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PA Prepares to Boost Medicaid Primary Care Rates

Pennsylvania will soon begin paying primary care providers more for the services they deliver to their Medical Assistance patients.
Under the Affordable Care Act, state Medicaid programs are required to pay primary care providers Medicare-level fees for calendar years 2013 and 2014.  This policy was adopted as part of a broader effort to recruit more physicians to serve Medicaid patients at a time when Medicaid enrollment will increase significantly in most states.
Now, the Pennsylvania Department of Public Welfare (DPW) is presenting its plan for how it will go about implementing this federal requirement.
DPW has issued a new Medical Assistance Bulletin titled “Medical Assistance Program Fee for Select Primary Care Services and Physician Attestation Form” that identifies eligible providers and explains how they can go about receiving the enhanced payments.  That bulletin can be found here.  DPW also has issued an attestation form through which providers can assert their eligibility for the enhanced payments; that form, and directions for completing and submitting it, can be found here.

2013-01-29T06:00:39+00:00January 29th, 2013|Health care reform, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Prepares to Boost Medicaid Primary Care Rates

DPW Secretary Shares Views on Medicaid Program

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

2012-08-21T06:00:48+00:00August 21st, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on DPW Secretary Shares Views on Medicaid Program

DPW Updates Dependence Treatment Procedures

The Pennsylvania Department of Public Welfare (DPW) has issued a new Medical Assistance Bulletin updating its procedures for seeking prior authorization for opiate dependence treatment.
The new bulletin, which can be found here, applies to all licensed pharmacies and prescribers enrolled in the state’s Medical Assistance program that provide services through the Medical Assistance fee-for-service program.
An update of the Medical Assistance handbook for prior authorization of these services can be found hereBookshelf with law books.
The new policy takes effect on September 10.

2012-08-10T06:00:06+00:00August 10th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Uncategorized|Comments Off on DPW Updates Dependence Treatment Procedures

DPW Announces Fee Schedule Changes, More

The Department of Public Welfare (DPW) has announced changes in the Medical Assistance fee schedule and prior authorization requirements.  To read a notice describing these changes and find a list of affected procedure codes, see this notice in the Pennsylvania Bulletin.

2012-06-25T06:00:41+00:00June 25th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Announces Fee Schedule Changes, More

DPW Publishes Bulletin Addressing Preventable Conditions

The Pennsylvania Department of Public Welfare (DPW) has posted a new Medical Assistance Bulletin presenting the state Medicaid program’s policies governing the reporting of “provider preventable conditions” effective July 1, 2012.  The policy applies to providers that serve Medical Assistance recipients enrolled in the fee-for-service and ACCESS Plus programs.
Find the Bulletin hereBookshelf with law books.

2012-06-20T06:00:09+00:00June 20th, 2012|Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Publishes Bulletin Addressing Preventable Conditions

News from the Pennsylvania Health Law Project

The Pennsylvania Health Law Project has issued its May 2012 newsletter.  Included in it are articles on the expanded use of HealthChoices in the Medical Assistance program; information about proposed changes in the Medical Assistance Transportation Program; an update on limits on Medicaid recipients’ use of prescription drugs; the removal of children from the state’s Medicaid rolls; and the 2013 increase in Medicaid payments for primary care providers.
Download the May edition of Health Law PA News, the newsletter of the Pennsylvania Health Law Project, hereHarrisburg, PA capital building.

2012-06-07T06:00:24+00:00June 7th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on News from the Pennsylvania Health Law Project

DPW Launches “Open Government” Web Site

The Pennsylvania Department of Public Welfare (DPW) has launched a new “transparency portal” on its web site through which the public can obtain a broad array of DPW information and data.
The available information includes facility and program audits, Medical Assistance fee schedules and payments, and individual provider reimbursement data.
The reimbursement data is especially broad, offering detailed information about state Medical Assistance payments to individual providers.
Read a DPW news release about the new DPW web site feature here and visit the site itself through this linkFinancial paperwork.

2012-06-01T14:58:49+00:00June 1st, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on DPW Launches “Open Government” Web Site
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