The following is an update of selected state health policy developments in Pennsylvania from October 6- October 10 (Some of the language used below is taken directly from state documents).

Budget Update 

Tensions rose in the continued budget impasse this week. As the stalemate reached 100 days, House Democrats amended and sent SB 160, a $50.25 billion budget bill, over to the Senate. All four caucuses and the Governor held press conferences staking out their respective positions and the path forward remains uncertain. The Senate placed itself on a 24-hour call-of-the-chair but is formally scheduled to return on October 20^th. The House is set to return on October 27^th.

General Assembly 

Rep. Arvind Venkat introduced HB 1925, which would regulate the usage of AI in healthcare.

The House amended a technical amendment into HB 446 which would allow individuals to take dispensed, unused medications home with them following a hospital stay.

HB 1828, which requires private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by recognized authorities, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

HB 1881, which expands pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

The House Aging & Older Adult Services Committee unanimously passed HB 1894 which would enhance counseling of individuals on the LIFE program during the MA long term care enrollment process.

SB 507 was advanced by the Senate on second consideration and by the Senate Appropriations Committee and is positioned for third and final consideration. This bill would create a licensure pathway for certified midwives in Pennsylvania, allow midwives to prescribe treatment for opioid use disorder, and modernizes the current collaborative agreement structure.

Department of Drug & Alcohol Programs

DDAP, in partnership with CODE PA, announced improvements to the ordering process for PA’s Overdose Prevention Program through a streamlined application process.

Department of Human Services

In this week’s PA Bulletin, DHS announced the addition of targeted case management (TCM) services for eligible juveniles effective October 12, 2025. The Department will use existing payment methodologies for the physical health and behavioral health pre-release and post-release TCM services rendered to eligible juveniles being released from a carceral setting, with CMS approval. The Department will issue an MA Bulletin to advise enrolled providers of the addition of TCM for eligible juveniles to the MA Program Fee Schedule and instructions for billing these services.

Following Executive Order 2025-02 ,  DHS affirmed that Pennsylvania’s Medicaid program will continue to support access to vaccinations at no out-of-pocket cost for Pennsylvanians whose health care is covered by Medicaid and CHIP.

The Department issued a MA Bulletin Notice adopting the American Academy of Pediatric Dentistry’s Dental Periodicity Schedule.

The Department released the MCO Enrollment Report for August 2025.

Department of Health 

The Department of Health Division of Acute and Ambulatory Care (DAAC) revised its policy on when facilities must notify DAAC in advance of certain events and removed the requirement to provide 30 days’ notice before adding new equipment. See the revised guidance here and email DAAC at RA-DAAC@pa.gov with any questions.

DOH has updated the forms that hospitals and ambulatory surgical facilities should use for exception requests. Follow the links on this document for the most current forms.

DOH issued a notice to facilities explaining that the department will be adhering to the CMS guidance for survey activities during the federal government shutdown. DOH will continue to conduct state and Medicaid only licensure, occupancy, and complaint surveys. Federal survey activities will be limited to the excepted surveys identified by CMS, including hospice surveys and other facility surveys involving allegations of immediate jeopardy or actual harm and survey-related activities associated with federal terminations from CMS. The department is awaiting CMS guidance on managing any follow-up activities related to surveys completed prior to September 30.

Stakeholder Meetings

DHS and the Treasury Department are partnering on a webinar on a PA Achieving a Better Life Experience (ABLE) Savings Program for OLTL Service Coordinators, Direct Service Providers, MCO Staff, and anyone working in employment support services. The webinar is scheduled for October 29^th from Noon to 1pm. Individuals can register here.