The following is an update of selected state health policy developments in Pennsylvania from November 10 – November 14 (Some of the language used below is taken directly from state documents). 

Budget Update

After a stalemate lasting 135 days, the General Assembly has passed a comprehensive Fiscal Year (FY) 2025-2026 budget. The state House of Representatives passed Senate Bill 160 – the General Appropriations Act – by a vote of 156-47. Senate passed it by a vote of 40-9. 

In total, the FY 2025-2026 budget spends $50.1 billion, which represents a $2.3 billion or 4.7 percent increase over the prior fiscal year. It is nearly $1.4 billion less than the budget proposed by Governor Shapiro in February. The budget is balanced primarily by utilizing prior-year funding lapses and special fund balances in state agencies totaling $3 billion. Using these funds in the 2025-26 budget prevented draining the state’s emergency reserves in the Rainy Day Fund, while leaving more than $200 million in the fund’s balance.

The budget includes a new Working Families Tax credit program. However, it does not include many of the spending initiatives highlighted in the governor’s proposal, such as additional mass transit funding, taxation for skill games, minimum wage increases, or legalization and taxation of recreational adult use cannabis. Also part of the deal includes the Commonwealth ending its participation in the Regional Greenhouse Gas Initiative.

In addition to the General Appropriations Bill, the General Assembly also passed code bills related to the budget and its enactment. House Bill 416 is an amended Fiscal Code which includes various instructions to help effectuate passage of the budget bill. House Bill 749 is an update to the Human Services Code which includes several policy provisions below:

• Regulatory alignment with federal rules on MA reimbursement for behavioral health in telehealth settings – the “Four Walls” Requirement,
• Requires DHS to report to the General Assembly on SNAP recipient data and lottery winnings, resources, and vehicles owned by public assistance recipients
• Crosschecking MA and SNAP beneficiaries with data from DOH’s Vital Records system and wage records from the Department of Labor & Industry
• Requires DHS to study the feasibility of a brokerage model for nonemergency Medical Transportation Services
• Allows indefinite suspension of MA benefits for incarcerated individuals while incarcerated, among other provisions.

General Assembly

On Monday, November 17^th, the House Human Services Committee will hold an informational hearing on the federal SNAP changes in HR 1 and their impacts on Pennsylvania. The livestream link will be made available here.

The House Health Committee will meet on Tuesday Nov. 18^th to consider HB 1652 and HB 1715. Both bills would amend the Newborn Child Testing Act to update newborn screening requirements to include Gaucher Disease (HB 1652) and Duchenne Muscular Dystrophy (HB 1715), respectively.

Department of Health

The Department issued a Health Alert Network notice urging providers’ awareness for Acute Flaccid Myelitis through late Fall.

DOH updated the residency criteria for the Chronic Renal Disease Program effective November 15, 2025. 

Department of Human Services

DHS is launching Human Services Helpers, a Substack that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department has announced it has restarted issuing full November Supplemental Nutrition Assistance Program (SNAP) benefit payments.

DHS shared a suicide prevention resource guide in recognition of National Suicide Prevention Month.

The Department released a Medical Assistance Bulletin with revisions to the MA Fee Schedule and prior authorization requirements.

The Department issued an updated Preferred Drug List which will be effective Jan. 1, 2026.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

• Antihemophilia Agents
• Antiparasitics, Topical
• Antipsoriatics, Topical
• Calcium Channel Blockers
• Casgevy
• Continuous Glucose Monitoring Products
• COPD Agents
• Cytokine and CAM Antagonists
• Dupixent
• Epinephrine, Self-Administered
• Glucocorticoids, Inhaled
• Glucocorticoids, Oral
• Hepatitis C Agents
• Hepatic and Biliary Agents
• Immunomodulators, Dermatologics
• Immunosuppressives, Oral
• Lipotropics
• Lipotropics, Statins
• Lyfgenia
• Migraine Acute Treatment Agents
• Monoclonal Antibodies
• Multiple Sclerosis Agents
• Natalizumab
• Proton Pump Inhibitors
• Thrombopoietics
• Stimulants and Related Agents
• Ulcerative Colitis Agents

The Department released an updated Managed Care Directory. 

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

The DHS Medical Assistance Advisory Committee plans to meet December 4^th at 10am. You can register for the meeting here.

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here. 

Federal Update

Click here for a review of this week’s federal activities.