Pennsylvania state budget issues Archives - Safety-Net Association of Pennsylvania

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 6^th, 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:

Organ Donation Advisory Committee – November 6

Renal Disease Advisory Committee – October 24

Special Pharmaceutical Benefits Program Advisory Council – October 23

PA Safety Net Admin2025-10-03T21:07:51+00:00October 3rd, 2025|Governments, Medical Assistance Advisory Committee, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues|Comments Off

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 3^rd and voting session on October 6^th through 8^th. 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 29^th. 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 25^th meeting of the MAAC have been posted on the MAAC website:

PA Safety Net Admin2025-09-26T19:05:37+00:00September 26th, 2025|Governments, Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues, Uncategorized|Comments Off

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.

PennLive reported on the Pennsylvania hospitals that were recently included in the U.S. World News & Reports list of best hospitals in the country.

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.

PA Safety Net Admin2025-08-15T20:00:26+00:00August 15th, 2025|Meetings and notices, Pennsylvania Rural Health, Pennsylvania state budget issues|Comments Off

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.

PA Safety Net Admin2025-08-01T20:53:57+00:00August 1st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off

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 Safety Net Admin2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

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.

PA Safety Net Admin2024-05-10T20:07:25+00:00May 10th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 20

The following is an update of selected state health policy developments in Pennsylvania from October 16 – 20. (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 policy-related legislative activity.

The House of Representatives voted 199-4 to concur with the Senate’s amendments to House Bill 1351, which reauthorizes the hospital Quality Care Assessment, increases Medicaid reimbursement for ambulance transportation, and makes changes to the skilled nursing facility case-mix rate. The bill has been presented to Governor Shapiro for his signature.

The Senate unanimously passed Senate Bill 941, which enables certain flexibilities for addiction treatment providers. The bill has been received in the House and referred to the Professional Licensure Committee.

The House of Representatives’ Health Committee met on Wednesday, October 18 and favorably reported the following bills.
- House Bill 1417, which restores dental coverage for Medical Assistance recipients.
- House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania.
- House Bill 1694, which requires the Department of Drug & Alcohol Programs to create an annual report on the use of opioid settlement funds by state and county governments.
- Senate Bill 500, which requires Medicaid coverage for medically prescribed pasteurized donor human milk.

The Senate will return to session next Monday, October 23 through Wednesday, October 25. The House of Representatives is recessed until Monday, October 30.

Department of Human Services

The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through November. Find the updated calendar here.

Department of Health

The Department of Health has recommended long-term care facilities use its COVID-19 Infection Control and Outbreak Response Toolkit for Long-Term Care when preparing for and responding to a COVID-19 outbreak. A 2023-2024 Influenza Toolkit is also available. For assistance on COVID-19 infection prevention and control, providers are strongly encouraged to reach out to LTC-RISE and Project Firstline.

The DOH Bureau of Family Health has announced a funding opportunity for community-based, non-profit organizations to provide direct, individualized services to families who qualify for the Community to Home (C2H) program. The application will be open through December 19, 2023. Find additional information here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Chiropractic’s proposed rulemaking. Find additional information in this Pennsylvania Bulletin notice.

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

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Subcommittee of the MAAC – October 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, October 25 at 1:00 p.m. To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – October 26

The MAAC will hold a meeting on Thursday, October 26 at 10:00 a.m. To participate virtually, register here.

DOH – Organ Donation Advisory Committee – November 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 2 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2023-10-20T20:19:25+00:00October 20th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for September 22

The following is an update of selected state health policy developments in Pennsylvania from September 18 – 22. (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for voting session this week. The following bills were passed on third and final consideration.
- House Bill 1209 and House Bill 1407 make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. Both bills will now be sent to Governor Shapiro for his signature.

- Senate Bill 712 allows clinical laboratories certified by the federal government to directly or indirectly advertise or solicit business for diagnostic laboratory testing under certain terms and conditions. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.

- Senate Bill 773 makes various changes to the Medical Marijuana Act. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.

The House Health Committee held a public hearing on Wednesday, September 20 on House Bill 1657, which amends the Clean Indoor Air Act. A recording of the hearing may be viewed here.

Democrat Lindsay Powell won a special election Tuesday, September 19 to fill the vacancy created by the resignation of Representative Sara Innamorato (D – Allegheny), who’s running for Allegheny County Executive. Powell’s victory will preserve the Democrat’s one-seat majority in the House of Representatives.

The state House of Representatives will convene next Monday, September 26 and Tuesday, September 27 for voting session.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to electronic visit verification requirements for pediatric home health aide services in the fee-for-service and managed care delivery systems.

DHS has released for public comment its Medical Assistance and Children’s Health Insurance Programs Managed Care Quality Strategy (MCQS). Comments will be accepted until October 23, 2023. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced its intent to allocate $258 million for FY 2023-2024 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.

Department of Health

The U.S. Centers for Disease Control and Prevention (CDC) reported this week that a team of epidemiologists from the Pennsylvania Department of Health (DOH) was the first to identify the transmission of Legionella from an organ directly to a transplant patient. This finding will help protect transplant recipients from serious lung infections. The published research can be viewed in the CDC’s Morbidity and Mortality Weekly Report.

DOH has released a Health Advisory (PAHAN – 719) with recommendations regarding the updated (2023-2024) Monovalent mRNA COVID-19 vaccines.

Medicaid Continuous Coverage Unwinding

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – September 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, September 27 at 1:00 p.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – September 28

The MAAC will hold a meeting on Thursday, September 28 at 10:00 a.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here.

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

PA Safety Net Admin2023-09-22T18:52:13+00:00September 22nd, 2023|Medicaid Eligibility Redetermination , Medicaid supplemental payments, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off

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 published an updated Medicaid Managed Care Organization (MCO) Directory.

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 Safety Net Admin2023-09-05T13:44:35+00:00September 1st, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for Friday, March 10

The following is an update of selected state health policy developments in Pennsylvania from March 4 to March 10. (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro delivered his first budget address before the General Assembly this week. The themes highlighted throughout his speech included investing in public safety and public health, creating opportunity by growing the state’s economy, expanding the workforce, ensuring that every child has access to a quality education, and increasing access to mental health services. In total, Governor Shapiro’s proposed FY 2024 budget would spend $45.8 billion, a $2.5 billion or 5.9 percent increase over the current fiscal year. For further information about the proposed budget, see the following resources:

General Assembly

The Senate unanimously passed Senate Bill 8 this week. This legislation requires insurers to cover 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. It 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 pursuant to Act 52 of 2020. Senate Bill 8 was received in the House and referred to the Insurance Committee.
The state House and Senate appropriations committees will begin hearings on Governor Shapiro’s proposed FY 2024 budget the week of March 20. A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be viewed here.
The state House and Senate are now recessed until the conclusion of budget hearings. Both chambers will return to session on Monday, April 24.
The House Democratic Caucus announced its 2023-2024 legislative session committee chairs this week. Representative Dan Frankel will serve as chair of the Health Committee and Representative Stephen Kinsey will serve as chair of the Human Services Committee. A complete list of the House committee chairs can be viewed here.

Department of Human Services

The Department of Human Services (DHS) has posted a notice to inform presumptive eligibility providers of care to pregnant women that the income guidelines used to determine presumptive eligibility have been updated effective January 12, 2023. Go here to see the notice, which includes information about the criteria for qualifying for presumptive eligibility and the new income guidelines.
DHS has posted a reminder that all Medicaid-enrolled providers who dispense hearing aid supplies to Medicaid patients must submit a copy of their renewed Department of Health certification to MA Provider Enrollment by March 16 to continue providing and billing DHS for hearing aid supplies. Find that notice here.
DHS has issued a request for information seeking stakeholder input and information concerning the current Community HealthChoices agreement for the anticipated re-procurement of Community HealthChoices managed care organization contracts. Specifically, the state seeks information on the statement of work for the upcoming re-procurement before issuing a request for application for vendors to bid on program participation. Go here to learn more about the request for information and what the state seeks from interested parties. The deadline for submitting comments is April 14.
DHS has shared minutes from the February 23 meeting of the Medical Assistance Advisory Committee and minutes from the January 25 meeting of that committee’s consumer subcommittee.
Acting DHS Secretary Dr. Val Arkoosh has written an op-ed column outlining how the state will work with its Medicaid population and various organizations to determine the continued eligibility of current participants in the face of the end of the continuous Medicaid eligibility that was part of the federal government’s and the state’s response to the economic challenges posed by COVID-19. That column was published in several newspapers across the state; find an example here from the Pittsburgh Tribune-Review. The ideas outlined in this op-ed column are reinforced and explained in greater detail in this Shapiro administration news release.

Department of Health

The Department of Health has issued a request for applications to award grants to local health departments, health systems, health clinics, Federally Qualified Health Centers, Rural Health Clinics, non-profit organizations, local governments, 501(c)(3) organizations, and other clinical providers serving the 10 counties with the highest suicide rates in Pennsylvania (Venango, Blair, Dauphin, Berks, Luzerne, Lycoming, Wayne, Franklin, Sullivan, and McKean counties) for a suicide prevention pilot program. It seeks to fund applicants addressing evidence-based suicide prevention strategies for youth between the ages of 15 and 24 and creating local inventories of suicide prevention resources. The overall goal of this funding is to promote the reduction of factors that increase risk and increase factors that promote resilience among disproportionately affected populations especially among Pennsylvania youth. Learn more from this solicitation notice, which includes a link to the request for applications. Applications are due by April 6.
The Department of Health has published decisions on recent requests for exceptions to health care facility regulations. Find those decisions in this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania fell 19 percent over the past week after falling 17 percent the previous week. In addition, the number of daily deaths has declined slightly.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 fell 16 percent last week after a nine percent decline the previous week and was below 1000 for the first time since May of 2022. The number of COVID-19 patients on ventilators declined 17 percent last week and the number in hospital ICUs fell 28 percent and is down into double digits – 98 – for the first time since July of 2022.
The CDC reports an 18 percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 after a 13 percent decline the previous week.
For the week ending March 8, 10 Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 29 counties experienced a substantial rate of community transmission; and the remaining 29 counties experienced a high rate of community transmission. This reflects a significant improvement over recent weeks.

Stakeholder Events

Patient Safety Authority – Board Meeting – March 16

The Patient Safety Authority board will meet virtually on Thursday, March 16 at 1:00. For information about participating in the meeting, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – March 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday March 22 at 1:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – March 23

The Medical Assistance Advisory Committee will hold its next public meeting virtually on Thursday, March 23 at 10:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting April 5

The Medical Assistance Advisory Committee’s managed long-term services and support subcommittee will hold a public meeting on Wednesday, April 5 at 10:00 in Harrisburg. For information about how to join the meeting in person or participate remotely, see this DHS notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-03-10T21:19:08+00:00March 10th, 2023|COVID-19, HealthChoices, Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget, Pennsylvania state budget issues|Comments Off

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