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SNAP Asks PA Delegation for COVID-19 Aid

SNAP has written to Pennsylvania’s congressional delegation to request additional COVID-19 legislation between now and the end of the year to help Pennsylvania safety-net hospitals respond to the health care and financial challenges posed by the pandemic.

Safety-Net Association of Pennsylvania logoIn its letter, SNAP asked Congress for:

  • additional funding for the Provider Relief Fund for assistance to hospitals;
  • extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and
  • the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states.

Read SNAP’s message to Congress.

 

2020-12-08T06:00:24+00:00December 8th, 2020|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off on SNAP Asks PA Delegation for COVID-19 Aid

COVID-19 Update: Friday, December 4

The following is the latest COVID-19 information from the state and federal governments as of 2:45 p.m. on Friday, December 4.

SNAP Advocacy

Safety-Net Association of Pennsylvania logoSNAP has written to Congress to request additional COVID-19 legislation between now and the end of the year.  SNAP asked Congress for additional funding for the Provider Relief Fund; extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states.  Read SNAP’s message to Congress.

Pennsylvania Update

Department of Health

The Department of Health recognizes the need to protect the patients and residents in healthcare facilities by ensuring that visitors (including Department of Health employees) follow guidance and requirements issued by the Department of Health and CMS regarding visitation to healthcare facilities.  Surveyors from the Department of Health are required to follow these requirements and guidance.  The Department of Health also has its own testing program for our surveyors.  Because of HIPPA we cannot share medical results of our employees, but again we can assure you that all employees who are on site at facilities are compliant with all Department of Health and CMS guidance and requirements.

Department of Health – by the numbers

  • For the second consecutive day, Pennsylvania set a new high for new COVID-19 cases in a single day.
  • More than 11,000 Pennsylvanians have now died from COVID-19.  Daily death figures are now the highest they have been since the pandemic began.
  • Nearly 38,000 residents of long-term-care facilities and more than 7100 people who work in those facilities have contracted COVID-19.  Those figures encompass 1316 facilities in 65 of Pennsylvania’s 67 counties.
  • More than 15,000 health care workers in the state have contracted COVID-19.
  • More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
  • Nearly 600 Pennsylvanians are currently breathing with the help of a ventilator because they have COVID-19.
  • 16 percent of hospital adult ICU beds are currently unoccupied, as are 15 percent of medical/surgical beds, 40 percent of pediatric beds, 17 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.

Around the State

  • The Pittsburgh Tribune-Review reports that “More than one-third of hospitals in Southwestern Pennsylvania anticipate staffing shortages in the coming week.”
  • It also notes that “In Allegheny County, just over 11% of adult ICU beds in the county remain available – about 91 beds in total.”
  • ICU beds are a major concern, the Tribune-Review adds, explaining that “Intensive care units already are at capacity in two Western Pennsylvania hospitals.  Officials with Butler Health System said in a release Wednesday units at Butler Memorial and Clarion hospitals are full, and the health system has activated phase one of its surge plan.”
  • That plan “…includes converting Butler Memorial’s post-anesthesia care unit into an intensive care unit, which will add 15 more critical care beds in the hospital.”
  • In addition, the Tribune-Review adds, “The health system will suspend all nonemergency elective surgeries and procedures that would require an in-patient stay, a move officials hope will free up as many beds as possible.”
  • In addition, the Pittsburgh Business Times reports that the state’s Keystone region also is expected to see staffing shortages in the coming week.  That region consists of Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties.
  • The Harrisburg Patriot-News explains that “WellSpan York Hospital has put up a tent outside its emergency room and plans to add trailers.  A spokesman said the space is for isolating ER patients awaiting results of COVID-19 tests.  It’s not being used to house hospitalized patients, nor is the ER housing hospitalized patients.”
  • The Philadelphia Business Journal notes that on Wednesday, Philadelphia’s Health Department “…reported 859 patients with Covid are now being treated in city hospitals, nearing the 1,000 Covid admissions level Philadelphia medical centers experienced during the spring.”
  • Finally, the Philadelphia Inquirer reported that “The counties whose hospital ICUs were completely filled with coronavirus patients, according to state data, included Lycoming, Schuylkill, and Washington.  Most have small capacities, with some having fewer than five or 10 ICU beds in total, according to state data.”

Department of Human Services

DHS’s Office of Developmental Programs has posted guidance to community and life-sharing home providers about how to apply updated COVID-19 testing guidance and infection control procedure guidance issued by the state’s Department of Health.

Federal Update

Centers for Medicare & Medicaid Services

  • CMS has updated its FAQs on Medicare fee-for-service billing with 14 new questions that address administration and billing for monoclonal antibody therapy.  The new questions can be found on pages 33-34, p. 34, pp. 120-121, p. 121, pp. 121-124, pp. 124-125, p. 125 (four questions), p. 126, pp. 126-127, p. 127, and pp. 127-128.
  • CMS covers much the same ground in an updated version of its document “Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction.”
  • CMS has published a statement on its intended use of its enforcement discretion on skilled nursing facility consolidated billing for COVID-19 vaccines and monoclonal antibody infusions.  Through the exercise of this discretion, CMS will permit Medicare-enrolled immunizers to bill directly and receive direct reimbursement from the Medicare program.  Go here to see the complete statement.

Coronavirus (COVID-19) Stakeholder Calls 

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

COVID-19 Office Hours Call

Tuesday, December 8 at 5:00 (eastern)

Toll Free Dial-In:  833-614-0820; Access Passcode:  3129517

Audio Webcast link:  go here.

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

Audio Webcast link:  go here.

Conference lines are limited so CMS encourages interested parties to join via audio webcast.

To listen to the audio files and read the transcripts for past stakeholder calls, go here.

Department of Health and Human Services

  • HHS has issued a fourth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to increase access to critical countermeasures against COVID-19, including greater use of telehealth.  Go here for a more detailed description of what the amendment authorizes.

Food and Drug Administration

  • On Tuesday, December 8 at noon (eastern) the FDA will host a webinar on its enforcement policy for sterilizers, disinfectant devices, and air purifiers during the COVID-19 pandemic as part of its series on respirators and other personal protective equipment for health care personnel use during the pandemic.  Go here for further information about the webinar and how to participate.
  • The FDA has issued emergency use authorization for a bioburden-reduced N95 respirator.  See the FDA’s letter of authorization and its fact sheet for health care providers.

Centers for Disease Control and Prevention

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

2020-12-07T09:59:52+00:00December 7th, 2020|Coronavirus, COVID-19, Safety-Net Association of Pennsylvania|Comments Off on COVID-19 Update: Friday, December 4

COVID-19 Update for Wednesday, December 2

The following is the latest COVID-19 information from the state and federal governments as of 2:45 p.m. on Wednesday, December 2.

Pennsylvania Update

Governor Wolf

  • Governor Wolf has renewed his COVID-19 public health emergency declaration.  See the announcement of the renewal here and go here to see the declaration itself.
  • On Tuesday the governor posted a message on Twitter stating that “PA is projected to run out of ICU beds this month.”
  • Governor Wolf and the Department of Health have extended the state’s contract with a vendor to perform COVID-19 testing throughout the state.  Over the next 12 weeks, five teams will provide testing in 61 counties – counties without their own health departments; the six counties not receiving this testing have their own health departments that perform testing.  Work begins immediately, with testing available from December 2 through December 6 in Bedford, Mifflin, Tioga, and Northampton counties and from December 4 through December 8 in Butler County.  Learn more about this new testing initiative in this news release from the governor’s office.

Department of Health

The Department of Health has updated its interim guidance for skilled nursing facilities to incorporate new state and federal guidance issued since the last update on October 13, 2020.

The Department of Health issued a health advisory with guidance for long-term-care facilities on testing and managing residents with acute respiratory illness symptoms when COVID-19 and influenza viruses are both circulating.

Department of Health – by the numbers

  • Pennsylvania’s number of COVID-19 cases today surpassed 375,000.
  • More than 10,500 Pennsylvanians have now died from COVID-19.  The past two days have had the two highest single-day death totals in the state since the pandemic began.
  • More than 36,000 residents of long-term-care facilities and more than 6800 people who work in those facilities have contracted COVID-19.  Those figures encompass 1289 facilities in 65 of Pennsylvania’s 67 counties.
  • More than 14,800 health care workers in the state have contracted COVID-19.
  • The number of people currently hospitalized with COVID-19 has doubled since November 16.  The Department of Health reports that “Most of the patients hospitalized are ages 65 or older…”
  • The number of COVID-19 patients currently breathing with the help of a ventilator has doubled since November 17.
  • More than 1000 Pennsylvanians are currently in hospital adult intensive care units being treated for COVID-19.
  • 16 percent of hospital adult ICU beds are currently unoccupied, as are 15 percent of medical/surgical beds, 41 percent of pediatric beds, 17 percent of pediatric ICU beds, and 32 percent of airborne isolation unit beds.
  • The state-wide positivity rate on COVID-19 tests rose from 11.1 percent two weeks ago to 11.7 percent last week, according to the early warning dashboard released weekly by the governor and Department of Health.  Sixty-six of Pennsylvania’s 67 counties have positivity rates greater than five percent; five counties – Juniata, Mifflin, Bedford, Somerset, and Tioga – had positivity rates greater than 20 percent.
  • A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.
  • That same dashboard shows that 66 of the state’s 67 counties exhibited “substantial levels of community transmission” last week, up from 59 of 67 counties the previous week.
  • In light of the growing number of COVID-19 cases, the Department of Health is now prioritizing case investigations.  As a result, the number of successful contract-tracing efforts was 22 percent last week, up from 10 percent the previous week.
  • Of the confirmed cases reported between November 15 and November 21 in which contact tracing was successful, only one percent said they visited a business establishment 14 days prior to the onset of symptoms (down from 13 percent two weeks ago).  Drilling down on this data, the dashboard reports that

Compared to data reported on November 23, this week’s data indicated an increase for people who reported going to a restaurant (51 percent vs. 48 percent last week), going to a salon/barbershop (8 percent vs. 7 percent last week), and slight increases for those going to some other business (24.5 percent vs. 24 percent last week) and going to a bar (15.3 percent vs. 15 percent last week). The data saw a decrease for people who reported going to a gym/fitness center (10 percent vs. 14 percent last week). The number of those who attended a mass gathering or other large event decreased to 13 percent from 16.3 percent last week.

In addition, 16 percent of respondents said they had attended a mass gathering or other large event 14 days prior to onset of symptoms; two weeks ago, that figure was nearly 19 percent.

Around the State

  • Pennsylvania State MapThe Philadelphia Inquirer reported on Monday that “788 patients with COVID-19 were hospitalized in Philadelphia as of Monday… up 48% since Nov. 18, when 530 coronavirus patients were in the hospital.  69 patients were on ventilators.”
  • Across the state, the Pittsburgh Tribune-Review reported late last week that “A staggering rise in new covid-19 cases in Allegheny County means fewer people will receive calls from case investigators who have been overwhelmed with the rapid increase, Allegheny County Health Director Dr. Debra Bogen said Friday.  On Thursday and Friday, the county recorded a combined 1,642 new cases – more than the total number of new cases in May and June combined.”
  • In response, Pittsburgh’s public safety department has formed a task force to enforce new state COVID-19 restrictions.  The Tribune-Review reports that according to a policy spokesperson, the task force, requested by the city’s mayor, will “…conduct random, unannounced compliance checks at various businesses…  All violations will be documented.  In addition, police officers on regular patrol will respond to all complaints for violations of the Governor’s order.”
  • During a Monday news briefing, according to the Pennsylvania Capital-Star, “State Health Secretary Dr. Rachel Levine said the number of hospitalized individuals was a record, higher than totals in spring.”

Department of Human Services

Department of State

The Department of State has extended until 90 days after the governor’s COVID-19 emergency declaration ends all temporary practice permits issued by the State Board of Nursing for RNs and PNs (licensees from other states who may or may not still need to be examined) and graduate temporary permits for RNs and PNs (graduates of nursing education programs who have yet to be examined) that were in effect on March 6, 2020 unless (1) the temporary practice permit holder was subsequently issued a license after March 6, 2020 or (2) the temporary practice permit holder subsequently failed the licensure examination after March 6, 2020.  See the Department of State’s notice here.

Federal Update

Centers for Medicare & Medicaid Services

  • CMS has announced the introduction of two new Medicare condition codes that will take effect for claims received on or after February 1, 2021:  one to enable providers to report when a service is provided as part of Expanded Access approval and another to enable providers to report when the service is provided as part of an Emergency Use Authorization.  Find an article about the new codes here in MLN Matters, CMS’s online publication.
  • CMS has updated its compendium of COVID-19 emergency declaration of blanket waivers for health care providers with new information about its Medicare ground ambulance data collection system; see page 31 for details.
  • CMS has updated its COVID-19 FAQs on Medicare fee-for-service billing with a new section for Indian Health Services hospitals (see pages 150-151).

Department of Health and Human Services

  • HHS’s Office of the Assistant Secretary for Preparedness and Response has compiled a new hospital operations toolkit for COVID-19.  It covers capacity, patient care policies and processes, infection prevention and control, and administration.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response will host a webinar titled “Crisis Standard of Care and COVID-19:  What’s Working and What Isn’t” on Thursday, December 3 at noon (eastern).  Speakers will discuss clinical consultation versus triage support, systems-level information sharing, coalition-level coordination activities, and recent publications/resources to help with COVID-19 planning efforts.  Go here to learn more about the webinar and how to register for it.

Food and Drug Administration

Centers for Disease Control and Prevention

When a COVID-19 vaccine is authorized by FDA and recommended by ACIP, vaccination in the initial phase of the COVID-19 vaccination program (Phase 1a) should be offered to both 1) health care personnel and 2) residents of long-term care facilities.

National Institutes of Health

Government Accountability Office

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

2020-12-03T06:00:40+00:00December 3rd, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update for Wednesday, December 2

COVID-19 Update: Tuesday, November 24

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Tuesday, November 24.

Pennsylvania Update

Governor Wolf/Department of Health

Citing modeling that projects 22,000 new COVID-19 cases a day in Pennsylvania in December, Governor Wolf and Department of Health Secretary Levine have introduced new mitigation efforts.  The governor’s news release announcing these new efforts noted that “In the past week, the number of COVID-19 attributable deaths has quadrupled, and the average daily case count is 7 times higher than it was two months ago.”

The news release also explained that “The new measures include revamped school safety attestation, targeted business and gathering restrictions, and a new enforcement plan that includes liability protection for businesses enforcing the Secretary of Health’s strengthened mask-wearing order.”

The new mitigation effort also addresses elective procedures performed in acute-care hospitals.  The order establishes criteria under which the Department of Health may order hospitals to reduce by 50 percent the number of elective procedures performed in their facilities for a period of seven days.  Orders to reduce elective procedures can be triggered based on hospital staffing levels, COVID-19 surges, and available bed capacity.  Such orders will apply to all acute-care hospitals in any region that meets two of the three metrics and will be in effect for seven days, with renewal possible depending on conditions within the region; regions are defined in the executive order.  The order takes effect on November 30.  See Secretary Levine’s order addressing required reduction of elective procedures in regions with low acute-care treatment capacity.

Department of Health

Department of Health – by the numbers

  • Financial paperworkPennsylvania’s number of COVID-19 cases today surpassed 321,000.
  • In three of the past ten days Pennsylvania has set a new single-day high for the number of new cases.
  • Nearly 10,000 Pennsylvanians have now died from COVID-19.
  • More than 32,000 residents of long-term-care facilities and more than 6000 people who work in those facilities have contracted COVID-19.  Those figures encompass 1244 facilities in 64 of Pennsylvania’s 67 counties.
  • More than 14,000 health care workers in the state have contracted COVID-19.
  • The number of people currently hospitalized with COVID-19 has doubled in the past two weeks.
  • The number of COVID-19 patients currently breathing with the help of a ventilator has doubled since November 5.
  • Nearly 826 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19; that is a 43 percent increase in the past week.
  • 17 percent of hospital adult ICU beds are currently unoccupied, as are 17 percent of medical/surgical beds, 39 percent of pediatric beds, 19 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.  There are now more COVID-19 patients in adult ICU beds in Pennsylvania than there are currently unoccupied adult ICU beds in the state.
  • The state-wide positivity rate on COVID-19 tests rose from 9.6 percent two weeks ago to 11.1 percent last week, according to the early warning dashboard released weekly by the governor and Department of Health.  Sixty-six of Pennsylvania’s 67 counties have positivity rates greater than five percent.
  • A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.
  • That same dashboard shows that 59 of the state’s 67 counties exhibited “substantial levels of community transmission” last week, down from 63 of 67 counties the previous week.
  • In light of the growing number of COVID-19 cases, the Department of Health is now prioritizing case investigations.  As a result, the number of successful contract-tracing efforts was down to 10 percent last week; it was 21 percent the previous week.
  • Of the confirmed cases reported between November 8 and November 14 in which contact tracing was successful, 13 percent said they visited a business establishment 14 days prior to onset of symptoms (down from 19 percent two weeks ago).  Among them:
    • 48 percent reported going to a restaurant
    • 24 percent reported going to some other business establishment
    • 15 percent reported going to a bar
    • 14 percent reported going to a gym/fitness center
    • seven percent reported going to a salon/barbershop

In addition, 16 percent of respondents said they had attended a mass gathering or other large event 14 days prior to the onset of symptoms; two weeks ago, that figure was nearly 19 percent.

Federal Update

Provider Relief Fund

The Provider Relief Fund web page has been updated with the following notice:

The application deadline for the Provider Relief Fund Phase 3 General Distribution was Nov. 6, 2020. You must have submitted your Taxpayer Identification Number (TIN) for validation by 11:59 p.m. ET on Nov. 6, 2020 for Phase 3 relief funds. If you submitted your TIN for validation by the deadline and your TIN is validated by Nov. 13, you will be able to proceed with submitting your revenue documentation to complete your application by 11:59 p.m. ET on Nov. 27, 2020.

Department of Health and Human Services

  • HHS has announced plans to allocate doses of the investigational monoclonal antibody therapeutics casirivimab and imdevimab for treatment of non-hospitalized patients with mild or moderate confirmed cases of COVID-19 at high risk of hospitalization; this is often referred to publicly as the Regeneron antibody cocktail.  HHS will allocate 300,000 federally-purchased doses to state and territorial health departments that will determine which health care facilities receive the infusion drug.  Weekly allocations of the drug will be proportionally based on confirmed COVID-19 cases in each state and territory over the previous seven days based on data that hospitals and state health departments enter into the HHS Protect data collection platform.  Learn more from HHS’s announcement about the allocation plan.  Find additional information about allocation here.
  • HHS has published a Request for Information notice in which it seeks to “…gather information on effective innovative approaches and best practices in health care in response to the COVID-19 pandemic by non-HHS health care systems and providers.”  Comments are due by December 24.  Go here to see the brief notice.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a paper on the designation of individual hospitals as COVID-19 hospitals within health systems or geographic areas.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a report on crisis standards of care and patient surge management for COVID-19.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a presentation with information on the use of point-of-care tests for the diagnosis of COVID-19.

Centers for Medicare & Medicaid Services

  • CMS has posted the first episode in a series of short podcasts for frontline nursing home staff.  The series, “CMS Beyond the Policy:  Nursing Home Series for Frontline Clinicians and Staff,” is designed to reinforce training and infection control practices in nursing homes to help combat the spread of COVID-19.  To listen to the podcast, go here.

Food and Drug Administration

Centers for Disease Control and Prevention

Department of Labor

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

2020-11-25T06:00:23+00:00November 25th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: Tuesday, November 24

SNAP Asks Wolf to Sign COVID-19 Liability Protection Bill

Sign a bill to provide vital liability protection to health care providers during the COVID-19 emergency, SNAP asked Pennsylvania Governor Tom Wolf in a letter the association delivered to the governor yesterday.

Safety-Net Association of Pennsylvania logoIn the letter, SNAP wrote that

Medical professionals and hospitals on the frontlines should be permitted to use their clinical judgment without risk or fear from civil liability for decisions made in good faith. House Bill 1737, which was recently sent to your desk for consideration, would provide civil liability protections for the medical decisions made in caring for Pennsylvania’s citizens during the COVID-19 disaster declaration. This legislation would protect hospitals and providers from questionable lawsuits and the financial harm they could cause, especially at a time when hospitals have experienced significant financial stress.

Go here to see SNAP’s letter to Governor Wolf about Pennsylvania House Bill 1737.

2020-11-24T06:00:16+00:00November 24th, 2020|Coronavirus, COVID-19|Comments Off on SNAP Asks Wolf to Sign COVID-19 Liability Protection Bill

COVID-19 Update: Thursday, November 19

The following is the latest COVID-19 information from the state and federal governments as of 3:30 p.m. on Thursday, November 19.

Pennsylvania Update

Department of Health

The Department of Health has released its “COVID-19 Interim Vaccination Plan.”  Among other considerations, the plan addresses:

  • The phased approach the state proposes for administering vaccines to different segments of the population.
  • Provider recruitment and enrollment.
  • The readiness of the state’s health care infrastructure to play its planned role in administering vaccines.
  • Vaccine allocation, storage, and distribution.
  • Information technology and record-keeping considerations.
  • Regulatory considerations.
  • Public outreach.
  • Vaccine program communication.

During a Thursday afternoon news briefing, Secretary Levine made the following points about the planned vaccine program and other aspects of the state’s response to COVID-19.

  • Vaccines will be administered in three phases:  first, to health care personnel, people age 65 and older, high-risk individuals, and residents of congregate settings; second, other vulnerable populations and people with high-risk conditions; and third, the rest of the state’s population.
  • The state will make a special effort to work through mass vaccination clinics, FQHCs, and other groups to ensure outreach to at-risk people who do not participate regularly in the health care system.
  • In the beginning, it may be difficult to receive the Pfizer vaccines in some rural areas that lack hospitals with the capacity to store those vaccines, so residents of such areas may need to travel a bit to get vaccinated until other vaccines become available.
  • The state currently has adequate testing capacity and hospital beds the turnaround time on test results is much shorter than it was in the past.
  • The Secretary has confidence in the capacity of the state’s hospitals to handle the increased caseload of COVID-19 patients, does not plan to order them to suspend non-urgent procedures, but has contingency plans if the situation merits more drastic action.
  • Distribution of the monoclonal antibody bamlanivimab to hospitals will begin later this week.

Department of Health – by the numbers

  • Pennsylvania’s number of COVID-19 cases today surpassed 288,000.
  • For the third consecutive day, the state surpassed its previous high for the number of new cases in a single day.
  • More than 9500 Pennsylvanians have now died from COVID-19.  Daily death figures are now much higher than they have been since May.
  • The number of COVID-19 patients currently breathing with the help of a ventilator has nearly tripled since November 1.
  • More than 600 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
  • 16 percent of hospital adult ICU beds are currently unoccupied, as are 16 percent of medical/surgical beds, 38 percent of pediatric beds, 15 percent of pediatric ICU beds, and 35 percent of airborne isolation unit beds.  These percentages translate into 663 available adult ICU beds, 3188 available medical/surgical beds, 297 available pediatric beds, 50 available pediatric ICU beds, and 893 airborne isolation beds.  The number of available adult beds has fallen slightly in recent days while the number of available pediatric beds has risen slightly.

Federal Update

Provider Relief Fund

The Provider Relief Fund web page has been updated with the following notice:

The application deadline for the Provider Relief Fund Phase 3 General Distribution was Nov. 6, 2020. You must have submitted your Taxpayer Identification Number (TIN) for validation by 11:59 p.m. ET on Nov. 6, 2020 for Phase 3 relief funds. If you submitted your TIN for validation by the deadline and your TIN is validated by Nov. 13, you will be able to proceed with submitting your revenue documentation to complete your application by 11:59 p.m. ET on Nov. 27, 2020.

The Provider Relief Fund FAQ has been updated with three new questions and one modified question.

  • (pp. 15-16)  Will the Provider Relief Fund limit qualifying expenses for capital equipment purchases to 1.5 years of depreciation, or can providers fully expense capital equipment purchases?  (Added 11/18/2020)

Expenses for capital equipment and inventory may be fully expensed only in cases where the purchase was directly related to prevent, prepare for and respond to the coronavirus.  Examples of these types of equipment and inventory expenses include ventilators, computerized tomography scanners, and other intensive care unit- (ICU) related equipment put into immediate use or held in inventory; masks, face shields, gloves, gowns; biohazard suits; general personal protective equipment; disinfectant supplies.

  • Can providers include the entire cost of capital facilities projects as eligible expenses, or will eligible expenses be limited to the depreciation expense for the period?  (Added 11/18/2020)

Expenses for capital facilities may be fully expensed only in cases where the purchase was directly related to preventing, preparing for and responding to the coronavirus. Examples of these types of facilities projects include upgrading a heating, ventilation, and air conditioning (HVAC) system to support negative pressure units; retrofitting a COVID-19 unit; enhancing or reconfiguring ICU capabilities; leasing or purchasing a temporary structure to screen and/or treat patients; leasing a permanent facility to increase hospital or nursing home capacity.

  • (p. 16)  Do providers report total purchase price of capital equipment or only the depreciated value?  (Modified 11/18/2020)

Providers who use accrual or cash basis accounting may report the relevant depreciation amount based on the equipment useful life, purchase price and depreciation methodology otherwise applied. Providers may report an expense for items purchased with a useful life of 12 months or less if in accordance with their existing accounting policies.  For additional information on capital depreciation, please refer to the other Frequently Asked Questions related to capital equipment and capital facility projects.

  • (pp. 24-25)  Providers may have significant fluctuations in year-over-year net patient revenues due to settlements or payments made to third parties relating to care delivered outside the reporting period (2019-2020). Should Provider Relief Fund recipients exclude from the reporting of net patient revenue payments received for care not provided in 2019 or 2020?  (Added 11/18/2020)

Provider Relief Fund recipients shall exclude from the reporting of net patient revenue payments received or payments made to third parties relating to care not provided in 2019 or 2020.

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

2020-11-20T06:00:47+00:00November 20th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: Thursday, November 19

COVID-19 Update: Tuesday, November 17

The following is the latest COVID-19 information from the state and federal governments as of 3:45 p.m. on Tuesday, November 17.

Pennsylvania Update

The Wolf Administration/Department of Health

The Wolf administration and Department of Health announced new COVID-19 mitigation efforts in the face of growing numbers of new cases.  See their announcement here.  The new effort consists of four components.

  • A memorandum to acute-care hospitals presenting projections that the state could run out of ICU beds in December.  It urges hospitals to act now, on their own, to address capacity planning and elective procedures matters.
  • An order requiring anyone who visits from another state to have a negative COVID-19 test within 72 hours prior to entering Pennsylvania.  If someone cannot get a test or chooses not to, they must quarantine for 14 days upon arrival in Pennsylvania.  Pennsylvanians visiting other states are required to have a negative COVID-19 test within 72 hours prior to returning to the state or to quarantine for 14 days upon return to Pennsylvania.  The order does not apply to those who cross state boundaries for work or to receive medical care.  It takes effect on Friday, November 20.
  • A strengthened order addressing the wearing of masks stating that masks must  be worn indoors and outdoors when people are away from their home.  When outdoors, they must wear masks if they are not able to remain at least six feet away from anyone not in their household the entire time they are outdoors.  When indoors, masks are required even if people are physically distant from individuals not in their household.  This means that even if people are able to be six feet apart, they will need to wear a mask while inside if with people other than members of their household.  This order applies to every indoor facility, including homes, retail establishments, gyms, doctors’ offices, public transportation, and anywhere food is prepared, packaged, or served.
  • The departments of Health and Education issued recommendations for colleges and universities to implement a testing plan for when students return to campus following breaks and holidays.

Department of Health

Department of Health – by the numbers

  • Pennsylvania’s number of COVID-19 cases today surpassed 275,000.
  • In 11 of the past 15 days, Pennsylvania has surpassed its previous high for the number of new cases in a single day.
  • More than 9300 Pennsylvanians have now died from COVID-19.  Daily death figures are now generally higher than they have been since May.
  • More than 30,000 residents of long-term-care facilities and more than 6100 people who work in those facilities have contracted COVID-19.  Those figures encompass 1162 facilities in 63 of Pennsylvania’s 67 counties.
  • More than 13,600 health care workers in the state have contracted COVID-19.
  • The number of people currently hospitalized with COVID-19 has nearly doubled since November 1.
  • The number of COVID-19 patients currently breathing with the help of a ventilator has more than doubled since November 1.
  • Nearly 600 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
  • 19 percent of hospital adult ICU beds are currently unoccupied, as are 17 percent of medical/surgical beds, 38 percent of pediatric beds, 12 percent of pediatric ICU beds, and 35 percent of airborne isolation unit beds.  These numbers have barely changed since the last update.  The percentages translate into 782 available adult ICU beds, 3412 available medical/surgical beds, 316 available pediatric beds, 41 available pediatric ICU beds, and 943 airborne isolation beds.
  • The state-wide positivity rate on COVID-19 tests rose from 6.9 percent last week to 9.6 percent this week, according to the state’s early warning monitoring dashboard.
  • A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.
  • All but five Pennsylvania counties now have positivity rates greater than five percent.
  • 59 of the state’s 67 counties are considered to be in “substantial transmission status.”
  • Of the confirmed cases reported between November 1 and November 7, 16 percent responded to contact tracers’ questions about whether they spent time at a business establishment.  Of those who answered, 18 percent said they visited a business establishment 14 days prior to onset of symptoms.  Among them:
    • 53 percent reported going to a restaurant
    • 26 percent reported going to some other business establishment
    • 11 percent reported going to a bar
    • 12 percent reported going to a gym/fitness center
    • seven percent (reported going to a salon/barbershop
    • 9 percent said they had attended a mass gathering or other large event 14 days prior to onset of symptoms.

Overall, these numbers are slightly better than those from the previous week.

City of Philadelphia

In the face of growing numbers of new local COVID-19 cases, the city of Philadelphia has announced new mitigation efforts addressing businesses and business activities, recreational facilities and activities, retail and other consumer businesses, and more.  The announcement also details enterprises that will continue under current guidelines.  See the city’s announcement here and find further information here.  The new guidelines take effect on November 20 and continue until at least through January 1, 2021.

Federal Update

Provider Relief Fund

The Provider Relief Fund web page has been updated with the following notice:

The application deadline for the Provider Relief Fund Phase 3 General Distribution was Nov. 6, 2020. You must have submitted your Taxpayer Identification Number (TIN) for validation by 11:59 p.m. ET on Nov. 6, 2020 for Phase 3 relief funds. If you submitted your TIN for validation by the deadline and your TIN is validated by Nov. 13, you will be able to proceed with submitting your revenue documentation to complete your application by 11:59 p.m. ET on Nov. 27, 2020.

Department of Health and Human Services

  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted information about high-flow nasal cannulation, an oxygen therapy that is a non-invasive resuscitation therapy for COVID-19 patients.  HHS has purchased kits to use when administering this therapy and health care facilities can work through their local and state health departments to secure a supply.  Go here to learn more about the therapy and how to acquire supplies.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response presents a speaker series focused on how the COVID-19 pandemic can affect health care professional stress and resilience.  Topics in this series include acute and chronic stressors, identifying at-risk employees, and fostering resilience.  Go here for further information.
  • HHS has entered into partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains to improve access to eventual COVID-19 vaccines.  Participating pharmacies will counsel customers about vaccines and order and administer vaccines at no cost to those customers.  Learn more in this HHS announcement.

CMS COVID-19 Stakeholder Calls 

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Nursing Homes

Wednesday, November 18 at 4:30 – 5:00 PM (eastern)

Toll Free Attendee Dial-In:  833-614-0820

Access Passcode:  1335116

Audio Webcast link:  go here

Centers for Disease Control and Prevention

Food and Drug Administration

  • The FDA has updated its guidance on investigational COVID-19 convalescent plasma.  The updated guidance extends the period of enforcement discretion through the end of February 2021.  This extension will permit continued access to convalescent plasma for the treatment of hospitalized COVID-19 patients while blood establishments develop the necessary operating procedures to manufacture the plasma consistent with the emergency use authorization.  The guidance also includes a new recommendation that authorized COVID-19 convalescent plasma not be collected from individuals who have received an investigational COVID-19 vaccine.
  • The FDA has updated its FAQs on the development of COVID-19 tests.
  • The FDA has established a new webpage, A Closer Look at COVID-19 Diagnostic Testing, to provide health care providers and other public health professionals, including those who might purchase COVID-19 tests, with more technical information and resources.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

2020-11-18T06:00:22+00:00November 18th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: Tuesday, November 17

COVID-19 Update: Friday, November 13

The following is the latest COVID-19 information from Pennsylvania’s state government as of 2:00 p.m. on Friday, November 13.

Department of Health

The Department of Health updated its guidance for providers on the counseling of patients evaluated for or diagnosed with COVID-19 to self-isolate and identify persons with whom they were in close contact in the 48 hours before symptom onset.  A COVID-19 Close Contact Worksheet and COVID-19 Patient Instructions for Self-Isolation While Awaiting Laboratory Results accompanied the guidance.

Department of Health – by the numbers

  • Pennsylvania’s number of COVID-19 cases today surpassed 250,000.
  • At the height of the pandemic in the spring, Pennsylvania never exceeded 2000 new cases in a single day.  On October 22 the state reached that mark for the first time and five days later it rose past 2500.  On November 6 the state climbed past 3000 new cases in a single day for the first time and then, quickly, past 4000 in one day on November 7 and past 5000 yesterday.  The number has now risen for five consecutive days, to an all-time high today.
  • More than 9200 Pennsylvanians have now died from COVID-19.  Daily death figures are now generally higher than they have been since May.
  • Nearly 29,000 residents of long-term-care facilities and more than 6000 people who work in those facilities have contracted COVID-19.  Those figures encompass 1144 facilities in 63 of Pennsylvania’s 67 counties.
  • More than 13,300 health care workers in the state have contracted COVID-19.
  • The number of people currently hospitalized with COVID-19 has doubled since late last month.
  • The number of COVID-19 patients currently breathing with the help of a ventilator has done the same.
  • Nearly 500 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
  • 18 percent of hospital adult ICU beds are currently unoccupied, as are 15 percent of medical/surgical beds, 35 percent of pediatric beds, nine percent of pediatric ICU beds, and 36 percent of airborne isolation unit beds.
  • The state-wide positivity rate on COVID-19 tests rose from 6.1 percent last week to 6.9 percent this week.
  • A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.
  • According to the early warning dashboard released weekly by the governor and Department of Health, counties with especially high positivity rates during the week of October 25 were led by Bedford (17.5 percent), Indiana (14 percent), Armstrong (13.1 percent), Franklin (12.3 percent), Lawrence (12.2 percent), Bradford (12.1 percent), Wyoming (12 percent), and Venango (11.8 percent).
  • That same dashboard shows the following counties currently experiencing “substantial levels of community transmission” of COVID-19:  Adams, Armstrong, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Carbon, Centre, Clarion, Crawford, Dauphin, Delaware, Elk, Franklin, Fulton, Huntingdon, Indiana, Jefferson, Juniata, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Mercer, Mifflin, Montgomery, Northampton, Northumberland, Philadelphia, Schuylkill, Tioga, Union, Venango, and Wyoming.

Of the confirmed cases reported between October 25 and October 31, 21 percent responded to contact tracers’ questions about whether they spent time at a business establishment.  Of those who answered, 18.7 percent said they visited a business establishment 14 days prior to onset of symptoms.  Among them:

  • 55 percent reported going to a restaurant
  • 26 percent reported going to some other business establishment
  • 13 percent reported going to a bar
  • 12 percent reported going to a gym/fitness center
  • eight percent (reported going to a salon/barbershop

In addition, 18.9 percent of respondents said they had attended a mass gathering or other large event 14 days prior to onset of symptoms.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

2020-11-16T06:00:19+00:00November 16th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: Friday, November 13

COVID-19 Update: Thursday, November 5

The following is the latest COVID-19 information from the state and federal governments as of 3:00 p.m. on Thursday, November 5.

Pennsylvania Update

Department of Health

The Department of Health updated its hospital guidance to clarify that hospitals must test COVID-19 patients prior to discharge to another facility and communicate those test results to the receiving facility prior to discharge.

In response to an increase of new COVID-19 cases in Huntingdon County, the Department of Health contracted for drive-through and indoor testing clinics in the county from October 29 through Monday, November 2.

During a news conference this week, Secretary Levine noted that Pennsylvania is now seeing more COVID-19 “long-haulers”:  people who continue to experience COVID-19 symptoms over a period of months.

Even though current case counts in Pennsylvania are higher than they were during the earlier days of the pandemic, fewer people are hospitalized with the disease, fewer are being treated on ventilators, and fewer are dying.  Secretary Levine attributes these improvements to better medical care, more experience treating COVID-19 patients, and better therapeutics.  In addition, long-term-care facilities are doing a better job of preventing and limiting outbreaks.  She attributed this improvement in part to the help those facilities are receiving through the state’s Regional Response Health Collaborative program.

She also noted that cases are less concentrated among elderly Pennsylvanians than in the pandemic’s early days and that younger people are better equipped to fight the disease.

The state recently released data that illustrates this change:

  • In north central Pennsylvania, approximately seven percent of cases in April were among people ages 19 to 24 while that same age group accounted for approximately 28 percent of cases in October.
  • In northeastern Pennsylvania, that figure rose from six percent of cases in April to approximately 16 percent of cases in October.
  • In southeastern Pennsylvania it rose from nearly five percent of cases in April to nearly 14 percent of cases in October.
  • In southeastern Pennsylvania it rose from approximately five percent of cases in April to nearly 12 percent of cases in October.
  • In northwestern Pennsylvania it rose from nearly seven percent of cases in April to approximately 14 percent of cases in October.
  • In south central Pennsylvania it rose from approximately seven percent of cases in April to approximately 12 percent of cases in October.

The state is still struggling with people unwilling to cooperate with contact tracers when they are informed that they have COVID-19, Secretary Levine continued.  Only 24 percent are currently doing so.

Among those who are cooperating, in the past week more than half of those people said they had been in a restaurant or “large business” or mass gathering setting in the past two weeks.

Department of Health COVID-19 Vaccine Planning

Last week we introduced you to an executive summary of Pennsylvania’s COVID-19 vaccination plan.  Today, Secretary Levine held a news briefing to provide additional information about Pennsylvania’s plan.  According to a report in the York Daily Record, Secretary Levine said that the state intends to distribute the vaccines in phases and that “In the first phase, when vaccine doses are likely to be limited, high-risk workers in health care settings, first responders, other essential workers, people with pre-existing health conditions and adults in long-term care are likely to be prioritized.”  Learn more from the York Daily Record article.

Department of Health – by the numbers

  • Pennsylvania’s number of COVID-19 cases recently surpassed 220,000.  The past week has seen the highest number of new cases on a daily basis since the pandemic began and Thursday’s new case count was the state’s new single-day high.
  • The number of new cases in Pennsylvania during the week ending October 29 was 43 percent higher than the previous week.
  • With today’s latest figures, the death count now exceeds 8900.
  • Of that number, 61 percent have been residents of long-term-care facilities.
  • Overall, nearly 27,000 residents of long-term-care facilities and more than 5800 people who work in those facilities have contracted COVID-19.  Those figures encompass 1100 facilities in 63 of Pennsylvania’s 67 counties.
  • More than 12,700 health care workers in the state have contracted COVID-19.
  • The number of people currently hospitalized with COVID-19 is higher than it has been at any time since May.
  • The number of COVID-19 patients currently breathing with the help of a ventilator is higher than it has been since mid-June.
  • 20 percent of hospital adult ICU beds are currently unoccupied, as are 18 percent of medical/surgical beds, 33 percent of pediatric beds, 12 percent of pediatric ICU beds, and 37 percent of airborne isolation unit beds.
  • The state-wide positivity rate on COVID-19 tests rose from five percent two weeks ago to six percent last week.
  • A positivity rate greater than five percent is considered “concerning,” Secretary Levine explained during her news briefing, adding that currently, 40 counties have rates higher than five percent.  Only 30 counties were at that level the previous week, she added.
  • According to the early warning dashboard released weekly by the governor and Department of Health, the following counties are currently experiencing “substantial level of transmission” of COVID-19:  Armstrong, Berks, Blair, Bradford, Cambria, Centre, Crawford, Dauphin, Delaware, Franklin, Fulton, Huntingdon, Indiana, Lackawanna, Lawrence, Lebanon, Lehigh, Luzerne, Mifflin, Philadelphia, Schuylkill, Tioga, Venango, Westmoreland, Wyoming, and York.

Department of Human Services

DHS is no longer requiring non-nursing home providers to submit interim reporting on their CARES ACT/Act 24 spending.  Interim reports would have been due on November 6 and are still required of nursing homes.

DHS’s Office of Long-Term Living and Office of Developmental Programs (ODP) have updated their guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.

ODP has issued guidance to individuals, families and designated persons, licensed and enrolled providers of ODP residential services, and all interested parties on developing visitation policies in ODP residential settings to protect residents, staff, and visitors from COVID-19.

Federal Update

Provider Relief Fund

  • A reminder that applications for Phase 3 general distribution payments are due Friday, November 6.
  • HHS has updated the Provider Relief Fund FAQ with two modified items; the second bullet below addresses the deadline for Phase 3 applications.
    • p. 6 – Does HHS intend to recoup any payments made to providers not tied to specific claims for reimbursement, such as the General or Targeted Distribution payments? ( Modified 11/5/2020)

The Provider Relief Fund and the Terms and Conditions require that recipients be able to demonstrate that lost revenues and increased expenses attributable to COVID-19, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, exceed total payments from the Relief Fund. Provider Relief Fund payment amounts that have not been fully expended on the combination of healthcare expenses and lost revenues attributable to coronavirus by the end of the final reporting period, must be returned to HHS. HHS reserves the right to audit Relief Fund recipients in the future to ensure that this requirement is met and collect any Relief Fund amounts that were made in error or exceed lost revenue or increased expenses due to COVID-19. Failure to comply with the Terms and Conditions may be grounds for recoupment.

  • p. 41 – Tax Identification Number (TIN) Validation Process

When is the deadline to submit an application? (Modified 11/5/2020)

The deadline to submit an application under Phase 3 – General Distribution is November 6, 2020 at 11:59 PM EST for those that have had their TIN validated in Phase 2 or received funds as part of Phase 1. Any entity that has not yet received any General Distribution payments must submit their TIN for validation by November 6, 2020 at 11:59 PM EST. If the TIN is validated by November 13, 2020 at 11:59 PM EST, the entity will have until November 27, 2020 at 11:59 PM EST to submit an application.

Department of Health and Human Services

  • HHS’s Office of the National Coordinator for Health Information Technology (ONC) has posted FAQs about the information-blocking provisions of the regulation it published last week extending until April of 2021 the agency’s deadline for complying with its information-blocking requirements.  Find those FAQs here.

Centers for Medicare & Medicaid Services

  • CMS’s online publication MLN Connects directs providers and others to its COVID-19 vaccine toolkit for information about preparing to administer such vaccines when they become available.
  • CMS has updated its provider-specific fact sheets on new COVID-19-related waivers and flexibilities for the following providers:

Centers for Disease Control and Prevention

Food and Drug Administration

Congressional Research Service

 

2020-11-10T21:03:49+00:00November 6th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: Thursday, November 5

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its November 2020 newsletter Health Law News.

Included in this month’s edition are articles about:

  • How the renewal of the federal COVID-19 public health emergency declaration extends key Medicaid protections.
  • State planning for children with complex needs.
  • State efforts to connect people to COVID-19 testing and care.
  • An upcoming webinar about challenging Medicaid and Community HealthChoices waiver service denials.

Read about these subjects and more in the Pennsylvania Health Law Project’s November 2020 newsletter.

2020-11-17T15:00:32+00:00November 4th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter
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