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COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020.

Pennsylvania Administration

Since yesterday, the Department of Human Services has issued the following four new guidance documents:

We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information.

Any business that would like to seek a waiver to the mandate to close can send a request to this email address: RA-dcexemption@pa.gov
In addition, questions about whether or not your specific business needs to close can be directed to: ra-dcedcs@pa.gov

At the Secretary of Health’s daily update she noted that the number of diagnosed COVID-19 cases in the state doubled in the past two days.

Federal

Administration

CMS approved Washington state’s 1135 waiver request. The approval letter can be found here.

In addition, CMS released two telehealth toolkits: one for general practitioners that is available here and another for end-stage renal disease providers available here.

Congress

Congress is preparing a combination bill to both combat the spread of the coronavirus and also provide economic stimulus to counteract the negative effects of the state of emergency. As Congress deliberates, SNAP weighed in today with Pennsylvania’s congressional delegation, asking for immediate financial support for hospitals, the elimination of the Affordable Care Act Medicaid DSH cuts, and a moratorium on new regulatory requirements on hospitals. Find a summary of the bill here and SNAP’s letter to the delegation here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-23T06:00:11+00:00March 23rd, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

Largest PA Health Insurers to Underwrite Members’ Coronavirus Testing

Some of Pennsylvania’s largest health insurers will waive co-pays for coronavirus testing for their members.

The insurers – Aetna, Capital Blue Cross, Cigna, Geisinger, Highmark, Independence Blue Cross, Pennsylvania Health & Wellness, United Healthcare, and UPMC Health Plan – will cover such tests when they are medically ordered and performed by approved medical labs.

Not all insurers serving Pennsylvanians will do the same. Among those that may not are short-term and limited duration plans.

Learn more about the role some Pennsylvania health insurers will play in coronavirus testing in the Philadelphia Business Journal article “Wolf: Major Pennsylvania health insurers to cover coronavirus testing.”

PA Safety Net Admin2020-03-10T10:13:39+00:00March 10th, 2020|Uncategorized|Comments Off

PA Introduces Testing for Coronavirus

Pennsylvania’s Department of Health now has the capacity to test for coronavirus and can perform six such tests a day.

Until Monday, the state needed to send any samples it wanted tested to the Centers for Disease Control and Prevention in Atlanta, which meant a two- to three-day wait for results. State turnaround will be 24 hours.

One by one, states are developing this capacity and hospitals and health systems, too, will no doubt be doing the same in the coming weeks. First, though, their testing must be approved by the federal Food and Drug Administration. Until then, they will have to rely on the state lab in Chester County.

Learn more about Pennsylvania’s new ability to perform coronavirus tests in the Pittsburgh Tribune-Review article “Pennsylvania Health Department begins testing for coronavirus.”

PA Safety Net Admin2020-03-04T13:00:36+00:00March 4th, 2020|Uncategorized|Comments Off

SNAP Rallies PA Delegation to Oppose MFAR

A proposed federal Medicaid regulation could limit Pennsylvania’s ability to finance its Medicaid program and jeopardize supplemental payments to the state’s private safety-net hospitals, so SNAP has asked members of the state’s congressional delegation to sign a letter to CMS Administrator Seema Verma asking her to reconsider the potentially damaging Medicaid fiscal accountability regulation.

Safety-Net Association of Pennsylvania logo In its letter to members of the state’s congressional delegation, SNAP wrote on behalf of private Pennsylvania safety-net hospitals that

The proposed Medicaid fiscal accountability regulation (MFAR) would, if implemented, impose new limits on how states may raise their share of funds to support their Medicaid programs. If adopted, the commonwealth would face a serious challenge raising the money it needs to finance its share of the cost of its Medicaid program. In addition, MFAR would take a great deal of states’ Medicaid policy-making authority away from state governments and give it instead to the federal Department of Health and Human Services.

Two members of the state’s congressional delegation, Representatives Brendan Boyle (D-Montgomery/Philadelphia) and Mike Kelly (R-Butler/Crawford/Erie/Lawrence/Mercer), have written a bipartisan letter to be sent to CMS Administrator Seema Verma asking her to reconsider the troubling aspects of MFAR. SNAP wrote to members of the state’s congressional delegation asking them to sign onto the letter.

Go here to see the full SNAP letter to the delegation.

PA Safety Net Admin2020-03-03T06:00:10+00:00March 3rd, 2020|Federal Medicaid issues, Pennsylvania Medicaid policy, Uncategorized|Comments Off

PA Seeks to Connect Medicaid Beneficiaries With Job

Pennsylvania has launched a new program that seeks to help Medicaid beneficiaries who would like to find jobs.

The program, called Medicaid Work Supports, is a joint project of the state’s Department of Human Services and Department of Labor & Industry.

As described in The Impact, DHS’s weekly newsletter:

The Medicaid Work Supports initiative will create a more direct and systematic introduction to employment and training resources available to Pennsylvanians. When people are deemed eligible and enroll in a new Medicaid health plan, they will be asked if they are interested in help finding a job, training programs, and opportunities to get a high school diploma or GED. The referral system will help identify this population for the first time and create the opportunity for a meaningful, encouraging partnership between the MCOs, the PA CareerLink® system, and the enrollee to facilitate connections to employment and success in the workforce.

Individuals interested in learning more about these services will receive outreach either through PA CareerLinks®, their selected health plan, or their local county assistance office to provide awareness of and referrals to resources and programs available in their local community.

Learn more about Medicaid Work Supports in the February 14, 2020 edition of The Impact, DHS’s weekly newsletter.

PA Safety Net Admin2020-02-18T06:00:22+00:00February 18th, 2020|Uncategorized|Comments Off

A Look at Surprise Medical Bill Legislation

While Congress’s decision this week to put off addressing the surprise medical bill challenge until next year has disappointed many, that decision did not reflect any lack of ideas for what to do.

At last count, various parts of Congress were considering four major surprise medical bill proposals: one from the Senate Health, Education, Labor and Pensions Committee, one from the House Energy and Commerce Committee, one from the House Ways and Means Committee, and a compromise proposal from the Senate HELP and House Energy and Commerce committees. Some have been around for some time while one emerged only in the past week.

The Commonwealth Fund has prepared a summary of the four proposals that includes a chart that compares where they stand on six major aspects of surprise billing legislation:

The medical settings to which the legislation would apply.
Whether they hold consumers harmless for surprise bills.
Whether they ban balance-billing.
How – or if – they establish standard rates.
How they resolve disputes between insurers and providers.
How they interact with existing state surprise medical bill laws.

An effort by Pennsylvania’s General Assembly to address surprise medical bills met with a similar fate.

Learn more from the Commonwealth Fund report “Update on Federal Surprise Billing Legislation: Understanding a Flurry of New Proposals.”

PA Safety Net Admin2019-12-20T06:00:10+00:00December 20th, 2019|Uncategorized|Comments Off

PA Rural Hospitals to Get Boost From State

A new law seeks to stabilize the financial condition of Pennsylvania’s rural hospitals.

Harrisburg, PA capital building Senate Bill 314, passed by the legislature and signed by Governor Wolf, establishes a new Rural Health Redesign Center Authority and Pennsylvania Rural Health Redesign Center fund that will seek to support the delivery of health care by rural hospitals in the state by, as a legislative co-sponsorship memo explained,

creating an annual, prospective budget with regular, predictable payments;
improving the ability to develop and carry out expanded and innovative community health services; and
providing the capacity to pursue programs addressing key needs such as behavioral health and substance abuse and cooperative EMS.

The new approach will shift participating hospitals from fee-for-service to global payments. Eligible hospitals will receive monthly global budget payments from payers based on historic revenue data that is adjusted for care delivery changes and inflation.

Learn more from the Becker’s Hospital Review article “Pennsylvania governor signs law providing regular, predictable payments to rural hospitals” and from the co-sponsorship memo that accompanied the bill’s introduction in Pennsylvania’s General Assembly.

PA Safety Net Admin2019-12-05T06:00:13+00:00December 5th, 2019|Uncategorized|Comments Off

Progress Continues Toward Launch of PA Health Insurance Exchange

Pennsylvania remains on target to launch its own health insurance exchange in time for the 2021 open enrollment season.

Pennsylvania State Map The shift away from using the federal exchange and developing a state-based exchange was approved by the state legislature earlier this year. That shift took a major step forward recently when the state hired a contractor to create the site’s platform.

State officials estimate that once the state’s site is up and running it will costs $25 million a year to operate; currently, Pennsylvania pays $95 million a year to participate in the federal exchange. In addition, the state will be able to collect the three percent of premiums that insurers pay to appear on the federal site. Those seeking insurance on the new state site should benefit, too, with state officials estimating that purchasing reinsurance will enable consumers to save five to ten percent on premiums.

For an update on the status of the development of Pennsylvania’s health insurance exchange, see the Fierce Healthcare article “Pennsylvania takes another step toward launching state-based insurance exchange.”

PA Safety Net Admin2019-12-04T06:00:23+00:00December 4th, 2019|Uncategorized|Comments Off

PHC4 Reports on Hospital Mortality, Admission Rates, and Performance

Mortality rates, admission rates, and other aspects of hospital performance are the subject of a new report by the Pennsylvania Health Care Cost Containment Commission.

The report presents information on hospital volume and outcomes for 17 different medical conditions and surgical procedures from October 2017 through September 2018. It also compares hospital performance over the five-year period from 2013 through 2018 on an aggregate state-wide basis and for individual hospitals.

Overall, the report found decreases in hospital mortality for most of the 17 conditions, with respiratory failure, sepsis, colorectal procedures, and intestinal obstructions experiencing the biggest decreases (by percentage). Hospital admissions for chest pain, chronic obstructive pulmonary disease, and pneumonia experienced the biggest declines while admissions for respiratory failure and sepsis experienced significant increases (in numbers).

For state-wide and hospital-specific data on hospital performance on 17 medical conditions and procedures, see the new PHC4 documents that together constitute its Hospital Performance Report 2018.

PA Safety Net Admin2019-11-12T13:58:38+00:00November 12th, 2019|Uncategorized|Comments Off

PA Insurance Exchange Rates to Rise in 2020

Insurance premiums will rise on Pennsylvania’s new health insurance exchange in 2020, the Wolf administration has announced.

2020 will mark the first year Pennsylvania operates its own health insurance exchange under the Affordable Care Act. Previously, Pennsylvanians shopped for health insurance on the federal health insurance exchange.

Pennsylvania State Map Pennsylvania rates will rise an average of four percent for individual plans and 9.7 percent for small groups, the state Insurance Department has announced. All insurers that offered plans in 2019 will do so again in 2020 and the exchange will include a new insurer and increased choice in some of the state’s 67 counties. Beginning in 2020, residents of only six counties will have only a single insurer offering individual plans.

Learn more from this Wolf administration news release.

PA Safety Net Admin2019-10-18T06:00:04+00:00October 18th, 2019|Uncategorized|Comments Off

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