Affordable Care Act Archives - Page 15 of 16 - Safety-Net Association of Pennsylvania

PA Faces Decision on Insurance Exchanges

Pennsylvania must inform the federal government by November 16 whether it intends to create a state health insurance exchange as envisioned in the Affordable Care Act.
If the state decides not to create its own exchange, the federal government will create an exchange for it.
While some observers believe the state has intentionally not invested a great deal of time and effort in developing the exchange – or spent any of the $33 million the federal government gave it for this purpose – state officials insist that they are moving ahead with the work but have been hampered by a lack of direction from the federal government. In August, state insurance commissioner Michael Consedine wrote to U.S. Health and Human Services secretary Kathleen Sebelius seeking such direction but has not yet received a response.
Other states are in the same situation as Philadelphia – so many states, in fact, that many observers believe the federal government will extend the deadline for states to declare their intentions.Read more about this situation and what it means for Pennsylvania in this Allentown Morning Call article .

PA Safety Net Admin2012-11-13T06:00:49+00:00November 13th, 2012|Health care reform|Comments Off

Post-Election Diagnosis for Health Care

While President Obama’s re-election probably spells the end of talk of repealing the Affordable Care Act, many questions remain about how – and how completely – the health care reform law passed in 2010 will be implemented.
In the days following the election, observers are asking these and other questions.
In the article “Federal Deficit Talks Could Impact Obama’s Moves on Health Law,” Kaiser Health News speculates about the future of some of the more controversial and expensive aspects of the Affordable Care Act, including creation of the Independent Payment Advisory Board; the extensive insurance subsidies for which many Americans will be eligible; the future of the medical device tax; and the law’s provisions that limit the degree to which insurers can charge higher rates for older people.
The Stateline web site looks at the decisions ahead for state governments in the article “Obama Win Means Big Health Care Decisions for States.” Many governors still have not declared whether their state will expand their Medicaid programs – a move required by the Affordable Care Act but made optional by the Supreme Court in a June 2012 decision.
The first issue that will be addressed, though, is state decisions on whether to create their own health insurance exchanges, a key part of the reform law, or let the federal government create those exchanges for them. States are required to inform the federal government of their intentions by November 16, although it now appears they will be given more time. Pennsylvania is among the states that have not yet declared their intentions.
Meanwhile, looming over the health care industry is the prospect of sequestration, part of last year’s deficit reduction compromise, that leaves Medicaid untouched but will require a cut of two percent in all Medicare payments beginning on January 1 unless Congress acts to prevent these cuts. Read more about this in an article from The Hill titled “Sequester Would Cut $11 Billion from Medicare.”
These and other issues are of particular importance to Pennsylvania’s safety-net hospitals because of the especially large numbers of low-income and publicly insured patients they serve.

PA Safety Net Admin2012-11-09T10:42:28+00:00November 9th, 2012|Health care reform|Comments Off

Medicaid Primary Care Pay Raise Set; OB/GYNs, ER Docs Excluded

When the Affordable Care Act’s mandatory rate increase for primary care services provided to Medicaid patients takes effect on January 1, ob/gyns and emergency room physicians will not be among the beneficiaries of the temporary raise in pay.
Under a new regulation issued last week, only family doctors, internists, and pediatricians will receive the pay increase, which was established as a short-term (two years) incentive to attract more physicians to serve Medicaid patients in anticipation of the significant increase in enrollment expected when many states expand their Medicaid eligibility criteria in 2014.
When working under the supervision of eligible primary care physicians, nurse practitioners and physician assistants also will receive the enhanced Medicaid payments.
State Medicaid payments for primary medical care typically fall well below comparable Medicare rates. Under the reform law, Medicaid payments for such services will be raised to Medicare levels for two years, with the federal government footing the bill for the difference.
Because they serve so many Medicaid patients and the state’s outpatient fees are so much lower than those paid by Medicare, Pennsylvania’s safety-net hospitals and the primary care physicians they employ should benefit greatly from this new policy.
Read more about who will and won’t benefit from the primary care fee increase and how it will be implemented in this Kaiser Health News article .

PA Safety Net Admin2012-11-05T06:00:03+00:00November 5th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Implementation of Reform Act’s Medicaid Doc Pay Raise Uncertain

With the Affordable Care Act-mandated increase in Medicaid payments to primary care physicians now just a little more than two months away from taking effect, much remains unknown about how the increase will be implemented.
Under the 2010 reform law, payments to Medicaid primary care physicians will be increased to the same level as comparable Medicare payments, with the federal government picking up the entire $11 billion tab.
At this point, however, there are no regulations delineating how the increase will be achieved, leaving unanswered a number of questions, including what the new rates will be; how and when they will be paid; which physicians will receive them; and how physicians caring for Medicaid patients through managed care plans will receive their enhanced payments.
The purpose of the temporary, two-year increase is to attract more physicians to the care of Medicaid patients in time for the increased Medicaid eligibility that begins under the reform law in 2014.
Many physicians serving communities with large numbers of Medicaid patients, and those employed by Pennsylvania’s safety-net hospitals, are expected to benefit from this pay increase. Currently, Medicaid primary care physician payments in Pennsylvania are just 56 percent of comparable Medicare payments.
Learn more about the challenges of implementing this primary care physician Medicaid pay raise in this Kaiser Health News article.

PA Safety Net Admin2012-10-29T06:00:15+00:00October 29th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Philadelphia Hospitals Hoping for Medicaid Expansion

Hospitals in the greater Philadelphia want the state to expand its Medicaid program as envisioned in the Affordable Care Act, the Philadelphia Business Journal reports.
According to a spokesman for the Delaware Valley Healthcare Council, Philadelphia-area hospitals are concerned that the state might not expand Medicaid eligibility. That expansion, mandated by the 2010 health care reform law, was made optional earlier this year by a Supreme Court decision.
Read more about why Philadelphia-area hospitals – many of which are safety-net hospitals – are eager for the state to embrace the reform law’s Medicaid eligibility expansion in this Philadelphia Business Journal article .

PA Safety Net Admin2012-10-22T06:00:32+00:00October 22nd, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Medicare DSH Cuts Loom for PA Safety-Net Hospitals

Safety-net hospitals across the country will soon lose important funding that helps them care for many of their low-income and uninsured patients: their Medicare disproportionate share hospital payments (Medicare DSH).
Come 2014, the Affordable Care Act mandates a significant cut in hospitals’ Medicare DSH payments. The underlying rationale for this cut is that once the health care reform law’s individual insurance mandate takes effect and states begin greatly expanding Medicaid eligibility (a reform law mandate made optional by this year’s Supreme Court decision), hospitals will have fewer such patients and less need for supplemental DSH funding.
But as a Kaiser Health News article points out, hospital officials are concerned that the funding will phase out before the expanded insurance phases in, leaving them with fewer resources to care for their low-income, still-uninsured patients.
Pennsylvania’s safety-net hospitals, which care for large numbers of low-income and uninsured patients, figure to suffer considerably under such circumstances.
Learn more about the phase-down of Medicare DSH payments and the challenges hospitals will face in its wake in this Kaiser Health News article .

PA Safety Net Admin2012-10-17T06:00:13+00:00October 17th, 2012|Health care reform|Comments Off

PA Lags in Developing Health Insurance Exchange

Pennsylvania is unlikely to have a health insurance exchange (HIE) up and running when the individual insurance requirement mandated by the Affordable Care Act takes effect in 2014.
According to state insurance commissioner Michael Consedine, while Pennsylvania has laid considerable groundwork for developing its own exchange, its efforts have been hampered by lack of direction from the federal government on a number of key exchange-related issues. An August letter from Mr. Consedine to U.S. Health and Human Services Secretary Kathleen Sebelius has not yet been answered. In addition, the state legislature has not passed necessary enabling legislation.
If Pennsylvania does not establish its HIE by 2014, residents of the state will be served by an exchange established by the federal government. The state would still be free to establish its own exchange at a later date.
Read more about the situation in Pennsylvania today, what the state has done so far, and the obstacles to completing developing of the HIE in this Pittsburgh Post-Gazette report.

PA Safety Net Admin2012-10-15T10:42:06+00:00October 15th, 2012|Health care reform|Comments Off

Physician Reluctance Threatens Medicaid Expansion in PA

If Pennsylvania moves ahead and expands Medicaid eligibility as envisioned in the Affordable Care Act, the ability of newly enrolled recipients to obtain medical care may be jeopardized by the reluctance of some physicians to take on more Medicaid patients.
According to a recent article in the journal Health Affairs, 68 percent of the state’s doctors are currently accepting new Medicaid patients. Those who are not cite low reimbursement rates and already-high patient loads among the reasons they are not accepting new Medicaid patients.
Pennsylvania Governor Tom Corbett has not revealed whether he intends to expand Medicaid eligibility in the state and is not expected to do so until after the November election. The mandatory Medicaid expansion, part of the 2010 health care reform law, was ruled unconstitutional by the U.S. Supreme Court, leaving expansion decisions to the individual states.
The Pennsylvania Department of Health says that 94 percent of rural doctors and 84 percent of the state’s urban doctors currently care for Medicaid patients.
Read more about the situation in Pennsylvania today and its implications for Medicaid expansion in this Pittsburgh Post-Gazette article .

PA Safety Net Admin2012-09-11T06:00:28+00:00September 11th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

“Medicaid Works,” Foundation Declares

Medicaid improves access to care and saves lives and deserves to be expanded in the manner envisioned in the Affordable Care Act, according to a new blog entry on the web site of the health care-focused Commonwealth Fund.
According to the blog commentary, Medicaid “fulfills the two main purposes of health insurance – ensuring access to needed care and providing adequate financial protection from burdensome medical expenses.” It also cites research that “confirms that expanding Medicaid not only improves access to care and financial protection of vulnerable individuals and families, but actually saves lives.”
In addition, the blog suggests that Medicaid recipients have only slightly greater cost-related access-to-care problems than individuals with private insurance.
The Safety-Net Association of Pennsylvania (SNAP) and the state’s private safety-net hospitals have eagerly anticipated the expansion of Medicaid eligibility mandated by the Affordable Care Act. In the wake of the Supreme Court decision ruling the expansion mandate unconstitutional, these safety-net hospitals now await for Governor Corbett’s decision on whether Pennsylvania will move ahead with that Medicaid expansion.
The title of this commentary is “Medicaid Works: Public Program Continues to Provide Access to Care and Financial Protection for Society’s Most Vulnerable,” and it can be found here , on the Commonwealth Fund’s web site.

PA Safety Net Admin2012-08-29T06:00:13+00:00August 29th, 2012|Health care reform, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off

DPW Secretary Shares Views on Medicaid Program

In an extensive interview with the Central Penn Business Journal, Pennsylvania Department of Public Welfare Secretary Gary Alexander shared his views on the state’s Medicaid program, the changes he would like to see, and the challenges the state faces in the immediate future.
Among the issues Alexander addressed are his desire to have greater flexibility to operate the state’s Medical Assistance program; the state’s prospects for expanding Medicaid eligibility as called for in the Affordable Care Act; his concern that greater access will increase rather than decrease uncompensated care and emergency room use; his interest in greater transparency for health care costs and quality; and his fight against fraud, waste, and abuse.
Read the complete Central Penn Business Journal interview with Secretary Alexander here .