SNAPShots

SNAPShots

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.

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

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.

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.

PA Health Policy Update for June 23

The following is an update of selected state health policy developments in Pennsylvania from June 20 – 23.  (Some of the language used below is taken directly from state documents.)

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. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings.

  • The Senate voted to confirm Governor Josh Shapiro’s nominees for the Department of Drug and Alcohol Programs, Dr. Latika Davis-Jones, and Pennsylvania Insurance Department, Michael Humphreys. A recording of the Senate Health and Human Services Committee confirmation hearing can be viewed here. A recording of the Senate Banking and Insurance Committee confirmation hearing can be viewed here.
  • The General Assembly passed SB 262, which requires the Maternal Mortality Review Committee to publish severe maternal mortality data. The bill will now be sent to the governor.
  • The House unanimously passed HB 1209 and HB 1407, which enable Pennsylvania to meet its obligations under the 1998 Master Settlement Agreement (MSA) with tobacco product manufacturers and ensure the state is able to continue receiving funds from the tobacco settlement for health-related programs.
  • The Senate adopted SR 46 to establish the Task Force on Women Veterans’ Health Care to study the health care and access issues facing women veterans.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which requires an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition. The bill was reported as amended, to include xylazine.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership. The bill was reported as committed.
    • SB 817, which creates a primary care workforce initiative for Federally Qualified Health Centers (FQHCs). The bill was reported as committed.

A recording of the meetings can be viewed here.

  • The House Human Services Committee held a voting meeting Wednesday, June 22 at 11:30am to consider HB 850, which requires the Departments of Health and Human Services to apply for a waiver if the U.S. Department of Agriculture’s Food and Nutrition Service creates and makes a waiver available to the states that would allow those receiving SNAP and WIC to use those programs for menstrual hygiene products. The bill was reported as amended. A recording of the meeting can be viewed here.

The House and Senate will return to Harrisburg for voting session Monday, June 26.

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to inform Medical Assistance (MA) providers that DHS has added CPT code 0174A to the MA Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July. Find the updated calendar here.
  • DHS has announced the proposed Nursing Facility Assessment Program details for FY 2023-24, including the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program. Find additional information in this Pennsylvania Bulletin notice. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume one of its annual analysis of the financial performance of Pennsylvania’s acute-care hospitals.  The analysis found that hospital total margins across the state decreased 7.59 percentage points in FY 22. Go here to find a PHC4 news release describing the agency’s report, the report itself, and a link to downloadable data from the report. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) submitted comments to the Department of Human Services on their regulation #14-543Protective Services for Adults. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

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. Go here for details on how 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.

2023-06-23T21:27:26+00:00June 23rd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 23

PA Health Policy Update for May 26

The following is an update of selected state health policy developments in Pennsylvania from May 22 – 26.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) has updated its 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. 

Governor Shapiro

On Thursday Governor Shapiro signed Executive Order 2023-09 directing the Department of Aging to prepare and develop a Master Plan for Older Adults, which will serve as a 10-year roadmap to meet the needs of Pennsylvania’s senior population and improve commonwealth services for older Pennsylvanians. Find additional information in this press release issued by the governor’s office. 

General Assembly 

The state House returned to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.

  • The House Health Committee held a voting meeting Monday, May 22 to consider, among several resolutions, HB 1131 sponsored by Representative Lisa Borowski, which would remove the requirement for counties to operate state health centers in counties establishing their own local health departments. The bill was unanimously reported as committed. A recording of the meeting can be viewed here.
  • The House Human Services Committee held a voting meeting Tuesday, May 23 to consider, HB 849 sponsored by Representative Mike Schlossberg, to allocate funding for the Behavioral Health Commission on Adult Mental Health’s recommendations for funding, and HB 931 sponsored by Representative Eddie Day Pashinski, to establish the Kinship Care Legal Assistance Grant Program, which was reported as amended. HB 849 was reported as amended and the amended text can be found here. A recording of the meeting can be viewed here.

The state House and Senate will return to Harrisburg for voting session Monday, June 5. The following are selected health-related proceedings.

  • The House Human Services Committee will hold a joint hearing with the House Veteran Affairs and Emergency Preparedness Committee Monday, June 5 on the next generation of emergency and mental health response. The hearing will be held at 10:30am in Room 140 of the Main Capitol and will be live streamed here.
  • The House Health Committee will hold a voting meeting Tuesday June 6 to consider HB 106, the Patient Safety Act, which sets nursing staffing ratios and HB 754, which provides a standard notice to each nursing home resident and their designated representatives at the time of their admission into a nursing home facility that they have the option of having legal representation to assist with the application for Medicaid benefits. The meeting will be held at 10:00am in Room 205 of the Ryan Office Building and will be live streamed here.
  • The Senate Health and Human Services Committee will hold a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. The hearing will be held in Room 8E-A East Wing and will be live streamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (2023 – PAHAN – 697) with information from the Centers for Disease Control and Prevention (CDC) regarding an outbreak of suspected fungal meningitis among U.S. patients hospitalized in Texas. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of certain procedure codes to the Medical Assistance (MA) program fee schedule for the administration of additional bivalent doses of the SARS-CoV-2 vaccines manufactured by Moderna and Pfizer. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced updates to the MA program fee schedule for evaluation and management (E&M) procedure codes, including making adjustments to the fees for some procedure codes. These updates are effective for dates of service on and after June 1, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes G0312 and G0315 to the MA program fee schedule for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and novel coronavirus (COVID-19) vaccine counseling only visits. Find additional information in this Pennsylvania Bulletin notice.
  • Materials from the May 24 meeting of the Consumer Subcommittee of the Medical Assistance Advisory Committee viewed here.
  • Materials from the May 25 meeting of the Medical Assistance Advisory Committee meeting may be viewed here. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) released its initial revenue estimate for FY 2023-2024. The IFO estimates General Fund revenues of $45.292 billion for FY 2023-2024, which is a 1.3 percent increase over the current fiscal year. Find the report and corresponding presentation here 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission posted the following final regulations for public comment.

Stakeholder Events

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for May 19

The following is an update of selected state health policy developments in Pennsylvania from May 15 – 19.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) has announced it will maintain 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. 

2023 Primary Election

Pennsylvania’s 2023 primary election was held on Tuesday, May 16.  In addition to judicial and municipal elections, Pennsylvanians in two legislative districts voted in a special election to fill vacancies in the state House of Representatives. Democrat Heather Boyd defeated Republican Katie Ford to represent the 163 Legislative District and Republican Michael Stender defeated Democrat Trevor Finn to represent the 108 Legislative District. The outcome of these two special elections enables the Democrats to maintain their one-vote majority in the House. 

General Assembly

  • The House Agriculture and Rural Affairs Committee held a public hearing on May 18 to discuss access to rural medicine and health care in Pennsylvania. A recording of the hearing can be viewed here.
  • The state House will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.
    • The House Health Committee will hold a voting meeting Monday, May 22 at 10:00am to consider, among several resolutions, HB 1131 sponsored by Representative Lisa Borowski, which would remove the requirement for counties to operate state health centers in counties establishing their own local health departments. The meeting will be held in Room G-50 of the Irvis Office Building and will be live streamed here.
    • The House Human Services Committee will hold a voting meeting Tuesday, May 23 at 9:00am to consider, HB 849 sponsored by Representative Mike Schlossberg, to allocate funding for the Behavioral Health Commission on Adult Mental Health’s recommendations for funding, and HB 931 sponsored by Representative Eddie Day Pashinski, to establish the Kinship Care Legal Assistance Grant Program. The meeting will be held in Room 523 of the Irvis Office Building and can be live streamed here.
  • The state Senate will return to Harrisburg for voting session Monday, June 5. 

Department of Health 

The Department of Health began to register Temporary Health Care Services Agencies (THCSA) this month, as directed by Act 128 of 2022.  THCSAs are entities engaged in the business of procuring temporary employment in health care facilities for nurse aides, registered nurses, licensed practical nurses, and direct care staff. The statute requires any person that owns or operates a THCSA to register annually with the department and provide a list of each separate location. An application, instructions, and additional resources can be found on the THCSA website.

Department of Human Services 

  • The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) May 25 meeting. 
  • Personal care homes and assisted living residences are reminded that after May 11, they should report any COVID-19 outbreaks through the department’s Reportable Incident and Condition form for reporting. If a facility experiences a significant outbreak, it can contact the regional licensing office and ongoing assistance with infection prevention and control is available through the LTC-RISE program.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June.  Find the updated calendar here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) met May 18 and considered the following health-related regulations:

Stakeholder Events

DHS – Medical Assistance Consumer Subcommittee – May 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on Wednesday, May 24 at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – May 25

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, May 25 at 10:00 a.m.  Go here to register to participate.

 

PA Health Policy Update for May 5

The following is an update of selected state health policy developments in Pennsylvania from May 1 – 5.  (Some of the language used below is taken directly from state documents.) 

Medicaid Eligibility Redetermination 

The Department of Human Services (DHS) published the first section of 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. 

Governor Shapiro

Governor Shapiro signed the first bill of his administration on Monday. Act 1, formerly Senate Bill 8, requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. View this press release for additional information.

The Shapiro administration announced today that all commonwealth agencies completed a comprehensive review of their respective licensing, certification, and permitting processes as directed in the governor’s January 31 executive order. The administration will now work to establish “efficient processing times” for all permits and licenses. 

General Assembly

  • The state House and Senate returned to Harrisburg on May 1 for voting session. Below is coverage of selected health-related proceedings.
    • The House Health Committee held a public hearing Tuesday, May 2 on HB 106, the Patient Safety Act, which sets nursing staffing ratios. A recording of the hearing can be viewed here.
    • Representative Jennifer O’Mara (D-Delaware), Representative Eddie Day Pashinski (D-Luzerne) and Senator Carolyn Comitta (D-Chester) held a press conference Wednesday on hospital closure reform. More information can be found here.
    • The House Republican Policy Committee held a public hearing Thursday, May 4 on hospital pricing transparency. A recording of the hearing can be viewed here.
    • The Senate voted to confirm Governor Josh Shapiro’s nominee for the Secretary of Aging, Jason Kavulich, this week. A recording of the confirmation hearing in the Senate Aging and Youth Committee can be viewed here.
    • The Senate Health and Human Services Committee held a voting meeting on Tuesday, May 2 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act. The bill was unanimously reported as committed.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events. The bill was unanimously reported as committed.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE). The bill was unanimously reported as committed.
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk. The bill was unanimously reported as committed.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams. The bill was unanimously reported as amended.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here.

  • The state Senate will return to Harrisburg for voting session Monday, May 8. The state House is recessed and will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.
    • The House Aging and Older Adult Services Committee will hold an information meeting Wednesday, May 10 at 10:00am to receive updates from local Area Agencies on Aging and to discuss scams targeting older adults. The meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here. 

Office of the Attorney General 

Attorney General Michelle Henry issued the following Frequently Asked Questions (FAQ) document regarding medication abortion and mifepristone access in Pennsylvania. 

Department of Health 

The Department of Health’s (DOH) Division of Newborn Screening and Genetics, with support of the Newborn Screening and Follow-up Technical Advisory Board, is proposing that Guanidinoacetate Methyltransferase (GAMT) deficiency screening be added effective January 1, 2024 to the supplemental conditions mandated for screening. Additional information can be viewed in this Pennsylvania Bulletin notice. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to increase the funding and amend the payment methodology for the COVID-19 disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for FY 2022-23. Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its intent to allocate funding and amend the qualifying criteria and payment methodology allocation for DSH payments to acute-care general hospital trauma centers. These payments will amount to $18.034 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its funding allocation for FY 2022-23 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance (MA) Program, and to provide financial relief to hospitals during the COVID-19 pandemic. Learn more from this Pennsylvania Bulletin notice.
  • DHS published updates to the Medical Assistance (MA) Program Fee Schedule for administration of a booster dose of the SARS-CoV-2 vaccine manufactured by Novavax. Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced the temporary extension of the Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. The APM will be extended beyond the end of the federal PHE to September 30, 2024. Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued an updated Provider Quick Tip (#263) regarding the electronic submission process in the PROMISe Portal for Office of Medical Assistance Fee-for-Service (FFS) and Office of Long Term Living (OLTL) 180-day exception requests and other claims requiring documentation.

Revenue Collection Update

The Department of Revenue announced Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $51.1 million, or 0.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $37.9 billion, which is $1.2 billion, or 3.3 percent, above estimate. 

Stakeholder Events

DOH – WIC Advisory Board – May 10

The WIC Program Advisory will meet on May 10 from 1:00 p.m. – 2:00 p.m. Additional information and details on how to participate can be viewed in this Pennsylvania Bulletin notice. 

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DOH – HIV Community Prevention Planning Committee – May 18

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, May 17 and Thursday, May 18. For information on how to participate, review this Pennsylvania Bulletin notice.

DHS – Medical Assistance Consumer Subcommittee – May 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on Wednesday, May 24 at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – May 25

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, May 25 at 10:00 a.m.  Go here to register to participate.

 

PA Health Policy Update for April 28

The following is an update of selected state health policy developments in Pennsylvania from April 24 -28.  (Some of the language used below is taken directly from state documents.) 

Medicaid Eligibility Redetermination 

Medicaid unwinding has officially begun, and recipients will begin to receive their renewal packets and additional communications from the Department of Human Services 90 days prior to their individual renewal date. Individuals can view their renewal dates in COMPASS and can begin the renewal application online up to 60 days early. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

General Assembly

  • The state House and Senate returned to Harrisburg on April 24 for voting session. Below is coverage of selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee held a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. A recording of the hearing can be viewed here.
    • The House Insurance Committee held a voting meeting on Monday, April 24 to consider, among other bills, SB 8 which requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The bill advanced from committee and received a unanimous vote on final passage in the House.  SB 8 will move to the Governor’s desk for his consideration upon signature in the Senate.
    • The Senate Veteran Affairs and Emergency Preparedness Committee held a voting meeting to consider SB 81, which codifies the ability for EMS providers to leave a dose of Naloxone with an on-scene caregiver. The bill now moves to the full Senate for consideration. A recording of the meeting can be viewed here.
    • The House Health Committee held an informational meeting Wednesday, April 26 on unregulated intoxicants and psychoactive substances. A recording of the hearing can be viewed  here.
    • The House Human Services Committee held a voting meeting Wednesday, April 26 to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse. The bill was reported without amendment.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits. The bill was re-referred to the House Health Committee.

A recording of the meeting can be viewed here.

    • The House Professional Licensure Committee held an informational meeting on the Bureau of Professional and Occupational Affairs. A recording of the meeting can be viewed here.
  • The state House and Senate will return to Harrisburg for voting session Monday, May 1. Following are selected health-related proceedings.
    • The House Health Committee will hold a public hearing Tuesday, May 2 at 9:30am on HB 106, the Patient Safety Act, which sets nursing ratios. The hearing will be held in Room 523 of the Irvis Office Building and can be live streamed here.
    • The Senate Health and Human Services Committee is holding a voting meeting on Tuesday, May 2 at 11:00 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE).
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement.

The meeting will be held in Room 8E of the East Wing and will be livestreamed here. 

Department of Health 

The Department of Health issued a Health Alert (PAHAN – 693-04-28) with updated recommendations regarding the Monovalent and Bivalent mRNA COVID-19 vaccines.

Department of Human Services

  • The Department of Human Services (DHS) issued a press release highlighting how the Shapiro administration has reduced the backlog for Medicaid provider enrollment from 34,682 applicants waiting more than 30 days to less than 8,500. The press release notes the backlog has been reduced by 75 percent in the administration’s first 100 days.
  • DHS has issued Provider Quick Tip (#263) with an update notifying providers that the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS) and the Office of Long Term Living’s 180-day exception requests and other claims requiring documentation is available in the PROMISe Portal.

Stakeholder Events

PHC4 –Executive Committee & Council Meeting – May 4

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting at 9:30 a.m. and a council meeting at 10:00 a.m. on May 4, 2023. Go here for additional information and details on how to register to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

PA Health Policy Update for April 21

The following is an update of selected state health policy developments in Pennsylvania from April 17 -21.  (Some of the language used below is taken directly from state documents.) 

Governor Shapiro

Governor Shapiro announced this week his administration submitted a notice of intent to temporarily add xylazine, commonly known as “tranq,” to the list of schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. This step is an effort to limit access to xylazine, which is increasingly being found in Pennsylvania’s illicit drug trade. The administration also intends to schedule nitazenes, a class of synthetic opioids, as a schedule I drug. 

General Assembly

  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 20 on The State Master Plan on Aging. A recording of the hearing can be viewed here.
  • The House Children and Youth Committee held a public hearing Thursday, April 20 on overcrowding in Pennsylvania’s Juvenile Detention Facilities. A recording of the hearing can be viewed here.
  • The state House and Senate will return to Harrisburg on Monday, April 24 for voting session. Following are selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee will hold a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. The hearing will be held in Hearing Room 1 of the North Office Building and will be livestreamed here.
    • The House Insurance Committee will hold a voting meeting on Monday, April 24 at 11:00 a.m. to consider among other bills, SB 8 which requires insurers to cover all costs associated for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The meeting will be held in Room B31 of the Main Capitol and will be livestreamed here.
    • The House Health Committee will hold an informational meeting Wednesday, April 26 at 9:00 a.m. on unregulated intoxicants and psychoactive substances. The hearing will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.
    • The House Human Services Committee will hold a voting meeting Wednesday, April 26 at 9:15 a.m. to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits.

The meeting will be held in Room 523 of the Irvis Office Building and will be livestreamed here.

    • The House Professional Licensure Committee will hold an informational meeting April 26 at 10:00am on the Bureau of Professional and Occupational Affairs. The hearing will be held in Room 140 of the Main Capitol and will be livestreamed here.

Department of Health

  • DOH reminded long-term care facilities that the obligation to report COVID-19 cases and deaths through the ERS will continue beyond the end of the federal PHE on May 11. These records are reportable within 24 hours of diagnosis. Only new cases should be reported and positive cases that later result in death should be amended rather than entered as a new data record.  Find details on the reporting process here.
  • DOH encouraged nursing care facilities to make every effort to help temporary nurse aides to schedule and complete the required exams to become permanent certified nurse aides as soon as possible. When the federal PHE ends on May 11, candidates will have four months to complete the required testing as long as they are enrolled in an Approved Nurse Aide Training Program and candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here 

Department of Human Services

  • The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) April 27 meeting. In advance of the meeting, DHS also issued a briefing document outlining proposed changes and clarifications to the 340B Drug Pricing Program.
  • DHS issued proposed regulations to strengthen and clarify the Adult Protective Services Act (Act 70). Implementation of Act 70 began in 2015 but has operated under agency guidance and contract amendments rather than formal regulation. Find additional information and the proposed regulations in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into late May.  Find the updated calendar here. 

Insurance Department

The Insurance Department issued a request for comments on a proposal to suspend the reinsurance program for the state-based insurance exchange, PENNIE®, and potentially replace it with a possible “state subsidy wrap.” Additional information on the proposal and details on how to comment may be found in this Pennsylvania Bulletin notice. 

Office of the Attorney General 

Attorney General Michelle Henry joined a coalition of seventeen other Attorneys General submitting a letter in support of the Federal Trade Commission’s proposal to prevent businesses from having employees sign non-compete agreements as a condition of employment. Find additional information in this press release. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) released the agenda for its May 18 meeting. Following are certain health-related regulations IRRC will consider.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

DDAP – Xylazine: A New Drug Additive – June 12

The Department of Drug & Alcohol Programs (DDAP) will host two additional sessions of “Xylazine: A New Drug Additive,” presented by Savage Sisters Recovery, in Harrisburg on June 12, 2023. Please visit the Training Management System for details and to register.

Go to Top