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DHS Unveils Strategic Plan

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

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

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

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

2019-11-14T06:00:50+00:00November 14th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on DHS Unveils Strategic Plan

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its October 2019 newsletter.

Included in this month’s edition are articles about:

  • the state’s release of a request for applications for insurers to serve participants in Pennsylvania’s HealthChoices physical health care program
  • Pennsylvania’s new Medicaid preferred drug list
  • legislation to expand the state’s Medical Assistance for Workers Program
  • the expansion of the state’s Living Independence for the Elderly (LIFE) program to 14 new counties over the next 18 months.

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

2019-11-13T06:00:20+00:00November 13th, 2019|HealthChoices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Law Project Newsletter

PA Slams Brakes on Medicaid Transportation Program Overhaul

The plan to introduce major changes in Pennsylvania’s free medical transportation program for the Medicaid population has temporarily been halted.

As envisioned by the state, the current program, in which individual counties contract independently with transportation providers to serve their residents on Medicaid, was to be replaced by a regional approach in which the state contracts with three vendors to serve all of Pennsylvania.  Objections by members of the state legislature and county officials, however, led to legislation that requires the Department of Human Services, Department of Transportation, and Department of Aging to study the implications of such a change for patients and taxpayers and to report their preliminary findings to the legislature in September.

Learn more about Pennsylvania’s Medical Assistance Transportation Program, how it works now, how the state sought to change it, and what to expect in the near future in the Philadelphia Inquirer article “Overhaul of PA’s medical transport program on hold after counties raise concerns.”

 

2019-08-06T06:00:31+00:00August 6th, 2019|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Slams Brakes on Medicaid Transportation Program Overhaul

Change Coming to PA’s Medicaid Transportation Program

Pennsylvania’s Medicaid transportation program will soon be undergoing major change.

By law, states must provide free non-emergency medical transportation for their Medicaid recipients.  The Pennsylvania Medical Assistance Transportation Program has fulfilled that mandate for the past 35 years, with county governments shouldering primary responsibility for providing or arranging for the transportation for their Medicaid-covered residents.

Under a plan adopted by the Pennsylvania Department of Human Services, which administers the state’s Medicaid program, that would change, with the state currently reviewing proposals from private vendors that would serve as brokers and assume this responsibility for large sections of the state:  the eastern, central, and western parts of Pennsylvania.

Changing the program in this manner would enable Pennsylvania to change the classification of medical transportation from an administrative cost to a service cost, which would drawn down more federal Medicaid matching funds and save the state about $10 million a year.

Learn more about what the state is doing, why it is doing it, and why some people believe the new approach may be more expensive and less effective in the Philadelphia Inquirer article “As changes come to Pa. Medicaid transportation program, counties fear bumps in road.”

 

2019-06-13T06:00:53+00:00June 13th, 2019|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on Change Coming to PA’s Medicaid Transportation Program

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its March-April 2019 newsletter.

Included in this month’s edition are articles about:

  • The launch of a new tool to determine applicants’ eligibility for Medicaid-covered long-term services and supports.
  • An update on Medicare Part D payment problems that affect some dually eligible Medicare/Medicaid patients.
  • Highlights of the state’s Department of Human Services budget (including Medicaid).
  • An update on the status of the Affordable Care Act.

Go here for articles about these and other subjects.

2019-05-01T11:54:17+00:00May 1st, 2019|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2020 budget|Comments Off on PA Health Law Project Newsletter

New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

The Pennsylvania Department of Human Services has issued a new Medical Assistance Bulletin titled “Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans.”
According to the document,

The purpose of this Medical Assistance (MA) Bulletin is to remind hospitals of the requirements for the Hospital Uncompensated Care Program (Program) and reinforce the responsibility of hospitals to actively engage patients when determining eligibility for the Program.

See the entire Bulletin here.
 

2018-01-08T06:00:47+00:00January 8th, 2018|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on New Medical Assistance Bulletin Addresses Hospital Uncompensated Care

PA Medicaid Director Honored

Leesa Allen, deputy secretary of the Pennsylvania Department of Human Services’ Office of Medical Assistance Programs and state Medicaid director, has been appointed to the board of directors of the National Association of Medicaid Directors.

See the Wolf administration’s news release about Ms. Allen’s appointment here.

2017-09-20T06:00:15+00:00September 20th, 2017|Pennsylvania Medical Assistance|Comments Off on PA Medicaid Director Honored

Governor Proposes FY 2018 Budget

On Tuesday Pennsylvania Governor Tom Wolf unveiled his proposed FY 2018 budget to the state’s General Assembly.
This budget proposal includes a number of provisions with potential implications for Pennsylvania’s safety-net hospitals.
The Safety-Net Association of Pennsylvania has prepared a detailed review of those provisions. Officials of safety-net hospitals who would like to receive a copy of this memo may request one by using the “contact us” link on the upper right-hand corner of this screen.
Find a news release from the governor’s office that outlines the proposed budget here and go here (scroll to the bottom of the screen) for links to budget overviews, the entire budget itself, the Wolf administration’s presentation on its plan to consolidate Pennsylvania’s Department of Human Services, Department of Health, Department of Aging, and Department of Drug and Alcohol Services into a single new Department of Health and Human Services, and other related materials.
 

2017-02-10T06:00:00+00:00February 10th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2018 budget|Comments Off on Governor Proposes FY 2018 Budget

PA Announces Hospital Quality Incentive Program

Pennsylvania’s Medicaid program has announced plans to launch a new hospital quality incentive program that will focus on measuring preventable hospital admissions and will reward hospitals that improve their performance.
The program, part of a larger effort by the state to move away from volume-driven Medicaid payments and toward a greater focus on value and population health, will measure and reward incremental improvement in reducing preventable admissions and achieving the 25th or 50th percentile benchmark of a state-wide preventable event rate. Hospitals that meet their objectives will qualify for bonus payments from the state funded by proceeds from Pennsylvania’s state-wide hospital assessment.
healthchoicesHealthChoices, Pennsylvania’s Medicaid managed care program, seeks to purchase 7.5 percent of Medicaid services through value-based purchasing arrangements in calendar year 2017, 15 percent in 2018, and 30 percent in 2019. The Hospital Quality Incentive Program seeks to facilitate achieving these goals.
The Pennsylvania Department of Human Services has posted on its web site an explanation of the new program, a presentation on the program, and an FAQ. Find them here.

2016-08-18T06:00:42+00:00August 18th, 2016|HealthChoices PA, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Announces Hospital Quality Incentive Program

Hepatitis C Treatment Challenges PA’s Medicaid Program

The cost of treating Medicaid patients who suffer from hepatitis C is posing a challenge to Pennsylvania’s Medicaid program.
As new, more expensive, but more effective hepatitis C drugs reach the market, the state’s costs for treating Medicaid patients with the disease have doubled since 2013.
Meanwhile, the state continues to consider at what point in the progression of their hepatitis C Medicaid patients should be offered the most expensive drugs.
Prescription Medication Spilling From an Open Medicine BottleCurrent guidelines are evolving both in the state and nationally, with medical authorities and federal regulators weighing in with their views. Recently, an advisory committee to the Pennsylvania Department of Human Services offered its own recommendations for criteria for prescribing the most expensive drugs.
Learn more about the issue, the cost of treatment, and current Pennsylvania Medicaid policy on when hepatitis C patients must be offered the most expensive drugs and how that policy might be changing in this Pittsburgh Post-Gazette article.

2016-06-14T11:23:40+00:00June 14th, 2016|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Uncategorized|Comments Off on Hepatitis C Treatment Challenges PA’s Medicaid Program
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