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PA Health Policy Update for the Week of February 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of February 25, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House Appropriations Committee continued its FY 2023 budget hearings this week and the Senate Appropriations Committee began its hearings this week. Hearings will conclude March 17. A complete schedule of the hearings can be found here.

The Department of Health and Department of Drug and Alcohol Programs are scheduled to appear before the House Appropriations Committee next Thursday, March 3 at 10:00 a.m.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to inform Medical Assistance providers about updates related to billing and payment for the administration of monoclonal antibody therapies for the treatment of COVID-19. This bulletin applies to all physicians, certified registered nurse practitioners, certified nurse midwives, outpatient hospital clinics, home health agencies, independent medical surgical clinics, pharmacies, and renal dialysis centers enrolled in the Medicaid program who are authorized to administer monoclonal antibody therapies to Medicaid beneficiaries in the Medicaid fee-for-service delivery system. Providers rendering services in the Medicaid managed care delivery system should address any coding and billing questions to the appropriate managed care organization. Learn more from this Medical Assistance Bulletin.

The Department of Human Services has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that it is implementing an alternative payment methodology to pay the Medical Assistance program fee schedule rate for the administration of COVID-19 vaccines during COVID-19 vaccine-only visit for dates of service on and after December 1, 2020 and that it will pay the enhanced Medicaid program fee schedule rate for the administration of those vaccines to homebound Medicaid beneficiaries during vaccine-only visits for dates of service on and after April 1, 2021. Find the bulletin here.

Department of Health

Ninety-five percent of all Pennsylvanians ages 18 and older have had at least one COVID-19 vaccination and 76.2 percent ages 18 and older are now fully vaccinated, the Department of Health reports.

The Department of Health has updated its guidance on when people should receive COVID-19 vaccines and the appropriate intervals between primary doses and between primary doses and boosters. The update is based on recent CDC guidance.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced more than $15 million in grant funding for stabilization payments to substance use disorder treatment providers to assist with pandemic-related expenses. Through 108 grant agreements, 375 substance use disorder treatment provider locations will receive funding. All eligible applicants that applied were awarded funding. Learn more about the purpose of the funding and find a link to a list of organizations awarded grants in this department news release.

The Department of Drug and Alcohol Programs has posted a new FAQ for providers that combines questions from previous American Society of Addiction Medicine (ASAM) level-of-care-specific FAQ documents along with questions received through the ASAM Transition email account and technical assistance meetings with providers and stakeholders. Find the new FAQ here.

COVID-19: By the Numbers

Daily COVID-19 case counts remain high but fell significantly again over the past week. Pennsylvania’s seven-day average yesterday (February 24) was 2294 cases day; a week ago (February 17) its seven-day average was 3159 cases a day.
The number of new COVID-19-related deaths also declined again over the past week. Pennsylvania’s seven-day average yesterday (February 24) was 65 deaths a day; a week ago (February 10) its seven-day average was 83 deaths a day.
The Department of Health reports that the percentage of available adult ICU beds fell from 22 percent to 19.6 percent during the past week and the percentage of available pediatric ICU beds fell from 8.5 percent to 7.7 percent over the same period of time, leaving just 30 unoccupied pediatric ICU beds in the state.
The Department of Health also reports that approximately 9.9 percent of all staffed adult ICU beds in the state are occupied by COVID-19 patients this week, down from 12.7 percent last week, and that 25.8 percent of all ventilators in the state are currently in use, down from 26.6 percent last week.
For the first time in recent months, all 67 Pennsylvania counties are not experiencing high rates of COVID-19 transmission: Sullivan County is experiencing a moderate rate of community transmission and Carbon, Delaware, Dauphin, Lehigh, Monroe, and Snyder counties are “only” experiencing substantial rates of community transmission.
The decline in the number of new COVID-19 cases is reflected in a 65 percent decline since February 1 in the number of Pennsylvanians hospitalized with the virus and a 28 percent decline over the past week. The number of people on ventilators has fallen 60 percent since the first of the month and 23 percent in the past week and the number in ICUs has fallen 63 percent since the first of February and 30 percent over the past seven days.

Stakeholder Events

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m. Go here to register to participate.

Centers for Medicare & Medicaid Services – RFI on Medicaid and CHIP – March 1

On February 17, CMS published a request for information on access to care and coverage for people enrolled in Medicaid and CHIP. On Tuesday, March 1 at 3:30 p.m. (eastern) the agency will hold a webinar discuss with stakeholders its objectives in issuing the RFI and the process for submitting responses. Go here to register to participate.

Department of Health – Advisory Health Board – March 16

The Department of Health’s Advisory Health Board will meet virtually on Wednesday, March 16 at 2:00 p.m. to discuss programmatic and departmental activities. For information about how to participate, see this Pennsylvania Bulletin notice.

jsteinbock2022-02-25T21:28:43+00:00February 25th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off

PA Health Policy Update for the Week of January 10-14

The following is an update of selected state health policy developments in Pennsylvania for the week of January 10-14, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has announced the creation of the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment program, or LTC RISE, which seeks to give long-term-care facilities “…the support they need to battle COVID-19, recover, and rebuild.” Under the program, long-term-care facilities can pursue improvement projects in the areas of infection prevention and control and emergency preparedness; building a sustainable outbreak response operation; and promoting professional development and a resilient long-term-care facility workforce. The program is funded by a federal grant and replaces the state’s Regional Congregate Care Assistance Teams program, which expired at the end of 2021. Learn more about LTC RISE from this Wolf administration news release and from the LTC RISE web page.

General Assembly

The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act. This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act. The bill was received in the Senate and referred to the Health and Human Services Committee.
The House Health Committee convened on Tuesday, January 11 and favorably reported House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid. The committee also reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m. The hearing will take place at the University of Pittsburgh at Bradford.
The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
- Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
- House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
- House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

Various Department of Human Services (DHS) regulations were suspended to facilitate the state’s response to the COVID-19 pandemic. Some of those suspensions have been lifted, so some of the temporarily suspended regulations are being enforced again. For an updated list of regulations and their current status, organized by offices within DHS and with the most recent changes highlighted, go here.
DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of booster doses of COVID-19 vaccines. To find those new codes and the rates to be paid, see this Pennsylvania Bulletin notice.
DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of the Pfizer pediatric COVID-19 vaccine. Find the procedure codes, rates, and more in this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin informing providers of changes in billing procedures for certified registered nurse practitioners and physician assistants serving fee-for-service patients.
DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that the fee-for-service program will require prior authorization for prescribing Aduhelm (aducanumab), the new drug to treat Alzheimer’s disease.
DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that it has issued updated handbook pages presenting the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Xyrem (sodium oxybate)/Xywav (calcium, magnesium, potassium, and sodium oxybates) for fee-for-service patients. Find the notice here.
DHS announced that it intends to continue making Medical Assistance Day One Incentive payments to qualified non-public nursing facilities in FY 2022. These payments seek to give incentives to non-public nursing facilities to serve individuals who are Medical Assistance-eligible on the day of admission. Learn more about how and when the payments will be made and how they will be calculated in this Pennsylvania Bulletin notice.
DHS is making available for public review and comment its proposed renewal application for extension of the Section 1115 Medicaid demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration.” The effective dates of the current approved demonstration are October 1, 2017 through September 30, 2022. The extension requested will be for an additional five years, through September 30, 2027. Learn more about the program and the state’s planned request from this Pennsylvania Bulletin notice.
DHS’s Office of Child Development and Early Learning has updated its FAQ on its guidance for tuberculin skin testing and COVID-19 vaccinations for providers participating in its licensed programs. Find that FAQ here.

Department of Health

In the past week the Department of Health announced the opening of a new COVID-19 testing site in Cambria County to go along with other recently opened testing sites in Berks, Blair, Centre, Clinton, Delaware, Luzerne and Mifflin counties. In addition, the state has announced that a new high-volume and high-throughput COVID-19 testing site will be opening soon in Delaware County at Mercy Fitzgerald Hospital. This site will be staffed by U.S. Department of Health and Human Services contractors with additional support from the host location, the costs for which will be eligible for reimbursement by FEMA. The Department of Health continues to talk to federal officials about the possibility of opening an additional high-volume testing site in the south-central part of the state.

The Department of Health has announced that Credentia will serve as its new contractor to operate the Pennsylvania nurse aide registry previously operated by Pearson Vue. Go here for the nurse aide registry search. The Pearson Vue link no longer works as of January 3.

COVID-19: By the Numbers

Daily COVID-19 case counts are higher than they have been at any time since the pandemic began. The state’s total of 33,650 new cases last Saturday, January 8 was the highest single-day total since the pandemic began.
The number of new COVID-19-related deaths remains very high.
To date, Pennsylvania has had nearly two million confirmed cases of COVID-19, more than 400,000 cases that have been classified as “probably” COVID-19, and more than 38,000 deaths attributed to the disease.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
Since January 1, the number of Pennsylvanians hospitalized because of COVID-19 has risen 42 percent; the number in hospital ICUs because of COVID-19 has risen 20 percent; and the number on ventilators because of the virus has risen 20 percent.
This situation is reflected in the high rate of occupancy in the state’s hospitals. In Pennsylvania today there currently are only 475 unoccupied adult ICU beds – 13.3 percent of the total of such beds in the state; 2097 unoccupied medical/surgical beds – 10.3 percent of such beds; 35 unoccupied pediatric ICU beds (9.5 percent); 276 unoccupied pediatric beds (25.5 percent); and 914 unoccupied airborne isolation beds (28.5 percent).
On January 11 the Department of Health elaborated on some of these figures, reporting that approximately 31 percent of all staffed adult ICU beds are occupied by COVID-19 patients, up from 28 percent last week, and that 33 percent of all ventilators state-wide are currently in use, up from 32 percent last week.
Media reports confirm the challenges some communities and hospitals are facing, including Delaware County, where every hospital bed is filled and one hospital is closing its ER; a report than an especially high proportion of hospital patients in Lehigh County need intensive care; a report that some Philadelphia-area hospitals are overwhelmed with patients while hospitals in the Erie area are seeing record numbers of COVID-19 patients, hospitals in the Lancaster area are seeing record numbers of COVID-19 patients, and a mid-state health system has instituted new policies to limit how many people may visit its hospitals’ patients.

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

The Pennsylvania Rural Health Redesign Center Authority Board will hold its next virtual meeting on Tuesday, January 18 at 10:00 a.m. The meeting will provide updates on a variety of topics, including model status updates, federal grant deliverables, global budget methodology, and more. It also will address current and upcoming activities. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Infant Hearing Screening Advisory Committee – January 20

The Infant Hearing Screening Advisory Committee will hold a public meeting both in person and virtually on Thursday, January 20 at 1:00 p.m. Agenda items will include reports by the cytomegalovirus and audiology subcommittees, an assessment of audiology training currently in development, and a review of upcoming program activities. For information about how to join the meeting, either virtually or in person, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m. Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m. This meeting will be broadcast live through Commonwealth Media Services. Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting. Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27 at 10 a.m. To participate, call 412-648-8888 or 866-588-4789. The meeting ID is 487 872 318#. Learn more from this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m. Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Go here to participate or join by phone at 1-408-418-9388.

jsteinbock2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of December 6-10

The following is an update of selected state health policy developments in Pennsylvania for the week of December 6-10, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate Democratic Policy Committee held an informational hearing this week on substance use disorder treatment facilities. The hearing was co-hosted by senators Schwank, Tartaglione, and Muth. Panelists included individuals affected by the addiction crisis, treatment providers, and the Department of Drug and Alcohol Programs. Testimony offered at the hearing and a video recording may be found here.

The state House and Senate will return to session next week. The following are the relevant health committee hearings currently scheduled.

The House Health Committee has scheduled a hearing on Monday, December 13 at 9:00 a.m. to discuss COVID-19 treatment options. Chairman Kathy Rapp has indicated the committee will examine House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat COVID-19.
The Senate Health & Human Services Committee is scheduled to convene on Tuesday, December 14 at 11:00 a.m. to consider, among other bills, Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health; Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning; Senate Bill 848, which creates a chief nursing officer position in the Department of Health; Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board; and Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception. The committee also will consider House Bill 118, which establishes requirements for the final disposition of fetal remains.
The House Human Services Committee has scheduled an information hearing on House Bill 1644 for next Thursday, December 16 at 9:30 a.m. House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner. The Human Services Committee also has scheduled an 11:00 a.m. hearing to examine community participation supports during COVID-19 pandemic.

Department of Human Services

The Department of Human Services (DHS) has updated its list of regulations that have been suspended to facilitate the state’s response to the COVID-19 emergency. Find the updated list here.
The federal Centers for Medicare & Medicaid Services (CMS) has written to state Medicaid directors to encourage them to take advantage of a provision in the American Rescue Plan that authorizes their programs, beginning on April 1, 2022, to provide 12 months of postpartum Medicaid coverage to pregnant women enrolled in either their Medicaid or CHIP programs. Learn more from the CMS letter to state Medicaid directors. Pennsylvania announced in August that it would extend this coverage.
CMS has sent a letter to state Medicaid directors to help them understand provisions in the Consolidated Appropriations Act of 2021 that include new reporting requirements for non-disproportionate share hospitals (DSH) supplemental payments and a change in the methodology for calculating hospital-specific DSH limits. See that letter here.
DHS has issued a news release elaborating on Pennsylvania’s spending plan for approximately $1.2 billion in enhanced federal Medicaid funding made available to states through the American Rescue Plan Act. This funding will support Medicaid’s home and community-based services system throughout the state. Learn more from this DHS news release.

Department of Health

The Department of Health (DOH) has issued a seasonal influenza update urging providers to encourage their patients to receive flu vaccines, offering treatment recommendations, and reminding providers that they are required to report flu cases to the state. Learn more in this department influenza update and reminder health alert.
DOH has updated two health alerts, PA-HAN-609 and PA-HAN-610, to clarify that the visitation guidance from the department applies only to skilled nursing facilities and that other types of facilities, such as personal care homes, assisted living facilities, and intermediate-care facilities, should seek guidance from their licensing agencies when it comes to COVID-19 visitation policies.
DOH has distributed communication that it received from the Centers for Medicare & Medicaid Services informing states that the federal government will not be enforcing the health care provider vaccination mandate while federal litigation is pending.

COVID-19: By the Numbers

Daily COVID-19 case counts remain near their highest levels since the beginning of the pandemic. To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
The number of new COVID-19-related deaths also remains high.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus all rose sharply in the past week.
These numbers reflect the growing rate of occupancy in the state’s hospitals. There currently are only 481 unoccupied adult ICU beds – 13.5 percent of the total of such beds in the state; 2019 unoccupied medical/surgical beds – 10 percent of such beds in the state; 29 pediatric ICU beds (7.7 percent); 234 pediatric beds (20.8 percent); and 919 airborne isolation beds (29.1).
Media reports confirm the challenges some communities and hospitals are facing, including this report on the situation at the nine hospitals that constitute Geisinger Health; this report on the situation in Allegheny County; this report on the situation in the Erie area; and this report on the situation throughout Pennsylvania.
The Department of Health reports that 6.7 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters. Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that nearly 170,000 boosters have been administered to city residents since August 13.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has established minimum qualifications for the positions of project director, facility director, clinical supervisor, counselor, and counselor assistant but these regulations permit persons to meet those qualifications with a degree in an “other related field.” In Licensing Alert 03-2021 the department lists “other related fields” that meet qualifications and notes that this list is not necessarily all-inclusive and that the department will review those degrees on a case-by-case basis. Find the licensing alert here.

The Department of Drug and Alcohol Programs has published its long-delayed, much discussed final standards for drug and alcohol recovery house licensure. Find them in this Pennsylvania Bulletin notice.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published its annual report on the financial performance of the state’s non-general acute-care hospitals, including rehabilitation hospitals, psychiatric hospitals, long-term acute-care hospitals, and specialty hospitals. Learn more from this PHC4 news release and the report itself. PHC4 also offers download data from the report in Excel format.

jsteinbock2021-12-10T21:44:43+00:00December 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

PA Health Policy Update for the Week of October 11-15

The following is an update of selected state health policy developments in Pennsylvania for the week of October 11-15, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf announced a new grant program to support community organizations conducting outreach on COVID-19 vaccines. The $5 million COVID-19 Vaccine Outreach Grant Program is available to eligible organizations, including non-profits, child care, and educational institutions. The program will provide grants from $10,000 up to $100,000 to support targeted outreach efforts such as sponsorship of vaccine-related community events, equipment rental to assist with setting vaccine appointments, local media buys, creation of outreach and training materials, and more. Learn more about the program from this news release from the governor’s office and the program’s web page, which includes a link to application guidelines. The deadline for the first round of grant applications is November 1.

General Assembly

The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Saving Community Hospitals: Keeping Care Close.” The informational hearing, held in Downingtown, focused heavily on Tower Health’s recent decision to sell Chestnut Hill Hospital and close Jennersville Hospital. Labor issues, including clinical staffing levels, also were discussed. Panelists included representatives from SEIU Healthcare, the Pennsylvania State Association of Staff Nurses and Allied Professionals (PASNAP), and first responders. A press release issued following the hearing can be found here. The same committee will hold another hearing in Stroudsburg on Monday, October 18 at 1:00 p.m. focused on consolidation in the health care sector.

Department of Human Services

The Department of Human Services (DHS) issued Medical Assistance bulletin 99-16-15, “Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder” on August 17, 2016 to remind providers of the requirements of Act 62 of 2008 and to issue a list of procedure codes that are subject to the MA cost avoidance process described in the bulletin. Effective August 23, 2021, the list of procedure codes subject to the MA cost avoidance process under Act 62 will be updated as a result of the implementation of the 2021. Learn about the update here.
DHS has added two new documents to its “Hospital Assessment Initiative” web page under the heading of “Potentially Avoidable Admissions:”
- Hospital Quality Incentive Program Webinar
- Hospital Quality Incentive Program (HQIP) Measurement – Potentially Avoidable Admission (PAA)
DHS has updated its Pennsylvania PROMISe Provider Handbook: 837 Professional/CMS-1500 Claim Form. DHS also has updated its “CMS-1500 Billing Guide for PROMISe^TMHealthy Beginnings Plus (HBP) Providers.”

Department of Health

The departments of Human Services and Health have announced that the Regional Congregate Care Assistance Teams (RCAT) will continue to provide COVID-19 prevention, preparation, and response support to long-term-care facilities from October 1, 2021 through December 31, 2021. More information, including contact information for each regional lead, can be found here.

The Department of Health has developed a series of new vaccine hesitancy materials to assist long-term-care facilities with their vaccine outreach efforts. These materials include:

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) will propose changes to modernize the confidentiality of substance use records in the state, the department informed stakeholders in a message delivered through its listserv. Another message to stakeholders elaborates on the department’s intentions.

In preparation for this undertaking, DDAP surveyed stakeholders on the state’s substance use confidentiality policies and has posted the appendices to its summary report.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained very high this week and today it passed the 1.5 million mark since the pandemic began. Approximately 31,780 of these cases have been among health care workers.
The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly six times greater this year than in 2020. Between October 6 and October 12, 2020 there were 1101 COVID-19 cases in school-aged kids compared to 6433 cases in the same age group during the same week this year.
The number of new COVID-19-related deaths continues to rise slightly. This week Pennsylvania passed 30,000 deaths from the disease since the pandemic began.
Every county in Pennsylvania continues to experience a high level of COVID-19 transmission.
The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
70.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – nearly 6.4 million people. 3000 Philadelphians and 77,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; the latter number represents a much larger weekly total than in recent months.

Stakeholder Events

Independent Regulatory Review Commission – Consideration of Department of Drug and Alcohol Regulation – October 21

Pennsylvania’s Independent Regulatory Review Commission will consider final-omitted rulemaking Standards for Drug and Alcohol Recovery House Licensure (#74-4). The commission will be considering a revised version of a proposed regulation it rejected in July. To review a history of the regulation and its latest version, go here. To register to view the meeting virtually or offer testimony, send an email to irrchelp@irrc.state.pa.us.

Infant Hearing Screening Advisory Committee- October 21

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, October 21, 2021 at 1:00. Go here for information on how to participate.

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – October 28

The Medical Assistance Advisory Committee will meet on Thursday, October 28 at 10:00 a.m. Go here to register to participate virtually.

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m. To participate:

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m. To participate virtually or by phone, go here for further information.

jsteinbock2021-10-15T21:19:47+00:00October 15th, 2021|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

PA Health Policy Update for the Week of September 20-24

The following is an update of selected state health policy developments in Pennsylvania for the week of September 20-24, 2021. (Some of the language used below is taken directly from state documents.)

General Assembly

House Republican leadership held a press conference on Monday to discuss their legislative agenda for the fall. In addition to addressing the Wolf administration’s mask mandate for K-12 schools, they plan to work on legislation to address the opioid and addiction crises and COVID-19 regulatory waivers and flexibilities. View the news conference here.
The House of Representatives sent House Bill 1861 to the Senate, where it was referred to the Health & Human Services Committee. This bill will likely serve as the legislative vehicle for an extension of the health-related COVID-19 regulatory waivers and flexibilities set to expire on September 30, 2021.
The House of Representatives unanimously approved House Bill 1774, which amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP). Specifically, the bill extends the sunset date to December 31, 2028 and grants the Department of Labor & Industry access to the prescription monitoring program.
Senate Bill 397 and Senate Bill 398 were reported as amended by the House Professional Licensure Committee on Monday. These two bills would modernize Pennsylvania law on physician assistants and their oversight.
The House and Senate will be in session again next week on Monday (9/27), Tuesday (9/28), and Wednesday (9/29). The following health care-related committee meetings have been scheduled:
- The House State Government Committee will convene on Monday (9/27) to consider, among other bills, House Bill 1893, which amends the Disease Control and Prevention Act of 1955 to make disease information under this act subject to the Right-to-Know Law. The committee also will consider Senate Bill 533, which prohibits certain regulatory and administrative actions during a disaster emergency.

- The Senate Health & Human Services Committee will convene on Monday, September 27 at 12:00 p.m. to consider House Bill 1861 (COVID-19 regulatory waiver and flexibility extension); House Bill 1774 (Achieving Better Care by Monitoring All Prescriptions Program); Senate Bill 782 (payment for FDA-approved anti-obesity drugs); Senate Bill 815 (pelvic exam consent requirement); and Senate Bill 818 (allowable ambulatory surgical center procedures).

Department of Human Services

The Department of Human Services (DHS) has posted a notice in the Pennsylvania Bulletin updating the Medical Assistance fee schedule to add fees for third doses of the Pfizer and Moderna COVID-19 vaccines. Find the notice and the new fees here.
DHS has added October dates to its schedule of remittance advice (RA) mailing dates/electronic RA delivery dates. Find the updated list with the October dates here.
DHS has posted a document offering tips to providers on how to meet the Medical Assistance program’s provider validation requirements.
DHS has posted a Medical Assistance Bulletin addressing coverage of home accessibility durable medical equipment and the procedure for obtaining 1150 administrative waivers in the fee-for-service delivery system. Find the announcement here.
To its Hospital Quality Improvement Program (HQIP) Racial and Ethnic Health Disparities web pages DHS has added a page on Hospital Quality Incentive Program measures and an attestation form for implementation of process incentive pathways for addressing racial and ethnic disparities.
DHS has revised its participating drug company list for the Medicaid drug rebate program. Find the revisions here.
DHS has updated its Medicaid managed care directory. Find the updated version here.

Department of Health

The Department of Health has updated its interim infection prevention and control recommendations for health care settings to add new options for fully vaccinated individuals working in facilities in counties with low to moderate rates of community transmission of COVID-19.
The Department of Health, Department of Drug and Alcohol Programs, and the Pennsylvania Commission on Crime and Delinquency have written to Pennsylvania hospital officials advising them on how they can secure a supply of Narcan to support hospital- and community-based naloxone distribution efforts to help in the fight against overdose-related deaths. See their letter here.
Acting Secretary of Health Alison Beam has signed an order to ensure that vaccine providers are prepared to start COVID-19 booster shots as soon as the CDC issues federal guidance to do so. The order requires vaccine providers, as possible, to provide online scheduling for vaccination appointments; provide a telephone number to assist with scheduling appointments; offer walk-in appointments; and work with local Area Agencies on Aging and Medicaid managed care plans to help schedule appointments for eligible adults and people who cannot leave their homes to get vaccinated. Learn more from the Department of Health’s announcement about the order and the order itself.

COVID-19: By the Numbers

The daily number of new COVID-19 cases remained very high this week. Today the number of Pennsylvanians who have contracted COVID-19 surpassed 1.4 million.
The number of COVID-19 cases among school-aged children (between 5-18 years old) is 12.2 times greater this year than in 2020. Between September 15 and September 21, 2020 there were a total of 650 COVID-19 cases in school-aged kids compared to 7,928 cases in the same age group during the same week in 2021.
According to Pennsylvania’s COVID-19 dashboard, only 41 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
The number of new COVID-19-related deaths also remains high. Yesterday the number of Pennsylvanians who have died from COVID-19 rose past 29,000.
For the third consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
The number of Pennsylvanians hospitalized because of COVID-19 rose 13 percent in the past week and has risen 44 percent since the first of the month; the number on ventilators has risen 14 percent in the past week and 38 percent since the first of the month; and the number in hospital intensive care units has risen 12 percent in the past week and 37 percent since the beginning of September.
68.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.1 million people – up from 67.5 percent last week. 10,000 Philadelphians and 74,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; some of the 74,000 were added to the ranks of the vaccinated as the result of a Department of Health adjustment of its vaccination data.

Around the State

“Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again,” reports Spotlight PA, which takes a closer look at some of the waivers that have been in place in Pennsylvania, what they do, and what the stakes might be if they are not renewed.
Emergency department volume at Children’s Hospital of Pittsburgh and Excel Health Frick Hospital has risen so much that the hospitals have erected tents to help them handle growing numbers of patients, according to the Pittsburgh Tribune-Review.
Mobile clinics operated by the organization Latino Connection are making a special effort to provide COVID-19 vaccines to Hispanic communities around the state, the Allentown Morning Call reports.
Black Doctors COVID-19 Consortium, a group launched to ensure access to COVID-19 vaccines for Philadelphia’s African-American community, will extend its scope of endeavor and open a primary care clinic to help address health disparities and inequities. The Philadelphia Inquirer explains the group’s evolution.
“A new study from Penn State shows Pennsylvania could avoid billions of dollars in health damages by joining a regional cap and trade program targeting power plant emissions… The team at Penn State used four types of damage estimates to find that the commonwealth could reduce health impacts caused by power plant pollution by between $18 and 40 billion dollars over the next nine years by joining the Regional Greenhouse Gas Initiative (RGGI).” StateImpact Pennsylvania explains.
Spotlight PA has posted an update on its reporting on what it calls the “…growing dementia care crisis in one of the nation’s most rapidly aging states…” Read it here.
“Mental health agencies in Bucks, Dauphin, Carbon, Monroe and Pike counties are using new grant funding to test out a program designed to help people who live with serious mental illness and are at risk of ending up in jail.” Learn more from this WITF story.
An EMS organization serving parts of Lancaster County is encountering funding problems – a situation found in other parts of the state as well, according to the Pennsylvania Capital-Star.

jsteinbock2021-09-24T20:29:14+00:00September 24th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

COVID-19 Update: Wednesday, April 7

The following is the latest COVID-19 information from Pennsylvania’s state government as of 3:30 p.m. on Wednesday, April 7..

Governor Wolf

Effective last Sunday, April 4, Governor Wolf and the Department of Health lifted the mandate that businesses operate through telework when possible. Even so, the revised orders “highly encourage” continued use of telework if possible. Learn more from the governor’s revised order, the revised Department of Health order, and this FAQ about this change.
This week Pennsylvanians in Phase 1B of the state’s vaccination plan became eligible to schedule COVID-19 vaccinations appointments, the Wolf administration announced in a news release. Phase 1B eligible people include those living in congregate settings not otherwise specified as long-term-care facilities, people receiving home and community-based services, U.S. Postal Service workers, manufacturing workers, clergy and other essential support for houses of worship, public transit workers, and education workers.
The same news release notes that on April 12 all Pennsylvanians in Phase 1C will be eligible to start scheduling vaccination appointments and on April 19 all residents will be eligible to start scheduling vaccination appointments.
Pennsylvania has completed its campaign to vaccinate school teachers and staff, the governor’s office announced. More than 112,000 such individuals were vaccinated.

Department of Health

The Department of Health has released a summary of all COVID-19-related health alerts, advisories, and updates it has issued during the pandemic, including information on which health alerts were replaced by others after release.

Department of Health – by the numbers

The daily number of new COVID-19 cases has risen in the past six weeks after a period of more modest numbers. Nearly half of all new COVID-19 cases in the country were diagnosed in just five states last week and Pennsylvania is one of the five, according to the Pittsburgh Tribune-Review.
Amid daily case counts higher now than they have been in recent months but much lower than they were in December and January and growing numbers of Pennsylvanians receiving vaccines, the number of COVID-19 tests being performed in the state, Department of Health data shows, is now roughly half of what it was at the pandemic’s peak during the first ten days of December.
Despite the rising number of new COVID-19 cases, daily death totals are not rising and are much lower than they were during the pandemic’s autumn and winter peak.
For the week from March 26 through April 1 the state’s overall COVID-19 test positivity rate was 9.5 percent, up from 7.6 percent last week. This is the third consecutive week the state’s positivity rate has risen.
Ten counties currently have a positivity rate lower than five percent, down from 17 counties last week, and one has a rate greater than 20 percent.
Five counties are currently experiencing low levels of community transmission of COVID-19, down from six last week; 17 counties are experiencing moderate levels of community transmission, down from 26 last week; and 45 counties are currently experiencing substantial levels of community transmission, up from 35 counties last week.
The number of Pennsylvanians hospitalized with COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of COVID-19 all continue to rise.
Currently, 21 percent of adult ICU beds in the state are unoccupied, as are 18 percent of medical/surgical beds, 17 percent of pediatric ICU beds, 30 percent of pediatric beds, and 36 percent of airborne isolation units.
Earlier this week, according to the state’s vaccine dashboard, the number of Pennsylvanians who have been fully vaccinated against COVID-19 passed the two-million mark. This number does not include Philadelphia, which operates a separate COVID-19 vaccination program and where another 327,000 people have been vaccinated according to the city’s Department of Public Health.

Department of Human Services

DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.

Department of Education

The Pennsylvania Department of Education has released information on how individuals who become temporary nurse aides during the pandemic can become permanent nurse aides. Go here for further information.

General Assembly

The state House on Tuesday passed House Bill 605, which provides limited immunity from COVID-19 liability. The bill covers health care facilities and practitioners, schools, colleges and universities, child care centers, local governments, and companies that make personal protective equipment. The bill also requires an arbitration program for personal injury lawsuits stemming from COVID-19. The bill passed 107-95 and now moves to the Senate for consideration.
The state House this week passed House Bill 854, which requires state agencies and contractors – defined as any person who enters into a contract with a state agency – to preserve all COVID-19 records for at least 10 years after the disaster order is terminated. The bill passed 111-90 and now heads to the Senate for consideration.

Around the State

Lancaster County’s mass vaccination site should be ready to reach its target capacity of 6000 vaccinations a day, Lancaster Online reports.
Philadelphia is expanding vaccine eligibility to sanitation workers, maintenance and janitorial staff, utility workers, and postal and package delivery workers this week, according to the Philadelphia Inquirer.
York County’s district attorney has tested positive for COVID-19, has symptoms, and is recovering and quarantining at home, the York Dispatch reports.
The operator of a Berks County COVID-19 clinic reported that demand for vaccines slowed enough last week that his staff needed to work to fill available appointments. The Reading Eagle tells this unusual story.
The city of Allentown’s Health Bureau and its EMS staff will visit the homes of people whose health conditions make leaving home difficult to administer COVID-19 vaccines, according to the Allentown Morning Call.
FEMA will open a second vaccination site in Philadelphia, the Inquirer reports. Once open, it is expected to administer 1500-2500 shots a day. The facility will be staffed by FEMA, with help from the city and state.