The following is an update of selected state health policy developments in Pennsylvania January 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The state House of Representatives and Senate are scheduled to return to session on Monday, January 27, 2025. 

Department of Human Services

  • The Department of Human Services (DHS) has issued final-form regulations regarding Psychiatric Rehabilitation Services (PRS). The regulations, which are effective upon publication in the Pennsylvania Bulletin incorporate several updates, including lowering the minimum age to 14 years old for PRS eligibility, the inclusion of individuals with posttraumatic stress disorder, bipolar disorder, major depressive disorder, and anxiety disorders without requiring an exception process, and the implementation of a weekly file note requirement. Find additional information in this Pennsylvania Bulletin notice. 
  • DHS has provided final notice of the FY 2024-2025 nursing facility assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities subject to the assessment. Find those details in this Pennsylvania Bulletin notice.  
  • DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the top 15 non-English languages used by Medicaid beneficiaries and to remind providers of their responsibility to provide interpretation and translation services free of charge to all individuals who have limited English proficiency, vision limitations, and/or auditory limitations. 

Health Department

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 782) to share information with health care professionals about exposure to environmental contaminants, including a list of trainings and resources from academic and governmental organizations that can help providers assess environmental exposures and respond to patient concerns.
  • DOH has shared an announcement from the Federal Office of Rural Health Policy regarding new funding available for the Rural Residency Planning and Development (PRPD) program.

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced it took an important step toward fully implementing the commonwealth’s new Pharmacy Benefit Manager (PBM) reform law. PID established a new process for pharmacies to challenge a health benefit plan’s designation of a specialty drug, as provided by Act 77 of 2024. PBMs and pharmacies looking for more information about Act 77, including a schedule that outlines the Act’s full implementation dates, can visit PID’s website here. 

Pennsylvania Supreme Court 

The Pennsylvania Supreme Court and the Administrative Office of Pennsylvania Courts (AOPC) have announced their efforts to combat the behavioral health crisis, including the establishment of an Office of Behavioral Health.  

Around the State  

  • The Pennsylvania Capital-Star has published an article highlighting laws enacted by the General Assembly in 2024 that will take effect this year, including bills that improve access by mandating insurance coverage of biomarker testing and telemedicine. 
  • Prospect Medical Holding’s, the parent company of Crozer Health in Delaware County, decision to file for bankruptcy was covered by Harold Brubaker for The Philadelphia Inquirer in this article. 
  • WPSU has reported that Bucktail Medical Center in Clinton County has received a $1 million state grant from the Department of Community and Economic Development’s (DCED) Hospital and Healthsystem Emergency Relief fund. 

Stakeholder Meetings

DOH – Achieving Better Care by Monitoring All Prescriptions Board – 2025 Meeting(s)

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board, established under the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) has set its calendar for 2025. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.