Pennsylvania Medicaid Archives - Page 9 of 19 - Safety-Net Association of Pennsylvania

PA Health Policy Update for the Week of April 4-8

The following is an update of selected state health policy developments in Pennsylvania for the week of April 4-8, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session in Harrisburg this week.
The Senate passed House Bill 245 on third and final consideration this week. House Bill 245, which will be sent back to the House for concurrence, reduces the clinical residency requirement from three years to two years for an applicant who has graduated from an international medical college to receive licensure in Pennsylvania.
The state House and Senate will both be in session next Monday (4/11), Tuesday (4/12), and Wednesday (4/13).
As indicated by the House Republican Caucus “Week Ahead,” the House is planning to consider, among other bills, House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses, and House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
Several committee meetings are scheduled for next week. The following are health-related.
- The House Health Committee will hold an informational meeting on Tuesday, April 12 at 8:00 a.m. regarding “Opioids in the Commonwealth: Lessons learned and next steps.”

- The House Veterans Affairs and Emergency Preparedness Committee will meet on Tuesday, April 12 at 9:00 a.m. to consider House Bill 2097, which would make permanent a COVID-19 regulatory waiver that allows certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.

- The House Aging & Older Adult Services Committee will hold an informational meeting on Tuesday, April 12 at 9:30 a.m. to examine long-term-care facility workforce challenges.

- The Senate Health & Human Services Committee will meet on Tuesday, April 12 at 10:30 a.m. to consider the following bills.

- - Senate Bill 749, which seeks to provide clarity for employees and employers regarding current ambiguity in the state’s medical marijuana law concerning the use of medical marijuana in the workplace.
  - Senate Bill 1121, which requires the Department of Human Services (DHS) to verify wage records from employers and the Department of Revenue for Medicaid and SNAP beneficiaries.
  - Senate Bill 1124, which requires DHS to check death certificates at the Bureau of Vital Statistics against Medicaid and SNAP beneficiaries.
  - Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.

Department of Human Services

The Department of Human Services (DHS) has added two procedure codes to the Medical Assistance program fee schedule for use in laboratory testing for multiple respiratory pathogens, including COVID-19, effective with dates of service on and after March 21, 2022. Find the new codes in this Pennsylvania Bulletin notice.
DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a Medical Assistance Bulletin addressed to hospital emergency departments, county mental health/intellectual disability administrators, base service units, mental health review officers, and county crisis intervention programs to clarify the part of the Mental Health Procedures Act referring to the involuntary commitment process under section 302 and the 120-hour limit on holding a consumer for involuntary emergency examination and treatment. Find the bulletin here.
DHS has circulated the minutes of the March 24 meeting of the Medical Assistance Advisory Committee.
DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include February 22 data.
CMS has released its 2022-2023 Medicaid managed care rate development guide. This is a federal resource for states to use when setting capitation rates for Medicaid managed care plans. The guide provides details about information that must be included in states’ actuarial rate certifications for CMS to review and approve for rate periods between July 1, 2022 and June 30, 2023. Find the guide here.

Department of Health

The Department of Health (DOH) has introduced minor updates of its guidance for hospitals and health systems on “whether measures being implemented or contemplated are compliant with the statutory and regulatory requirements under the jurisdiction of the Department.” Among other things, the guidance cites June 30, 2022 as the end date for certain regulatory suspensions that were continued through that date by Act 14 of 2022. Find the updated guidance here.
DOH has updated its COVID-19 booster vaccine recommendations to reflect recent changes in CDC guidelines.
DOH has updated its reporting requirements for COVID-19 test results to bring them in line with revised federal requirements.
DOH has updated information about therapeutics to prevent and treat COVID-19 to reflect federal guidance barring the use of sotrovimab to treat COVID-19 because it is not effective in treating the Omicron BA.2 variant, which is the predominant COVID-19 variant in the country today.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the second consecutive week. The state’s seven-day average of new cases rose nearly 26 percent, from 585 cases on March 31 to 737 on April 7.
The number of new COVID-19-related deaths declined slightly, on the other hand, with the seven-day average of new deaths down by one, from 18 on March 31 to 17 on April 7.
The number of Pennsylvanians receiving hospital care for COVID-19, in hospital ICU units, and on ventilators because of the virus held steady over the past week.
After three weeks with no counties experiencing a high rate of transmission of COVID-19, two Pennsylvania counties found themselves in that category in the past week: Bradford and Pike. Another eight counties – Potter, Montgomery, Philadelphia, Adams, Susquehanna, Montour, Wayne, and Northampton – experienced substantial rates of community transmission. Five counties – up from three last week – experienced low levels of community transmission: Forest, Cameron, Snyder, Juniata, and Fulton. The remaining 52 Pennsylvania counties had moderate rates of community transmission over the past week. Find community transmission and other Pennsylvania-specific COVID-19 data here.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – April 12

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, April 12 at 10:00. To register to participate, go here. The dial-in number is 631-992-3221 and the access code is 766121118#.

Department of Aging – Pharmaceutical Assistance Advisory Board Virtual Meeting – April 13

The Department of Aging’s Pharmaceutical Assistance Advisory Board will meet virtually on Wednesday, April 13 at 8:30. For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30. The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00. To register to participate, go here.

jsteinbock2022-04-08T20:56:17+00:00April 8th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of March 28-April 1

The following is an update of selected state health policy developments in Pennsylvania for the week of March 28-April 1, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed into law Senate Bill 1019, which temporarily extends certain suspensions of regulations and statutes that were issued by agencies under the COVID-19 disaster declaration through June 30, 2022.

General Assembly

The House Health Committee convened on Tuesday, March 29 and favorably reported House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
The House Insurance Committee met on Tuesday and favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
The state Senate will be in session next Monday (4/4), Tuesday (4/5), and Wednesday (4/6). The House will be in recess next week.

Revenue Collection Update

The Independent Fiscal Office has released its March 2022 Revenue Update. General Fund collections for March were $579.2 million or 11.6 percent above estimate. Year-to-date General Fund revenue is $3.04 billion or 9.8 percent more than projected.

Department of Human Services

The Department of Human Services (DHS) has informed providers that effective Friday, April 1 at 12:00 a.m. the current Medical Assistance Provider Forms webpage will no longer be accessible. Instead, providers may order and receive Medical Assistance provider forms here. Find updated instructions here. DHS also offered the following explanation to stakeholders:

Over the next few months, the Department of Human Services (DHS) is transitioning web-based forms to a new enterprise solution. While we strive to provide a seamless transition, we understand there may be issues along the way. If you have any bookmarked links, they may no longer work. If you are trying to access an old link that no longer works, please go to https://www.dhs.pa.gov/docs/Publications/Pages/Express-Forms-Transition.aspx for a list of affected forms.

We understand that there may be confusion and issues that arise during this transition, and we appreciate your patience. If you identify a problem following the transition, please reach out to DHS’s Digital Communications Team at RA-PWDHSSOCIALMEDIA@pa.gov and we will assist you as we are able.

DHS has issued a Medical Assistance Bulletin advising providers that the Medical Assistance program is extending postpartum coverage from 60 days to 12 months beginning on April 1 and that this applies to all providers enrolled in the Medical Assistance program. Find the bulletin here.
As part of the response to the COVID-19 emergency, numerous state regulatory requirements were suspended by the legislature and DHS to facilitate an effective, timely response to the pandemic. Over time, some of those suspended requirements have been restored. DHS has updated its collection of regulatory requirements to reflect which suspensions remain in effect and which have been lifted. Find that compendium here.
DHS has posted a notice informing providers that the Provider Electronic Solutions software they may have used to submit HIPAA-ready transactions to the PROMISe system will not be supported after June 15 and urging them to use the PROMISe Provider Portal to submit claims, validate eligibility, conduct claim inquiries, and view their weekly remittance advice. Find that notice here.
DHS has posted a notice reminding Medical Assistance billing entities that federal law requires physicians and other practitioners who order, refer, or prescribe items or services for Medicaid beneficiaries to be enrolled in the Medical Assistance program and suggesting that billing entities remind unenrolled billing providers about this requirement. Find the notice here.
DHS has posted a notice reminding providers that the two percent Medicare sequestration imposed in 2013 and suspended in 2020 in response to the COVID-19 pandemic will be restored partially on April 1 and fully after July 1. Find that notice here.
DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include January 2022 data.
DHS has posted presentations delivered at the March 24 meeting of its Medical Assistance Advisory Committee (MAAC). See the presentations from:
The federal Centers for Medicare & Medicaid Services (CMS) has released an informational bulletin informing state Medicaid agencies that CMS is exercising enforcement discretion during the COVID-19 public health emergency regarding state submissions of updated Medicaid access monitoring review plans. CMS is delaying enforcement of the updated plans that are due by October 1, 2022 until October 1, 2024. Find the CMS informational bulletin here.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed slightly over the past week. On Wednesday, March 23 the state’s seven-day average of new cases was 574 cases a day; on March 31 it was 585 cases a day.
The number of new COVID-19-related deaths, on the other hand, fell by more than half over the past week, with the March 24 seven-day average of 37 deaths falling to 18 on March 31.
For the third consecutive week, no Pennsylvania counties are experiencing a high rate of community transmission. For the second consecutive week, just eight counties experienced a substantial rate of community transmission. Three counties – down from four last week – are experiencing a low rate of community transmission. The rest of the state – 56 counties – is experiencing a moderate rate of community transmission of COVID-19.
The number of Pennsylvanians receiving hospital care for COVID-19 fell significantly during March: the number hospitalized declined from 1356 on March 1 to 481 on March 31; the number being treated on a ventilator from 163 on March 1 to 54 on March 31; and the number in hospital ICUs from 252 on March 1 to 75 on March 31.

Department of Drug and Alcohol Programs

The departments of Drug and Alcohol Programs (DDAP) and Community and Economic Development have announced the availability of more than $1 million in grant funding for recovery houses to provide safe housing for individuals in recovery from a substance use disorder. The grants are designed to help existing recovery house facilities with physical upgrades to comply with all federal, state, and local laws and ordinances, including the Americans with Disabilities Act of 1990. Grants of up to $50,000 for a 12-month period beginning July 1, 2022 will be awarded to between 22 and 25 eligible applicants for health and safety upgrades including demolition, debris removal, rehabilitation improvements, environmental remediation costs, and construction and inspections to comply with DDAP’s regulations. Learn more from this Department of Drug and Alcohol Programs news release and go here for additional information about the grant program and the application process. There is no application deadline; applications will be accepted until all of the available money is spent.

In September of 2021, Governor Wolf signed into law Act 73, which extended three of DDAP’s temporary regulatory suspensions through March 31, 2022 in response to the COVID-19 pandemic. This week Governor Wolf signed Senate Bill 1019, which further extends DDAP’s regulatory suspensions that are “related to federal exemptions granted under the federal public health emergency declaration” until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” Three DDAP regulatory suspensions and a relevant Department of State regulation are included in this chart and also remain suspended. In November of 2021, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) announced that methadone take-home flexibilities will be extended for one year after the eventual expiration of the federal COVID-19 public health emergency. DDAP has submitted its written concurrence with this exemption. SAMHSA also has indicated that it is considering mechanisms to make this flexibility permanent. Narcotic treatment programs do not need to do anything additional at this time to continue taking advantage of this flexibility. Similarly, the U.S. Drug Enforcement Administration (DEA) also has announced that it is working to make its tele-prescribing regulations permanent.

Stakeholder Events

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues. To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m. Public comments will be taken after each presentation. Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation. There will be an additional period at the end of the meeting for additional public comments. Go here to register to participate.

Pennsylvania Long-Term Care Learning Network – Strategies to Reduce Hospitalizations and Emergency Room Visits – April 7

The Pennsylvania Long-Term Care Learning Network, part of DHS’s Quality Strategy for Nursing
Facilities, is holding a virtual webinar “Strategies to Reduce Hospitalizations and Emergency Room Visits” on Thursday, April 7 at 2:00 p.m. Go here to register to participate.

Department of Aging – Pharmaceutical Assistance Advisory Board Virtual Meeting – April 13

The Department of Aging’s Pharmaceutical Assistance Advisory Board will meet virtually on Wednesday, April 13 at 8:30 a.m. For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m. The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

jsteinbock2022-04-01T20:56:41+00:00April 1st, 2022|Coronavirus, COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of March 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of March 21-25, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration has announced how the state will spend $225 million in federal American Rescue Plan money appropriated through Act 2 of 2022 to support the health care workforce needs of hospitals and behavioral health providers. The money will be used in the following manner:
$100 million to be distributed to acute care, critical access, and children’s hospitals licensed by the Department of Health on a per-bed basis. The funding will be used strictly for recruitment and retention payments to direct care staff.
$110 million to be distributed on a per-bed basis to high-volume Medical Assistance hospitals, designated critical access hospitals, and inpatient and residential behavioral health facilities for recruitment and retention payments to key staff. In addition to their proportional share of the $100 million pool noted above, all SNAP member hospitals will share in this $110 million distribution as well.
$15 million to quadruple the funds available for the nurse loan forgiveness program at Pennsylvania Higher Education Assistance Agency (PHEAA), a high-demand program that received more than 20,000 applications by the March 1 deadline.

Learn more about the $225 million appropriation and how it will be spent from this Wolf administration news release and this list of funding recipients.

The governor’s office has published its regulatory agenda for 2022. The agenda, which is published semi-annually, is intended to provide the regulated community advance notice of regulations under development or consideration. Find the full regulatory agenda here.

General Assembly

The state House and Senate will return to Harrisburg for session next week. The House has scheduled a non-voting session day for Monday (3/28) and voting session for Tuesday (3/29) and Wednesday (3/30). The Senate is scheduled to be in voting session Wednesday (3/30).
The House Health Committee will convene on Tuesday, March 29 to consider House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
The House Insurance Committee will meet on Tuesday, March 29 to consider, among other bills, House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.

Department of Health

The Department of Health has expanded the Pennsylvania physician general’s standing order that enables people to go to pharmacies to obtain a dose of naloxone to include a form of eight milligram naloxone nasal spray. Members of the general public can print a copy of this standing order and present it at their local pharmacy to obtain naloxone. Learn more from this news release.

The Department of Health has issued a news release to remind stakeholders that there is a 30-day comment period for the proposed skilled nursing facility regulations it published on March 19. These proposed regulations include updates to align with federal regulations and expand the information that applicants for licensure must provide to operate a new facility or take ownership of an existing facility.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce the addition of two procedure codes, 87636 and 87637, to the Medical Assistance fee schedule for use in laboratory testing for multiple respiratory pathogens, including COVID-19. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin informing Medical Assistance providers that it has added CPT codes 90619 for the administration of the MenQuadfi® vaccine and 90697 for the administration of the Vaxelis® vaccine to the Medical Assistance fee schedule effective for dates of service on and after June 1, 2021. In addition, effective June 1, 2021 it has added MenQuadfi® and Vaxelis® to the list of vaccines available through the Department of Health’s Vaccines for Children Program. Find that March 21 bulletin here.
DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization. The revised handbook pages take effect on April 1. Find the bulletin here.
DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization. The revised handbook pages take effect on April 1 Find the bulletin here.
DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has updated guidance on its outpatient competency evaluation program for the psychological assessment by OMHSAS providers of incarcerated individuals awaiting adjudication. Learn more from this updated program memo and find a referral form and a rescind form that are part of the process described in the guidance.
DHS has updated its list of drug companies that participate in the state’s Medicaid drug rebate program. Find the revised list here.

COVID-19: By the Numbers

Daily COVID-19 case counts continue to fall in Pennsylvania. A week ago the state’s seven-day average of new cases was 750 cases a day; today (March 25) it is 625 cases a day.
The number of new COVID-19-related deaths is following the same downward trend: Pennsylvania’s seven-day average of deaths was 32 deaths a day a week ago but is 23 deaths a day today (March 25).
The decline in the number of Pennsylvania counties experiencing higher rates of community transmission of COVID-19 continues. For the second consecutive week, no counties are experiencing a high rate of community transmission. Last week, 21 counties were experiencing a substantial rate of community transmission; this week, just eight are. For the first time since the fall, some Pennsylvania counties – four of them (Forest, Snyder, Sullivan, and Cameron) – are experiencing a low rate of community transmission. The rest of the state – 55 counties – is experiencing a moderate rate of community transmission.
The number of Pennsylvanians hospitalized with COVID-19 has fallen 60 percent since March 1; the number in hospital ICUs because of the virus has fallen 63 percent since the beginning of the month; and the number being treated for the virus on a ventilator has fallen 69 percent since the first of the month and is at its lowest level since last July 29.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has created an informational flyer, suitable for posting in public places, with resources for individuals and their loved ones with substance use disorder, including QR code links to find treatment, order naloxone, and obtain educational materials.

Stakeholder Events

Department of Health – Advisory Health Board – March 31

The Department of Health’s Advisory Health Board will meet virtually on Thursday, March 31 at 10.00 a.m. to discuss programmatic and departmental activities. This meeting was a previously scheduled for March 16. For information about how to participate, see this Pennsylvania Bulletin notice, which has the original, superseded meeting date but still has the latest information on how to participate in the meeting.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m. The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy, and Critical Congenital Heart Defects subcommittees. Learn how to join the meeting in this Pennsylvania Bulletin notice.