The following is an update of selected state health policy developments in Pennsylvania from December 4 – 8.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro 

In October, the Shapiro administration established the Pennsylvania Behavioral Health Council through Executive Order 2023-20. As the administration and Council begin their work, they have asked interested stakeholders to complete a brief survey to share their insights. The survey will remain open until December 14, 2023. 

General Assembly 

The state House of Representatives and Senate will convene for session next week. Following are selected health care-related legislative proceedings currently scheduled.

• The House Health Committee will meet on Monday, December 11 at the call of the chair to consider Senate Bill 683, which requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
• The House Health Subcommittee on Health Care will convene on Wednesday, December 13 at 9:00 a.m. in Room G-50 of the Irvis Office Building for an information meeting on the “cannabis regulatory landscape.”
• The House Human Services Committee will convene on Monday, December 11 at 10:00 a.m. in Room 60 of the East Wing to consider Senate Bill 941, which enables certain flexibilities for addiction treatment providers. 

Department of Human Services

• The Department of Human Services (DHS) has announced the opening of a public comment period on its proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania. The public comment period will take place from December 2, 2023 through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.

• DHS has announced the addition of a procedure code to the Medical Assistance (MA) program fee schedule for the administration of an influenza vaccine. The effective date and MA fee are indicated in this Pennsylvania Bulletin notice.

• DHS has announced the addition of the following procedure codes to the MA program fee schedule for the administration of bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines manufactured by Pfizer, Inc. and Moderna, Inc. Find additional information in this Pennsylvania Bulletin notice.

• DHS has announced it will require prior authorization of all prescriptions for continuous glucose monitoring (CGM) products that are designated as preferred on the Statewide PDL. These prior authorization requirements apply to prescriptions dispensed on or after January 8, 2024.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 728) notifying health care providers of an increase in mycoplasma pneumoniae activity internationally and in some U.S. jurisdictions.

DOH has published guidelines and fees that a health care provider or facility may charge in response to a request for production of medical charts or records. The guidelines and fees, which can be found in this Pennsylvania Bulletin notice, are effective January 1, 2024. 

Revenue Collection Update 

The Department of Revenue announced Pennsylvania collected $3.1 billion in General Fund revenue in November, which was $46.4 million, or 1.5 percent, more than anticipated. Fiscal year-to-date General Fund collections total $16.1 billion, which is $1.1 million below estimate. 

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.

• Options Available for Coverage through Pennie or CHIP
• Communications and Contacts Cheat Sheet

Stakeholder Events 

DHS – 1115 Waiver Public Forums – December 11, 12, and 15

DHS will hold a series of public forums for the public to ask questions and submit comments related to the Bridges to Success: Keystones of Health for Pennsylvania. Following is the schedule of forums.

• Monday, December 11 at 12:00 p.m. Register to participate here.
• Tuesday, December 12 at 6:00 p.m. Register to participate here.
• Friday, December 15 at 9:00 a.m. Register to participate here. 

Board of Nursing – December 11

The State Board of Nursing will hold its monthly meeting on Monday, December 11. Find the agenda and details on how to participate in the meeting here.

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – ABC-MAP Board – 2024 Meeting Dates

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions (ABC-MAP) Board has published its 2024 meeting calendar. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice.