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PA Health Policy Update for September 1

The following is an update of selected state health policy developments in Pennsylvania from August 28 – September 1.  (Some of the language used below is taken directly from state documents.)

Fiscal Year 2023-2024 Budget Update 

The state Senate convened for voting session Wednesday, August 30 and passed the remaining legislative piece of the Fiscal Year (FY) 2023-2024 budget – the Fiscal Code. House Bill 1300, which passed by a vote of 29-18, will now be sent to the House of Representative for consideration. A Fiscal Note outlining the provisions contained in the legislation can be found here. The Fiscal Code advanced by the Senate is not agreed to by House Democratic leaders and the House is currently not scheduled to return to Harrisburg until September 26. 

General Assembly

The House Commerce Committee will hold an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. The informational hearing will be held in Room 515 of the Irvis Office Building and will be livestreamed here.

The House Republican Policy Committee will hold a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” The hearing will be held at the Pennsylvania College of Technology in Williamsport and will be live streamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin advising providers of updates to the Medical Assistance (MA) program fee schedule as a result of the 2023 Healthcare Common Procedure Coding System (HCPCS) updates. DHS is also adding other procedure codes and making changes to procedure codes currently on the MA program fee schedule. These changes are effective for dates of service on and after September 5, 2023.
  • DHS has published Provider Quick Tip #268 to remind prescribers and providers that certain procedure codes and modifier combinations require prior authorization.
  • DHS has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule, which are a result of the 2023 HCPCS updates.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 716) regarding respiratory syncytial virus (RSV). The advisory provides important information about recommended monoclonal antibodies and recently approved vaccines for RSV. 

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

Pennsylvania Health Care Cost Containment Council – September 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a meeting at 10:00 a.m. on Thursday, September 7, 2023. The public is invited to participate. Contact rgreenawalt@phc4.org for participation instructions. 

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.

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 9

The following is an update of selected state health policy developments in Pennsylvania from June 5 – 9.  (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 AssemblyHouse Chamber of the State House

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

  • The House Human Services Committee held 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. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held a voting meeting Monday, June 5 and considered the following bills and resolution:
    • HB 1184, which extends the Act 92 COLA moratorium until December 2025. The bill was reported as committed.
    • HB 1300, which adds a member of the Pennsylvania Long-Term Care Ombudsman’s Office to the Pennsylvania Long-Term Care Council. The bill was reported as amended.
    • HR 77, recognizing the month of June 2023 as “Alzheimer’s and Brain Awareness Month” in Pennsylvania. The resolution was reported as committed.

A recording of the meeting can be viewed here.

  • The House Health Committee held 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. HB 106 was reported as amended along party lines and HB 754 was reported as committed. A recording of the meeting can be viewed here.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 6 and considered the following bills and resolution.
    • SB 514, which requires a blood screening for lead exposure of all children by the age of two. The bill was reported as committed.
    • SB 520, which addresses Medicaid coverage for Assisted Living Residences. The bill was reported as amended.
    • SR 120, which directs the Legislative Budget and Finance Committee to conduct a study on the financial impact to EMS providers due to non-reimbursement from Medicaid for “treat and release” services. The bill was reported as amended.

A recording of the meeting can be viewed here.

  • The Senate Health and Human Services Committee held a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. A recording of the hearing can be viewed here.
  • The House Human Services Committee held a voting meeting Wednesday, June 7 to consider HB 1305, to establish funding for Pennsylvania’s 988 Suicide and Crisis Lifeline. A recording of the meeting can be viewed here. 

The Senate now stands in recess until Monday, June 19. The House will return to Harrisburg Monday, June 12 for voting session. The following are selected health-related proceedings.

  • The House Insurance Committee will hold a voting meeting Monday, June 12 at 11:00am to consider HB 1050, requiring health insurers to cover preventive health care services without cost-sharing. The meeting will be held in Room 60 East Wing and will be live streamed here. The Insurance Committee will reconvene on Wednesday, June 14 to consider HB 1140, expanding access to contraceptives. The meeting will be held in Room B31 of the Main Capitol. 

Department of Health

  • The Acting Secretary of Health wrote to hospitals this week to explain that the Department of Health (DOH) order requiring hospitals to make daily reports of specific data regarding supplies and equipment, dated March 24, 2020, will be terminated effective June 9, 2023. CMS requirements for reporting will remain. View the secretary’s letter here.
  • DOH has issued updated guidance for health care settings on how to identify and report COVID-19 outbreaks originating within the facility.
  • DOH has issued a Health Advisory (2023 – PAHAN – 703) with currently available information regarding the status of the ongoing fungal meningitis outbreak and highlights interim recommendations for diagnosis and treatment.
  • DOH has issued a Health Advisory (2023 – PAHAN – 702) regarding poor air quality conditions resulting from wildfires in Canada and current weather conditions.
  • DOH has issued a Health Advisory (2023 – PAHAN – 699) regarding Pennsylvania’s 2023 West Nile Virus (WNV) season and notifying providers that the first WNV-positive mosquito pools of were identified in Delaware, Fayette, and York counties.

Department of Human Services

The Department of Human Services (DHS) announced this week it has “completely eliminated [the] backlog of Medicaid provider enrollment and revalidation applications.” Additional information may be found in this press release.

DHS has released the minutes of the Medical Assistance Advisory Committee (MAAC) meeting held on May 25, 2023. 

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Advisory Board – June 15

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Thursday, June 15, 2023, from 9 a.m. to 10:30 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here. 

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.

PA Health Policy Update for June 2

The following is an update of selected state health policy developments in Pennsylvania from May 29 – June 2.  (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 AssemblyHarrisburg, PA capital building

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 Aging and Older Adult Services Committee will hold a voting meeting Monday, June 5 at 11:00am to consider the following bills and resolution:
    • HB 1184, which extends the Act 92 COLA moratorium until December 2025.
    • HB 1300, which adds a member of the Pennsylvania Long-Term Care Ombudsman’s Office to the Pennsylvania Long-Term Care Council.
    • HR 77, recognizing the month of June 2023 as “Alzheimer’s and Brain Awareness Month” in Pennsylvania.

The meeting will be held in Room 205 of the Ryan Office Building and can be livestreamed 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 voting meeting Tuesday, June 6 to consider the following bills and resolutions.
    • SB 514, which requires a blood screening for lead exposure of all children by the age of two.
    • SB 520, which addresses Medicaid coverage for Assisted Living Residences.
    • SR 120, which directs the Legislative Budget and Finance Committee to conduct a study on the financial impact to EMS providers due to non-reimbursement from Medicaid for “treat and release” services.

The meeting will be held in Room 8E-A East Wing 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 Secretary of Health has issued two final orders temporarily scheduling xylazine as a schedule III controlled substance and nitazenes as a schedule I controlled substance. Following are the two final orders published in the Pennsylvania Bulletin.

View this press release issued by DOH for additional information about the Shapiro’s administration’s efforts to limit overdose deaths.

Department of Human Services

  • The Office of Long-Term Living (OLTL) has published a document with the public comments submitted to DHS as part of the re-procurement of the Community HealthChoices (CHC) program. Comments were submitted between March 6 and April 14, 2023. Find a summary of the CHC RFI public comments here.
  • DHS has issued a Medical Assistance (MA) Bulletin advising providers of the updates to the evaluation and management (E & M) procedure codes on the MA Program Fee Schedule, as a result of the 2023 Healthcare Common Procedure Coding System (HCPCS) updates. In addition, DHS is also making changes to E & M codes currently on the MA Program Fee Schedule. These updates are effective for dates of service on and after June 1, 2023.
  • DHS has issued an MA Bulletin advising providers that DHS is end-dating three procedure codes related to the COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023.
  • DHS has issued an MA Bulletin advising providers about certain billing updates for the provision of COVID-19 vaccine counseling-only visits for beneficiaries under the age of 21 when a COVID-19 vaccine is not administered.
  • DHS has issued an MA Bulletin advising providers about billing updates for the provision of vaccine counseling-only visits for beneficiaries under the age of 21 for pediatric vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit when no pediatric vaccines are administered. 

State Board of Medicine 

The State Board of Medicine issued final rulemaking relating to the application for temporary graduate perfusionist licenses. Find the final rule in this Pennsylvania Bulletin notice. 

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Advisory Board – June 15

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Thursday, June 15, 2023, from 9 a.m. to 10:30 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here.

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 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 12

The following is an update of selected state health policy developments in Pennsylvania from May 8 – 12.  (Some of the language used below is taken directly from state documents.) 

End of the COVID-19 Public Health Emergency Hospital building

  • CMS has released an updated frequently asked questions (FAQs) document regarding changes made to the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) by the Consolidated Appropriations Act 2023.
  • CMS has sent a memo to state Medicaid and CHIP programs about the end of the COVID-19 public health emergency and the COVID-19 national emergency and the implications for Medicaid and CHIP.  Find that memo here. 
  • The DEA has announced that the full set of telemedicine flexibilities for prescribing controlled medications that were established in response to the COVID-19 public health emergency will remain in place for six more months, through November 11.  During this period the DEA and HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) will continue to consider the flexibilities’ future.  Learn more from this DEA announcement, which includes a link to a Federal Register notice. 
  • DOH has notified health care providers the CMS waiver allowing for Temporary Nurse Aides (TNAs) ends with the Public Health Emergency on May 11, 2023. TNA’s who have not completed the testing by May 11, 2023 may become Nurse Aide Candidates by enrolling in an approved Nurse Aide Training Program. After May 11, 2023, nurse aide candidates will have four months to complete the required testing as long as they are enrolled in an approved nurse aide training program. Nurse aide candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here. 

General Assembly

  • The state Senate returned to Harrisburg on Monday, May 8 for voting session and is now recessed until Monday, June 5.
  • The House Aging and Older Adult Services Committee held an information meeting Wednesday, May 10, to receive updates from local Area Agencies on Aging and to discuss scams targeting older adults. A recording of the meeting can be viewed here.
  • The House Agriculture and Rural Affairs Committee will hold a public hearing on May 18 to discuss access to rural medicine and health care in Pennsylvania. The hearing will be held at the Carnegie Natural History Museum in Pittsburgh at 11:00 a.m. and will be livestreamed 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. 

Joint State Government Commission

The Joint State Government Commission issued a study on the use of contracted workers at Medicaid funded long-term care facilities, as authorized under Senate Resolution 288 of 2021. The study can be viewed here. 

Department of Health 

  • The Department of Health (DOH) issued an update (PAHAN – 694 – 05-11) with information regarding infection prevention and control for COVID-19 in health care settings based on changes made by the Centers for Disease Control and Prevention (CDC) on May 8, 2023.
  • DOH reminded nursing care facilities that June 1, 2023 is the deadline for submitting the MCARE Surcharge Invoice Payment.  The 2022-23 surcharge letters and invoices were emailed to administrators on March 3 and again on April 22.
  • DOH issued a notice that the Division of Home Health will have the following new address effective May 8, 2023 – 2525 North 7th Street, Harrisburg PA 17110. 

Department of Human Services 

  • The Office of Mental Health and Substance Abuse Services (OMHSAS) issued a bulletin clarifying the 120-hour timeframe for Section 302 emergency involuntary commitments in response to questions regarding the previous bulletin issued in November 2022. The OMHSAS Bulletin may be viewed here.
  • DHS published Provider Quick Tip #233 confirming the waiver of Prudent Pay will not end on May 11, 2023 with the COVID-19 Public Health Emergency (PHE). It will remain in effect until further notice.

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

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 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 7

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

General Assembly

  • The House and Senate Appropriations Committees will resume budget hearings next week. 
    • On Tuesday, April 11 at 10:00 a.m., the Department of Human Services will appear before the House Appropriations Committee. The hearing will be held in the House chamber and will also be live streamed here.   
    • On Wednesday, April 12 at 9:30 a.m., the Department of Human Services will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here. 
    • On Thursday, April 13 at 9:30 a.m., the Department of Health will appear before the Senate Appropriations Committee. The hearing will be held in Hearing Room 1 of the North Office Building and will also be live streamed here.   
    • A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.  
  • The House Health Committee will hold an informational hearing Wednesday, April 12 at 10:00 a.m. on prescription drug affordability boards. The hearing will be held in in Room 205 of the Ryan Office Building and will be live streamed here. 
  • The House Democratic Policy Committee will hold a public hearing Thursday, April 13 at 12:00 p.m. on black maternal health. The hearing will be held in Room G-50 of the Irvis Office Building and will be live streamed here. 
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 13 at 1:00 p.m. on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. The hearing will be held in Room 515 of the Irvis Office Building and will be live streamed here.
  • The state House and Senate are currently recessed.  They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings. 

Department of Health 

  • The Department of Health (DOH) published the Pennsylvania State Health Improvement Plan (SHIP) that outlines goals, objectives, and strategies to improve the health of Pennsylvania residents over the next five years. The 2023-2028 SHIP was developed in collaboration with the Healthy Pennsylvania Partnership, which is made up of nearly 300 health care professionals, associations, health systems, health and human services organizations, community collaborations, local public health agencies, and government agencies. 
  • DOH issued a health update reminding healthcare facilities, providers, and laboratories to have heightened awareness for C. auris in their patients and updating a previous alert with information on new confirmed cases in Cumberland, Erie, and Monroe counties.  C. auris has been detected in ventilator-capable skilled nursing facilities, long-term acute care hospitals, and acute care hospitals since the current outbreak began in March 2020.  Find more information in this Health Update.  
  • DOH has alerted providers and laboratories to current outbreaks of Marburg virus in Tanzania and Equatorial Guinea and recommends they consider Marburg virus in patients with recent travel to those areas.  Find details in the Health Alert here.  

Department of Human Services   

  • The Department of Human Services (DHS) announced the Centers for Medicare & Medicaid Services (CMS) approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) waiver amendment, which took effect April 1, 2023. Changes in the approved waiver include benefits counseling, home health aide services, nursing services, and occupational, physical, and speech and language therapy services. The current approved CHC Waiver can be found here
  • OLTL released a transition plan to phase out temporary changes to the CHC 1915(c) Waiver. Effective May 11, 2023, OLTL will phase out its emergency flexibilities to coincide with the end of the federal Public Health Emergency. 
  • DHS announced CMS has approved OLTL’s OBRA Waiver amendment, which took effect April 1, 2023, for home and community-based services. The current OBRA Waiver can be viewed here.
  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to notify dental providers enrolled in the Medical Assistance program that DHS will begin accepting the 2019 American Dental Association (ADA) Claim Form upon issuance of this bulletin and will no longer accept the 2012 ADA Claim Form for dates of service on and after June 1, 2023.
  • DHS released a Provider Quick Tip (#263) notifying providers about an electronic submission process for FFS 180-day exception requests and other claims requiring documentation will soon be available in the Promise Portal. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs and DHS jointly issued a bulletin to update the guidance in OMHSAS bulletin 06-03 dated February 10, 2006. This bulletin includes the definitions of co-occurring capable and co-occurring enhanced programs as set forth in The ASAM Criteria. The information may be used to assist SCAs, BH-MCOs, and treatment providers in identifying co-occurring capable and co-occurring enhanced programs and in referring individuals to those programs.  

Revenue Collection Update  

The Department of Revenue announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $499.4 million, or 8.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.3 billion, which is $1.1 billion, or 3.7 percent, above estimate.  

Around the State   

WHYY reported about the end of continuous Medicaid enrollment, beginning April 1, 2023, and how individuals can prepare for renewals.   

The Erie Times-News published an article about the drug-resistant fungus, Candida auris, which was found in a patient at a health care facility in Erie County.    

Stakeholder Events  

PHC4 – Data Systems Committee – April 10 

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Data Systems Committee meeting on April 10 at 10:00 a.m. Go here for additional information and details on how to participate.   

DOH – State Child Death Review Team – April 20 

The State Child Death Review (CDR) Team will hold a public meeting on Thursday, April 20 from 1:00 – 3:00 p.m. Go here for additional information and details on how to participate.  

DOH – Renal Disease Advisory Committee – April 21 

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 21 from 10:00 a.m. to 12:00 p.m. Go here for additional information and details on how to participate.  

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. 

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