The following is an update of selected state health policy developments in Pennsylvania from July 3 – 7.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update 

The Fiscal Year (FY) 2023-2024 budget remains in flux. Earlier this week the House of Representatives voted to concur with the Senate-passed General Appropriations bill (House Bill 611) by a vote of 117-86. The vote occurred after Governor Shapiro issued a statement announcing his intent to line-item veto the full $100 million intended for the Pennsylvania Award for Student Success (or PASS) voucher program – an initiative adamantly opposed by House Democrats and among the chief points of contention leading to the budget impasse. House Bill 611 was subsequently signed in the House and is awaiting signature in the Senate before it can be sent to the governor.

It is unclear when the Senate will return to Harrisburg or when a final agreement between the various parties will be reached. Senate Republican leadership released a statement criticizing Governor Shapiro and indicating they will “continue to await legislative action by the House on the remaining budgetary components.” 

Governor Shapiro

Governor Shapiro held a press conference touting House Bill 611’s $45.5 billion spending plan and its critical investments in mental health, education, and law enforcement. The governor implored the Senate to return to Harrisburg and sign the bill so it can be sent to his desk. Governor Shapiro also urged the Senate Republicans and House Democrats to meaningfully engage and enact enabling legislation (Fiscal Code, etc.) that would allow the budget to be fully implemented.

Governor Shapiro signed SB 262 into law on Thursday July, 6, which is now known as Act 5 of 2023. Act 5 amends the Maternal Mortality Review Act to require the Maternal Mortality Review Committee to annually publish severe maternal mortality data. 

General AssemblyHouse Chamber of the State House

The House returned to Harrisburg this week for voting session and adjourned to the call of the chair, noting that they do not anticipate returning for voting session in the immediate future. The following are selected health-related proceedings.

  • The House Human Services Committee held a voting meeting July 5 to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The bill was reported as committed. A recording of the meeting can be viewed here.
  • The House passed HB 1515 to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments and HB 1218 which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bills now go to the Senate for consideration.
  • The House Aging and Older Adult Services Committee previously scheduled a voting meeting Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting was not held.

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. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin announcing its intent to reimburse health care providers for services rendered to Medicaid beneficiaries experiencing homelessness. Eligible services include but are not limited to, “primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder, and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.” DHS has updated the MA Program Fee Schedule accordingly. Find additional information in the department’s press release announcing the policy change.

  • DHS has announced it will require prior authorization of all prescriptions for Amyloid-Targeted Monoclonal Antibodies and certain drugs not included on the Statewide Preferred Drug List (PDL). These prior authorization requirements will apply to prescriptions dispensed on or after July 10, 2023.
  • DHS has provided final notice of its funding allocation for FY 2022-2023 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to general acute care hospitals. The department is not otherwise changing the qualifying criteria or payment methodology for these payments.
  • DHS has announced the end-dating of three procedure codes related to COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #267 with additional information regarding the department’s delayed implementation of Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals. 

Revenue Collection Update 

The Department of Revenue announced the commonwealth ended FY 2022-2023 with $44.9 billion in General Fund revenue collections, which is $1.3 billion, or 3.1 percent, above estimate.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published the public comments it received regarding DHS’ adult protective services proposed rulemaking. The comments may be viewed in this Pennsylvania Bulletin notice. 

Stakeholder Events

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Renal Disease Advisory Committee – July 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 21 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – August 3

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 3 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.