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PA Health Policy Update for October 31

The following is an update of selected state health policy developments in Pennsylvania from October 27- October 31 (Some of the language used below is taken directly from state documents). 

Budget Update

In a hopeful sign, top legislative leaders have met daily with the Governor and key staff throughout the week. The House and Senate are both set to return on November 17th. As negotiations continue, school districts and counties are adjusting services and payments to navigate the impasse.

General Assembly

During this week’s session, the House unanimously passed Rep. Ben Sanchez’s HB 446, allowing patients to take home unused medications following a hospital stay. The House also passed HB 1828, vaccine coverage and access legislation offered by Rep. Arvind Venkat, by a margin of 104-99. Both bills now move to the Senate for consideration.

The House Professional Licensure committee advanced Sen. Rosemary Brown’s SB 507. This legislation would update and modernize midwifery services in Pennsylvania.

The Senate Health & Human Services Committee voted to advance SB 270 and SB 614. Senator Amanda Cappelletti’s SB 270 would restrict online sales of human donor milk. SB 614, Chairwoman Michele Brooks’ legislation on FQHC Preceptors, was amended to limit the program to only rural areas.

The Senate Institutional Sustainability and Innovation Committee met to consider HB 157, SB 804, and SB 998. Rep. Kathy Rapp’s HB 157 would create a Rural Health Care Grant Program within the Department of Health. Senate Bill 804 from Sen. Boscola would prohibit toxic additives in IV Bags and medical equipment. Senate Bill 998, introduced by Rep. Rosemary Brown, would create a Nursing Education Capacity Expansion Grant Program within the Department of Community & Economic Development.

The House Health Committee held an informational meeting on the Department of Health’s Newborn Screening program on October 28th where Rep. Sailsbury’s House Bill 1652 was discussed. This legislation would add Gaucher Disease to the Newborn Screening program.

The Senate State Government Committee held a hearing to discuss SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

The House Human Services Committee amended and advanced House Bill 1974 by Rep. Venkat. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee voted out HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

Rep. Danielle Friel Otten released a co-sponsor memo for legislation to require coverage of obesity treatments.

Rep. Wendy Fink introduced HB 1997 which allows autologous or directed blood donations for certain medical procedures.

Department of Human Services

The Department issued several changes to the MA Fee Schedule, adding procedure codes, prior authorization requirements, and changing units and limitations on procedure codes.

State Board of Nursing

The State Board of Nursing issued final form regulations effective upon today’s publishing in the PA Bulletin, but with provisions relating to organ & tissue donation taking effect May 1, 2026.

Independent Regulatory Review Commission

IRRC will consider DHS’ proposed Covered Outpatient Drugs Regulation at their November 20th public meeting. 

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19th and Thursday November 20th both from 9am-3pm.

DOH’s Infant Hearing Screening Advisory Committee will meet on Thursday Nov. 13th from 10am – Noon.

DOH’s Spinal Cord Research Advisory Committee will meet on Friday Nov. 7th from 8:30am – 9:30am. 

Federal Update

Click here for a review of this week’s federal activities.

2025-10-31T18:57:20+00:00October 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for October 31

PA Health Policy Update for October 24

The following is an update of selected state health policy developments in Pennsylvania from October 20- October 24 (Some of the language used below is taken directly from state documents).

Budget Update 

Earlier this week, the Senate passed Senate Bill 160 (PN 1258) by party line vote in yet another volleying of a General Appropriations Act bill to the House. The Senate’s amendments to the bill reduced the overall spend number to $47.9 billion, down from the House’s last proposal of $50.25 billion.

The bill reflects a prior version (PN 529) of the budget bill but with increased appropriations for debt service payments and school employees’ pensions, while also reducing operating expense line items for the General Assembly. The Governor labeled the Senate’s most recent effort as “unserious.”

As the impasse continues, meaningful impacts to Pennsylvanians and providers are becoming more frequent. Absent budget enactment, Head Start providers are signaling closures, Westmoreland County plans to furlough workers soon, and Lancaster County intends to pause social services payments.

The House and Senate are both set to return on October 27th.

General Assembly 

Last week, the Senate was in session and passed by a margin of 49-1, Sen. Rosemary Brown’s SB 507, legislation to update and modernize midwifery services in Pennsylvania. The bill will be considered by the House Professional Licensure Committee on October 28th.

The Senate Labor & Industry Committee voted in support of SB 69 offered by Sen. Langerholc by a party line vote. This bill would create a “Recovery-to-Work” pilot program.

Next week, on October 28th, the House Health Committee will hold an informational meeting on the Department of Health’s Newborn Screening program.

On October 29th, the House Human Services Committee will meet to consider Rep. Benham’s HB 1939, and House Bill 1974 by Rep. Venkat. HB 1939 would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee will meet on October 29th to vote on HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

On October 27th, the Senate State Government Committee will consider SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

  • Marla Brown introduced HB 1962 which would cease state funding for any provider offering abortion services in PA.
  • HB 1965, introduced by Rep. Ryan Bizzarro, would allow EMS providers to perform community paramedicine services.
  • Paul Takac introduced HB 1980 which would require doctors to do an hour of medical nutrition continuing education every two years.
  • Mastriano introduced SB 1018 which would eliminate any mRNA vaccine mandates in Pennsylvania.
  • SB 1041 by Sen. Rosemary Brown would create the Complex Care Assistant Program, creating a certification program for family caregivers offering complex medical care to loved ones.
  • Senator Tartaglione introduced SB 1054 which would require the availability of opioid antagonists in Pennsylvania public schools.
  • Senator Collett has introduced SB 1055, companion legislation to HB 1881, which would expand pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines.

Department of Human Services

The Department of Human Services released September’s Physical Health Managed Care enrollment report.

Department of Health 

In response to revised CMS guidance on conducting facility surveys during the federal shutdown, which will allow states to request approval from CMS to conduct revisit surveys, DOH notified providers that it will be reviewing outstanding surveys, their timelines, and the deficient practice(s) to request permission from CMS to perform revisit surveys that are necessary to prevent termination or the denial of payment for new admissions.

DOH updated the Resident Data Reporting Manual for long-term care facilities to reflect changes to use the Patient Driven Payment Model (PDPM) for the Pennsylvania case mix payment system.

Stakeholder Meetings

On Nov. 7 from 10am to 3pm, the Brain Injury Advisory Board will hold their quarterly meeting to discuss the Department of Health’s Head Injury Program.

Federal Update 

Click here for a review of this week’s federal activities.

2025-10-24T19:20:42+00:00October 24th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for October 24

PA Health Policy Update for October 17

The following is an update of selected state health policy developments in Pennsylvania from October 14- October 17 (Some of the language used below is taken directly from state documents).

Budget Update 

The budget process has remained at a stalemate this week with no changes following House action last week. The Senate is scheduled to return this upcoming week. The House is set to return on October 27th.

General Assembly

Rep. Melissa Shusterman introduced HB 2005, which would remove the counseling and waiting period requirements for abortions in Pennsylvania. This legislation along with several other abortion-related bills will be considered by the House Judiciary Committee on October 22nd.

The Senate Labor & Industry Committee will convene on October 22nd to consider  Sen. Wayne Langerholc’s SB 69, which would create a “Recovery-To-Work” pilot program.

Rep. Jessica Benham introduced HB 1939, which would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index.

Senator Michele Brooks introduced SB 1043 and SB 1051, both designed to strengthen Pennsylvania’s eligibility for new federal Rural Health Transformation Fund dollars. The funding application offers states additional points in their total application score if they have adopted certain policy priorities of the Trump Administration or introduced legislation to do so. SB 1043 would require nutrition continuing medical education (CME) for clinicians to ensure providers are better equipped to address diet-related chronic disease. SB 1051 would require PA to join the Physician Assistant Licensure Compact to expand our rural workforce by making it easier for PAs from other states to practice in Pennsylvania.

Sen. Brooks also introduced SR174, which would urge Congress to establish a national database or  system to share wage, employment, unemployment compensation and other relevant eligibility data with the states to improve compliance with the recent eligibility verification changes in the federal HR1.

Senator Tina Tartaglione introduced SB 1054, which would require all high schools in Pennsylvania to maintain opioid antagonists, such as naloxone or Narcan, onsite.

Department of Human Services

The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) issued a request for proposals from non-profit organizations interested in expanding the Fairweather Lodge (FWL) model in the commonwealth. The FWL model is a structured, community-based program that supports individuals with serious mental illness reintegrate themselves into the community after facing homelessness or transitioning from state hospitals, correctional facilities, or long-term care settings. FWL providers offer emotional support, a place to live, and employment. OMHSAS is interested in establishing two to five new lodges that would serve up to 18 individuals. Find details and application materials here.

DHS issued Remittance Advice guidance for providers that do not receive a check or Remittance Advice (RA) within established time frames for each RA cycle.

DHS proposed rulemaking on minimum standards for the issuance of licenses to provide emergency behavioral health crisis intervention services in alignment with national best practices for crisis services. This proposed rulemaking also establishes new requirements related to service modalities including facility requirements, quality monitoring, staffing qualifications, services provided and training.

Department of Health

DOH issued a request for proposals from eligible community-based health care clinics (CBHCs) to fund the development of new CBHCs or the expansion of existing clinics to enhance maternity and postpartum care, hospital partnerships, or alternative care delivery systems. The deadline for applications is November 17. Find the RFP with more details and budgeting materials here.

Pennsylvania Insurance Department

PID announced the releasing of the final Affordable Care Act (ACA) health insurance rates for 2026, which reflect significant price increases for Pennsylvanians if Congress fails to extend enhanced premium tax credits (EPTCs).

Department of Aging

The Department of Aging (PDA) announced a new tool for screening in-home care workers to increase hiring transparency and protect older adults.

PDA reminded older Pennsylvanians that Medicare Open Enrollment begins October 15, with free insurance counseling available through Local Aging Agencies.

Stakeholder Meetings

DHS is hosting its next Medical Assistance Consumer Subcommittee meeting on October 22, 2025, at 1:00 pm. Interested attendees can register here.  The full MAAC will meet at 10 a.m. on October 23rd in the Keystone Building, Harrisburg.

DHS and the Treasury Department are partnering on a webinar on a PA Achieving a Better Life Experience (ABLE) Savings Program for OLTL Service Coordinators, Direct Service Providers, MCO Staff, and anyone working in employment support services. The webinar is scheduled for October 29th from Noon to 1pm. Individuals can register here.

Federal Update 

Click here for a review of this week’s federal activities.

2025-10-17T19:25:43+00:00October 17th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for October 17

PA Health Policy Update for October 10

The following is an update of selected state health policy developments in Pennsylvania from October 6- October 10 (Some of the language used below is taken directly from state documents).

Budget Update 

Tensions rose in the continued budget impasse this week. As the stalemate reached 100 days, House Democrats amended and sent SB 160, a $50.25 billion budget bill, over to the Senate. All four caucuses and the Governor held press conferences staking out their respective positions and the path forward remains uncertain. The Senate placed itself on a 24-hour call-of-the-chair but is formally scheduled to return on October 20th. The House is set to return on October 27th.

General Assembly 

Rep. Arvind Venkat introduced HB 1925, which would regulate the usage of AI in healthcare.

The House amended a technical amendment into HB 446 which would allow individuals to take dispensed, unused medications home with them following a hospital stay.

HB 1828, which requires private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by recognized authorities, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

HB 1881, which expands pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

The House Aging & Older Adult Services Committee unanimously passed HB 1894 which would enhance counseling of individuals on the LIFE program during the MA long term care enrollment process.

SB 507 was advanced by the Senate on second consideration and by the Senate Appropriations Committee and is positioned for third and final consideration. This bill would create a licensure pathway for certified midwives in Pennsylvania, allow midwives to prescribe treatment for opioid use disorder, and modernizes the current collaborative agreement structure.

Department of Drug & Alcohol Programs

DDAP, in partnership with CODE PA, announced improvements to the ordering process for PA’s Overdose Prevention Program through a streamlined application process.

Department of Human Services

In this week’s PA Bulletin, DHS announced the addition of targeted case management (TCM) services for eligible juveniles effective October 12, 2025. The Department will use existing payment methodologies for the physical health and behavioral health pre-release and post-release TCM services rendered to eligible juveniles being released from a carceral setting, with CMS approval. The Department will issue an MA Bulletin to advise enrolled providers of the addition of TCM for eligible juveniles to the MA Program Fee Schedule and instructions for billing these services.

Following Executive Order 2025-02 ,  DHS affirmed that Pennsylvania’s Medicaid program will continue to support access to vaccinations at no out-of-pocket cost for Pennsylvanians whose health care is covered by Medicaid and CHIP.

The Department issued a MA Bulletin Notice adopting the American Academy of Pediatric Dentistry’s Dental Periodicity Schedule.

The Department released the MCO Enrollment Report for August 2025.

Department of Health 

The Department of Health Division of Acute and Ambulatory Care (DAAC) revised its policy on when facilities must notify DAAC in advance of certain events and removed the requirement to provide 30 days’ notice before adding new equipment. See the revised guidance here and email DAAC at RA-DAAC@pa.gov with any questions.

DOH has updated the forms that hospitals and ambulatory surgical facilities should use for exception requests. Follow the links on this document for the most current forms.

DOH issued a notice to facilities explaining that the department will be adhering to the CMS guidance for survey activities during the federal government shutdown. DOH will continue to conduct state and Medicaid only licensure, occupancy, and complaint surveys. Federal survey activities will be limited to the excepted surveys identified by CMS, including hospice surveys and other facility surveys involving allegations of immediate jeopardy or actual harm and survey-related activities associated with federal terminations from CMS. The department is awaiting CMS guidance on managing any follow-up activities related to surveys completed prior to September 30.

Stakeholder Meetings

DHS and the Treasury Department are partnering on a webinar on a PA Achieving a Better Life Experience (ABLE) Savings Program for OLTL Service Coordinators, Direct Service Providers, MCO Staff, and anyone working in employment support services. The webinar is scheduled for October 29th from Noon to 1pm. Individuals can register here.

 

2025-10-14T16:33:27+00:00October 10th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for October 10

PA Health Policy Update for October 3

The following is an update of selected state health policy developments in Pennsylvania from September 29- October 3 (Some of the language used below is taken directly from state documents).

Budget Update 

As the state budget impasse continues on, with added pressure of a federal shutdown, this week the House positioned a budget bill, SB 160, into the House Appropriations Committee for future potential action. Additionally, the House amended HB 1331, Capital Debt Itemization legislation, with additional capital projects for future consideration.

General Assembly 

Both the House and Senate will return for voting session beginning on Monday, October 6th, the first time both chambers will be in voting session together since June.  For the week ahead, the following hearings and voting meetings are scheduled:

  • On Monday, the House Aging & Older Adult Services Committee will hold a voting meeting on Chairwoman Maureen Madden and Chairman Steve Mentzer’s HB 1894, legislation which would enhance educational efforts for the LIFE program during the Medicaid long-term care enrollment process. The committee will also consider HB 1528, Grandfamilies Assistance legislation to benefit grandparents raising grandchildren.
  • On Tuesday, the House Insurance Committee will meet to consider HB 1828 which would set into law the Governor’s recent actions requiring private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACOP), or the American Academy of Family Physicians (AAFP) according to their immunization schedules. The committee will also consider HB 1123, updating the recommended age for insurance coverage of colorectal cancer screenings from 50 to 45.
  • On Wednesday, the House Professional Licensure Committee will consider adding a pharmacy technician and a second acute care institutional pharmacist to the State Board of Pharmacy through HB 980. Also, the committee will also consider HB 1881 which would guarantee that Pennsylvania pharmacists’ vaccination practice authority can be guided by recommendations from Pennsylvania’s health authorities that may be informed by our state’s professional medical societies.

Below are some health care-related legislation introduced or co-sponsorship memos circulated this week:

  • Rep. Marla Brown circulated a co-sponsor memo for legislation to remove staffing ratios for nursing homes in Pennsylvania.
  • Sen. Judy Ward released a co-sponsor memo on legislation to address lags in MA enrollment in long-term care.
  • Sen. Cris Dush filed SB 125 proposing a Constitutional Amendment giving the General Assembly the authority to establish laws on venues for civil litigation in the Commonwealth as a way to address venue shopping in malpractice cases.

Department of Human Services

The Department of Human Services (DHS) has shared an update for Community Service Support Provider fee-for-service rates for the start of the new federal fiscal year.

Department of Health 

The Department of Health (DOH) issued a health alert with recommendations for health care providers to take in preparation for the 2025-2026 Respiratory Season, including details on reporting requirements. The Department also updated its Respiratory Virus Outbreak Toolkit, which gives recommendations to long-term care facilities on how to prepare for and respond to outbreaks of influenza, RSV, COVID-19, adenovirus, and more.

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) approved final regulations from the State Board of Nursing making additions to the continuing education requirements for certified registered nurse practitioners (CRNP) and registered nurses (RN) in the areas of opioid prescriptions and organ donation.

Around the State  

On Thursday, Governor Shapiro signed an Executive Order at the Children’s Hospital at Philadelphia directing the Department of Health to develop a plan to preserve access for children in the Vaccines for Children program without cost sharing if future Advisory Committee on Immunization Practices (ACIP) changes impact access, aligning vaccine guidance with American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Pediatrics (AAP), creating a website for vaccine information and guidance, ensuring insurance coverage without prior authorizations or cost sharing, among other points.

Stakeholder Meetings

DHS will hold their scheduled MAAC meeting on October 23, 2025, at 10am. Prior Authorization Guideline briefing documents are linked here (downloaded as zip file) for review and public comments are due as indicated on each document.

DOH announced upcoming meetings of several of its advisory committees:

PA Health Policy Update for September 26

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

Budget Update 

The state budget impasse continues to drag on. This week, the Senate was not in session but the House met for non-voting session. The Senate has scheduled a non-voting session day on October 3rd and voting session on October 6th through 8th. As highlighted in this Penn Capital Star article, with transit funding handled through other means, counties and schools will become the pressure point as negotiations continue.

Treasurer Stacy Garrity announced the creation of a $500 million loan fund for counties and Head Start providers as a bridge for funding through the budget stalemate.

General Assembly

The House will return for voting session beginning on Monday, September 29th.  For the House session week ahead, the following hearings and voting meetings are scheduled:

  • Monday, Sept. 29, 9:30am – The House Aging & Older Adult Services Committee will hold an informational meeting on the PA CareKit Program. The Department of Aging will offer testimony.
  • Monday, Sept. 29, 10:45am – House Human Services Committee will meet to consider HR 290, a resolution recognizing the month of September 2025 as “National Recovery Month” in Pennsylvania.
  • Tuesday, Sept. 30, 10am – The House Consumer Protection, Technology, and Utilities Committee will hold a voting meeting to consider HB 1530 which would create privacy and transparency requirements genetic data collected through direct-to-consumer genetic testing.
  • Tuesday, Sept. 30, off-the-floor – The House Health Committee will hold a voting meeting on the following legislation:
  • HB 880 – Updating and closing loopholes within Pennsylvania’s Clean Indoor Air Act.
  • HR 271 – A Resolution directing the Joint State Government Commission to establish an advisory committee and conduct a comprehensive study regarding the indoor air quality for seniors and children in this Commonwealth.

Below is some health care-related legislation introduced or co-sponsorship memos circulated this week:

  • Arvind Venkat introduced HB 1881 which would guarantee that Pennsylvania pharmacists’ vaccination practice authority can be guided by recommendations from Pennsylvania’s health authorities that may be informed by our state’s professional medical societies.
  • Rich Irvin filed a co-sponsor memo which proposed transferring the pharmacy delivery model in Medical Assistance (MA) from Managed Care back to a Fee-For-Service model as a means to impact reimbursements for pharmacies.
  • Cris Dush filed a co-sponsor memo proposing a Constitutional Amendment giving the General Assembly the authority to establish laws on venues for civil litigation in the Commonwealth as a way to address venue shopping in malpractice cases.
  • Lynda Schlegel Culver filed a co-sponsor memo to provide MA coverage for rapid whole genome sequencing (rWGS) for critically ill infants up to one year of age who are admitted to an inpatient intensive care unit with a complex illness.
  • Senators Michele Brooks and Lisa Boscola filed a co-sponsor memo for a resolution urging Congress to provide Pennsylvania with any and all assistance to help comply with the recent federal changes following the One, Big, Beautiful Bill Act.

Department of Human Services

The Department of Human Services (DHS) issued guidance to providers related to “Date of Death Recovery” following a recent audit noting recipient date of death discrepancies where recipients were deceased prior to the dates of service being billed.

DHS’ Office of Developmental Programs issued guidance for flu, RSV, and COVID vaccinations.

Department of Health 

The Department of Health (DOH) issued general immunization guidance to clinicians in response to last week’s federal ACIP meeting. The list clarifies organizations for doctors and families to consult on vaccine recommendations.

DOH issued a health alert to providers with guidance on when and how to exclude health care personnel from direct patient care when they are experiencing respiratory illness symptoms.

DOH reminded long-term care facility providers that the annual long-term care questionnaire is due by October 24. Facilities were contacted directly with instructions to complete the web-based questionnaire. Any questions should be directed to Aicha Hassane Noma at ahassaneno@pa.gov or email RA-dohbhssurveys@pa.gov.

Insurance Department

The Pennsylvania Insurance Department has confirmed the private insurance companies operating in the Commonwealth will continue to cover all of the vaccines covered under ACIP’s 2024 recommendations.

Around the State  

A group of statewide researchers have compiled a website which aims to track opioid settlement fund spending data in Pennsylvania, which is driven out primarily through counties.

Stakeholder Meetings

Medical Assistance Advisory Committee

The following materials presented at the September 25th meeting of the MAAC have been posted on the MAAC website:

PA Health Policy Update for August 15

The following is an update of selected state health policy developments in Pennsylvania from August 4 – August 15.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update 

While there has been considerable activity surrounding the state budget impasse, the passage of budget and mass transit legislation remains largely about political positioning rather than tangible progress toward a final budget for this fiscal year. It appears likely the budget impasse will extend into September.

The House stands adjourned until September 22 and the Senate until September 8. 

Department of Human Services 

The Department of Human Services (DHS) is taking steps to inform the commonwealth’s Rural Health Transformation Plan that will be required for submission to the federal government to receive an award of rural health funds that were included in the One Big Beautiful Bill Act. DHS is seeking feedback in the following areas as well as any ideas that help improve access in rural communities:

  • maternal health
  • mental and behavioral health
  • aging and access
  • transportation and EMS
  • rural healthcare workforce

Respondents should use this online form to submit feedback by August 29.

DHS has updated a guidance document for providers participating in the DHS Breast & Cervical Cancer Prevention & Treatment Program.

DHS’s calendar of Remittance Advice Dates has been updated to include September 2025. 

Department of Health

The Department of Health (DOH) is looking for feedback on the development and implementation of a virtual and/or hybrid skills assessment examination process for nurse aides entering the long-term care sector in Pennsylvania. DOH is interested in learning about existing models, technologies, operational logistics, training and credentialing frameworks, and regulatory considerations that support successful and scalable virtual nurse aide skills examination solutions. For more information and instructions for how to submit a response to this RFI here. 

Around the State 

  • Broad + Liberty discusses the impact of private equity and health care bankruptcies on patient access to care in this article related to the closure of Crozer-Chester hospitals in southeast Pennsylvania.
  • Spotlight PA in this article highlighted how the legislative action from this past week has only deepened the budget impasse in Harrisburg. 

Stakeholder Meetings

OMHSAS – Certified Recovery Specialist Feedback Sessions (Sept-Oct) 

The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) is hosting six stakeholder sessions to gather feedback on Certified Recovery Specialists (CRS) services within the Medicaid program. The intended audience includes county mental health providers, CRS, and CRS supervisors. Click here for registration information.

2025-08-15T20:00:26+00:00August 15th, 2025|Meetings and notices, Pennsylvania Rural Health, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for August 15

PA Health Policy Update for August 1

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

The SNAP State Health Policy Update is taking a summer break and will return on August 15 with more health policy news. 

Fiscal Year 2025-26 Budget Update 

Governor Shapiro and legislative leaders continue to negotiate a final Fiscal Year (FY) 2025-26 budget agreement. The state House of Representatives and Senate are currently in recess pending a final budget agreement.  

The Senate Republican Policy Committee is holding an informational meeting on August 5 regarding mental health services at the Geisinger Behavioral Health Center in Danville, PA. 

Department of Human Services  

DHS has issued Provider Quick Tip #278 indicating DHS has experienced a delay in implementing the updates noted in Medical Assistance (MA) Bulletin 99-25-03 titled, “Updates to Screening Guidelines for Prior Authorization”.  This MA Bulletin advised providers that the Department would transition from InterQual guidelines to Milliman Clinical Guidelines (MCG) as the screening guidelines for prior authorization requests to determine medical necessity for services, items, procedures, or level of care provided to MA beneficiaries in the Fee-for Service (FFS) delivery system, effective July 18, 2025.

The Department of Human Services has published in this week’s Pennsylvania Bulletin final-form rulemaking to amend a data element in the department’s case-mix payment system for nonpublic and county nursing facilities to utilize the Patient Driven Payment Model (PDPM) in place of the Resource Utilization Groups, Version III (RUG-III) classification system in setting Medical Assistance (MA) payment rates for nursing facilities. 

Department of Health 

The Department of Health (DOH) recently shared a message from the Pennsylvania State Police (PSP) asking health care operators for assistance investigating an individual who is accused of using several aliases to pose as a licensed practical nurse, registered nurse, and RN supervisor at multiple facilities in the commonwealth. Providers are asked to review their employment records and report new information to PSP directly. Find more information in this PSP notice. 

The Department of Health (DOH) is coordinating the statewide distribution of free potassium iodide (KI) tablets on August 14 for all Pennsylvanians who live, work, or study within 10 miles of the four active nuclear power plants in the Commonwealth.  The press release can be found here.

Department of Aging 

The Shapiro administration announced the members of an advisory committee to support the newly created Alzheimer’s Dementia and Related Disorders Office in the Department of Aging.

Around the State  

  • Secretary of the Budget Office, Uri Monson, penned letters to local educational leaders and county public welfare providers explaining which funds will not be able to be distributed during the budget impasse. Find more information and copies of the letters in this Spotlight PA article.
  • Less than half of Pennsylvania hospitals are complying with federal price transparency requirements, according to a new study discussed in this article from Erie News Now. 
  • The Philadelphia Inquirer reported on the nutritional value of food in hospitals and how some providers are working to improve it in this article. 
  • Spotlight PA launched the first in a series of articles called The Cost of Failing, which will analyze and chronicle mental health spending and services in all 67 counties over the last few state administrations to show how many fewer people receive mental health services in the commonwealth today than just a few years ago.
  • City & State reports on how rural hospitals across Pennsylvania are bracing for steep financial stress following the passage of the “One Big Beautiful Bill” and how these hospitals, which rely heavily on Medicaid revenue, face escalating risks of closures and service reductions as proposed cuts drive up uncompensated care and threaten stability in already vulnerable rural communities. 

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – August 6

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on August 6 at 10:00 a.m. The meeting will be held virtually. Register to participate here. 

DOH – Organ Donation Advisory Committee – August 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

2025-08-01T20:53:57+00:00August 1st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for August 1

PA Health Policy Update for July 12

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

FY 2024-2025 Budget Update 

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.
  • The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration. 

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024. 

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee. 

Centers for Medicare and Medicaid Services 

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics.  In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas.  For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking. 

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Health Policy Update for May 10

The following is an update of selected state health policy developments in Pennsylvania from May 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed Senate Bill 739 by a vote of 47-1. Senate Bill 739, which was amended before final passage, provides for coverage of telemedicine services. The bill will now be sent to the House for consideration.
  • The Senate unanimously passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system. The bill will now be sent to the House for consideration.
  • The House passed House Bill 1632, which amends the Workers’ Compensation Act to recognize post-traumatic stress injuries as eligible for workers’ compensation claims, by a vote of 154-46. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries, by a vote of 164-37. The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, May 6 and favorably reported, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.
    • House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange.

A recording of the meeting is viewable here.

  • The House Labor & Industry Committee met on Tuesday, May 7 and favorably reported House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee held an informational meeting on the nursing workforce crisis. A recording of both meetings is viewable here.

The state House of Representatives and Senate are now recessed. The House will return to session Monday, May 20 and the Senate will return Monday, June 3.

Department of Human Services 

The Department of Human Services (DHS) has announced its intent to increase the funding for a class of supplemental payments to qualifying hospitals for Fiscal Year (FY) 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional information in this Pennsylvania Bulletin notice. 

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on April 25.

Department of Health 

The Department of Health (DOH) has announced it will hold a public hearing on its proposed Preventive Health and Health Services Block Grant application for Federal Fiscal Year 2024. The hearing will take place on May 28 from 10:00 – 11:00 a.m. Find additional details on how to attend and comment in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Pharmacy’s proposed pharmacy technician registration regulations. Find additional information and IRRC’s comments in this Pennsylvania Bulletin notice 

Around the State 

  • The Pennsylvania Capital-Star has reported about legislation that would cover post-traumatic stress injuries for first responders under the state’s Workers’ Compensation Act.
  • Governor Shapiro has indicated he will sign legislation criminalizing the misuse of xylazine, which is contributing to a growing number of overdose deaths, according to a Philadelphia Inquirer article. 
  • PennLive has published an article about House Democrats’ efforts to pass legislation that would enact a key part of Governor Shapiro’s budget proposal to provide assistance to individuals purchasing insurance of the commonwealth’s state-based insurance exchange, Pennie.

Stakeholder Events 

PA Chamber – Healthcare Summit – May 22

The Pennsylvania Chamber of Business and Industry is holding its inaugural health care summit on Wednesday, May 22. The event will feature conversations about leading health care topics, including innovations in pharmaceuticals, workforce development, the medical malpractice landscape, and the role of AI in health care. To view additional details and register click here 

DOH – Preventive Health and Health Services Block Grant Committee – May 28

The Preventive Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, May 28 from 2:00 – 4:00 p.m. The purpose of the meeting is to present the Federal Fiscal Year 2024 workplan and budget information. The meeting will be held virtually and in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

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