteria or payment methodology for these payments.
  • DHS has announced the end-dating of three procedure codes related to COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #267 with additional information regarding the department’s delayed implementation of Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals. 

Revenue Collection Update 

The Department of Revenue announced the commonwealth ended FY 2022-2023 with $44.9 billion in General Fund revenue collections, which is $1.3 billion, or 3.1 percent, above estimate.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published the public comments it received regarding DHS’ adult protective services proposed rulemaking. The comments may be viewed in this Pennsylvania Bulletin notice. 

Stakeholder Events

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 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 – Renal Disease Advisory Committee – July 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 21 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – August 3

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 3 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-07-07T20:27:07+00:00July 7th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for July 7
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  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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