Pennsylvania state budget issues Archives - Page 4 of 5 - Safety-Net Association of Pennsylvania

The Proposed FY 2014 State Budget: Part 4 of 7

Medical Assistance Supplemental Payments

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about Medical Assistance supplemental payments.
Governor Corbett has proposed no change in the state’s spending on OB/NICU, burn center, and trauma center payments. Because of the reduction in the state’s federal medical assistance percentage (FMAP, or the rate at which the federal government matches state Medicaid spending), total payments to hospitals in each of these programs stands to decline 1.7 percent.
The total amount available for tobacco uncompensated care payments is slated for a 3.3 percent decrease, from $56.5 million to $54.7 million. This reflects two factors: a 1.7 percent decrease in money available from the tobacco settlement fund and the state’s reduced FMAP rate.
While total funding for physician practice plans is slated for an 18.9 percent decrease, this appears to reflect a decision to remove from this category one hospital that was added to the group last year. This would mean funding for physician practice plans would remain the same – as it would for academic medical center disproportionate share hospital payments (DSH).
Critical access hospital payments have been targeted for a $500,000 cut in state funds.
Inpatient DSH, outpatient DSH, medical education, and Community Access Fund payments do not have their own line-items in the proposed budget and therefore cannot be specifically identified in that budget. Traditionally, however, when an administration is contemplating changes in these payments, it indicates so in the programmatic revision commentary section of the budget document. In the case of these four payments that are so vital to so many Pennsylvania safety-net hospitals, they were not mentioned in the programmatic revision commentary.
Next Monday: Other Medical Assistance Issues

PA Safety Net Admin2013-02-15T06:00:49+00:00February 15th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 3 of 7

Hospital Assessment Revenue

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about revenue from the state-wide and Philadelphia hospital assessments.
The proposed budget assumes $633 million in revenue from the state-wide hospital assessment and another $148 million from the Philadelphia hospital assessment. While the revenue anticipated from the Philadelphia assessment appears to be in line with prior years’ collections, the revenue associated with the state-wide assessment appear to be greater than in the past. It is unclear whether this apparent increase reflects the state’s intention either to increase its share of assessment revenue or to raise the assessment rate.
Tomorrow: Medical Assistance Supplemental Payments

PA Safety Net Admin2013-02-14T06:00:06+00:00February 14th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 2 of 7

The Major Medical Assistance Spending Categories

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about the major Medical Assistance spending categories.
The proposed budget calls for what on the surface appear to be sizeable decreases in state funds available for Medical Assistance inpatient and outpatient funding – a decrease of 44.9 percent in inpatient and 31.6 percent in outpatient funding. What this actually represents, however, is the state’s continued shift toward greater use of managed care through its expanded HealthChoices program, which has been budgeted for a 5.7 percent increase in funding. Overall, the combined changes in the inpatient, outpatient, and capitation lines of the proposed budget represent a 1.4 percent decrease in the amount of state money available for physical health services.

Click on the accompanying chart to see the proposed changes in the state’s funding allocations for the major categories of Medical Assistance physical health spending from FY 2013 to FY 2014.
Tomorrow: Hospital Assessment Revenue

PA Safety Net Admin2013-02-13T06:00:22+00:00February 13th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 Pennsylvania State Budget: Part 1 of 7

The Big Picture

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over the next seven business days, SNAP will present the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals.
The following is a schedule of the remaining six parts of this overview:

Today: the big picture underlying the proposed budget.
In this proposed budget, the Department of Public Welfare (DPW) projects a three percent increase in Medical Assistance enrollment and caseload in FY 2014. Overall, the DPW budget calls for $14.2 billion in total spending on Medical Assistance – a decrease of less than half a percent from the current fiscal year’s available funding.
While some of the proposed changes in the budget are spending decisions, others reflect a reduction in the state’s federal medical assistance percentage, or FMAP (the rate at which the federal government matches state Medicaid spending), which will fall from its current 54.28 percent to an estimated 53.52 percent during FY 2014. Consequently, in some cases, lower payments would reflect a reduced federal contribution rather than a state decision to reduce those payments.
The major themes of next year’s proposed Medical Assistance budget appear to be a continued state-wide expansion of the HealthChoices Medical Assistance managed care program and expanded access to community-based services for individuals with intellectual disabilities and the elderly.
The budget does not provide for the Medicaid expansion envisioned in the Affordable Care Act. Governor Corbett has conveyed to the federal government that he will not expand Medicaid eligibility at this time but his document states that such expansion will be the subject of further analysis and public discussion.
Tomorrow: The Major Medical Assistance Spending Categories

PA Safety Net Admin2013-02-12T06:00:58+00:00February 12th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off

Health Law PA News

The Pennsylvania Health Law Project has published its January 2013 newsletter, which includes articles on the state’s budget process (including a schedule of upcoming budget hearings), the continued expansion of HealthChoices, changes in Medicaid-covered behavioral health and substance abuse services, limits on Medical Assistance benefits, the overall benefits of Medicaid expansion for Pennsylvania, and more.
Go here to download the Pennsylvania Health Law Project’s Health Law PA News.

PA Safety Net Admin2013-02-08T06:00:35+00:00February 8th, 2013|Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Says No to Medicaid Expansion (For Now)

Pennsylvania Governor Tom Corbett has at least temporarily closed the door to the Medicaid expansion envisioned in the Affordable Care Act.
On the same day that he presented his proposed state budget for the 2014 fiscal year, Mr. Corbett wrote to U.S. Health and Human Services Secretary Kathleen Sebelius, explaining that

At this time, and without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion.

See Governor Corbett’s letter to Secretary Sebelius here.
At the same time, however, the governor did not rule out the possibility of a change of heart sometime in the future. His proposed budget document explains that

At this time, analysis continues on the financial sustainability related to potential expansion of the Medicaid program. The Department of Public Welfare continues to have a dialogue with the U.S. Department of Health and Human Services (HHS) in an effort to obtain clarification and answers on a number of issues, including whether essential reforms of the Medicaid program can be accomplished to improve the health of our citizens and the effectiveness of the program. The department is currently reviewing the recently released proposed regulations on eligibility and benefits from HHS. While due diligence continues, no decision has been made at this time.

The administration intends to engage in an informed dialogue with the public and the legislature on whether expansion of the Medicaid program is prudent, affordable and the right choice for the commonwealth. When a final decision is made, it will be done in consultation with the Legislature and it may require modifications to be made and accounted for in the budget.

The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.

PA Safety Net Admin2013-02-07T06:00:12+00:00February 7th, 2013|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Proposed State Budget: Implications for PA Safety-Net Hospitals

Yesterday, Pennsylvania Governor Tom Corbett unveiled his proposed FY 2014 budget in a speech to the state’s General Assembly.
The Safety-Net Association of Pennsylvania (SNAP) has prepared a detailed summary of the budget proposal with an emphasis on provisions of particular importance to the state’s safety-net hospitals. To receive a copy of this memo, please contact SNAP at info@pasafetynet.org.

PA Safety Net Admin2013-02-06T06:00:23+00:00February 6th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Sneak Peek: PA Medicaid Costs to Rise $650 Million in FY 2014

In its mid-year budget briefing, the Corbett administration projects that Pennsylvania’s Medical Assistance costs will rise $650 million in the state’s 2014 fiscal year, which will begin on July 1, 2013.
The budget briefing also noted that the governor has directed state agencies to maintain level funding in their proposed FY 2014 budgets, that level funding essentially means a cut of seven to eight percent because of rising personnel costs, and that the governor “has reiterated that no new taxes will be part of the 2013-14 budget.”
Although the governor does not present his proposed FY 2014 budget for another two months, this raises the question of how the state might pay these increased Medicaid costs – or if next year’s budget might include payment cuts for the state’s Medicaid providers.
Cut would be particularly burdensome to Pennsylvania’s safety-net hospitals because of the especially high numbers of Medicaid patients they serve and their unusual dependence on Medicaid revenue.
Read about the mid-year budget briefing in this PA Independent article and find the budget briefing itself here .

PA Safety Net Admin2012-12-10T06:00:27+00:00December 10th, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Lawsuit Challenges Social Services Block Grants and the End of General Assistance Payments

A lawsuit has been filed in Pennsylvania’s Commonwealth Court challenging the state’s termination of General Assistance payments to low-income Pennsylvanians and the redirection of some state social services funding into block grants for selected counties.
General Assistance grants are small sums of money that were paid monthly to low-income Pennsylvanians. Many were thought to use this money for food, medicine, and other necessities.
Pennsylvania’s counties have long received social services funding from the state. Now, some counties have voluntarily agreed to accept less money in exchange for greater flexibility in how they spend it. Some of the services provided with this money are delivered by hospitals, including the state’s private safety-net hospitals.
The legal challenge is on procedural rather than policy grounds, with the plaintiffs alleging that the legislation that ended the General Assistance grants and created the social services block grant program violated a provision in the state constitution that requires legislation to address only a single issue.
Read more about the General Assistance and social services block grant lawsuit in this Philadelphia Inquirer article .

PA Safety Net Admin2012-10-26T06:00:16+00:00October 26th, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

New PA Health Law Project Newsletter

The Pennsylvania Health Law Project has just published its June/July “Health Law PA News” newsletter. The latest edition includes articles about the recently passed state Medical Assistance budget, the implications of the Supreme Court’s Affordable Care Act decision for Pennsylvania, changes in state human resources funding, a delay in HealthChoices expansion in western Pennsylvania, and the lawsuit to compel the state to reinstitute the AdultBasic program.
Read the newsletter here .