Independent Fiscal Office Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for June 20

The following is an update of selected state health policy developments in Pennsylvania from June 16 – 20. (Some of the language used below is taken directly from state documents).

Governor Shapiro

The Shapiro administration has shared a document with stakeholders outlining the potential impact of H.R. 1, the reconciliation package currently being considered by the U.S. Congress. The assessment primarily addresses the impact on Medicaid coverage. It does not include a detailed overview of the provisions in the reconciliation package related to provider taxes or state directed payments, from which Pennsylvania receives significant funding.

General Assembly

The state House of Representatives convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.

The House Health Committee met on Monday, June 16 and favorably reported, among other bills, House Bill 1234, which expands the Medical Assistance program to cover blood pressure monitors for home use as a pregnancy-related service on a per pregnancy basis.

The House Professional Licensure Committee met on Tuesday, June 17 and favorably reported House Bills 80 and 482, which enable Pennsylvania to join the Audiology and Speech-Language Pathology Interstate Compact and the National Occupational Therapy Licensure Compact respectively, and Senate Bill 115, which requires the Department of Human Services to offer a skills competency exam in lieu of high school diploma or GED requirements for individuals seeking employment as direct care staff in personal care homes or assisted living residences.

The House Insurance Committee met on Tuesday, June 17 and favorably reported House Bill 1445, which prohibits an insurer from denying what would otherwise be a service covered by the policy simply because the health care service was received in a school setting.

The state House of Representatives and Senate will reconvene in Harrisburg for voting on Monday, June 23.

Department of Human Services

The Department of Human Services (DHS) has announced the proposed annual case-mix per diem payment rates for state Fiscal Year (FY) 2025-26 for non-public and county nursing facilities that participate in the Medical Assistance (MA) program. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tip #263 regarding the electronic submission process for Office of Medical Assistance Programs’ (OMAP) fee-for-service (FFS) and the Office of Long-Term Living’s (OLTL) and LTC 180-day exception requests and other claims requiring documentation in the Promise Portal.

Department of Health

The Department of Health (DOH) has announced the Newborn Screening and Follow-up Technical Advisory Board is adding Metachromatic Leukodystrophy (MLD) screening, effective January 1, 2026, to the supplemental conditions mandated for screening and follow-up by commonwealth submitters and follow-up by the commonwealth newborn screening program. Find additional information in this Pennsylvania Bulletin notice.

DOH has published notice of the clinical laboratories approved for the following services.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has published a document outlining the impact of the Medicaid provisions included in the federal reconciliation bill passed by the U.S. House of Representatives. The document also includes a budget brief highlighting Pennsylvania Medicaid enrollment and funding trends from FY 2018-19 through the Shapiro administration’s proposal for FY 2025-26.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that most health insurers are requesting significant premiums increases for plan year 2026. On average, insurers are asking for a 19 percent increase to premiums in the individual market, and a 13 percent increase to premiums in the small group market.

Around the State

State Senate Majority Leader Joe Pittman (R-Indiana) has stated he, “sees no practical way that a budget will be completed on June 30.” His comments and the significant increase in funding for the Medicaid program were the subject of an article by the Pennsylvania Capital-Star.

The Pew Charitable Trusts has published an article about the share of state budgets spent on Medicaid and which states have increased their own resources on Medicaid.

A CBS3 report has highlighted insurance denials and called attention to the Pennsylvania Insurance Department’s external review process for claim denials.

Stakeholder Meetings

DHS – Consumer Sub-MAAC – June 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 25 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – June 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 26 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PHC4 – Council Meeting – July 3

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced it will hold a council meet on July 3 at 10:00 a.m. PHC4 will also hold an Education Committee meeting on June 25. Find additional information in this Pennsylvania Bulletin notice.

DOH – Newborn Screening Advisory Board – July 24

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 24 from 10:00 a.m. until 12:00 p.m. The meeting will be conducted in person only. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Health Research Advisory Committee – July 30

The Health Research Advisory Committee will hold a public meeting on Wednesday, July 30 from 10:00 a.m. to 11:00 a.m. The meeting will be held at the Nesquehoning Recreational Center. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – August 1

The Brain Injury Advisory Board will hold a public meeting on Friday, August 1 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-06-23T19:51:18+00:00June 20th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for June 13

The following is an update of selected state health policy developments in Pennsylvania from June 9 – 13. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred this week.

The Senate unanimously passed Senate Bill 95, which permits EMS providers to leave naloxone with a caregiver of a patient who overdosed. The bill also places certain disclosure requirements on pharmacies related to the retail and generic versions of prescribed medications. The bill was subsequently received in the House and referred to the Veterans Affairs and Emergency Preparedness Committee.

The House of Representatives passed House Bill 1549, which increases the state’s minimum wages, by a party-line vote. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1460, which provides for more oversight of health care entity merger and acquisition activities. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1088, which expands maternal blood pressure monitoring coverage. The bill will now be sent to the Senate for consideration.

The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 11 and favorably reported, among other bills, Senate Bills 535 & 536, which amend the Osteopathic and Medical Practice Acts to enable genetic counselors to order genetic tests as appropriate.

The Senate Health & Human Services Committee met on Wednesday, June 11 and favorably reported, among other bills, the following.
- Senate Bill 461, which seeks to improve testing and insurance coverage for Lyme disease testing.
- Senate Bill 715, which extends the Rare Disease Advisory Council’s sunset date to 2028.
- House Bill 27, which requires operating rooms to utilize surgical smoke evacuation systems.
- House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP).

A recording of the meeting is viewable here.

The House Human Services Committee met on Tuesday, June 10 and favorably reported House Bill 1100, which creates a grant program to provide eligible public-school entities with funding to acquire and distribute menstrual hygiene products, and House Bill 1590, which supports Pennsylvania’s implementation of a new federal Medicaid flexibility that waives the longstanding “four walls” requirement for outpatient behavioral health clinics. A recording of the hearing is viewable here.

The House Health Committee met on Tuesday, June 10 and favorably reported House Bill 1442, which places requirements on coroners to report Sudden Unexpected Death in Epilepsy (SUDEP), and House Bill 1527, which extends the Rate Disease Advisory Council’s sunset date to 2028. A recording of the meeting is viewable here.

The House Aging & Older Adult Services Committee met on Tuesday, June 10 for an informational hearing on the Older Adult Protective Services Act (OAPSA) and financial exploitation of older adults. A recording of the hearing is viewable here.

The Legislative Budget & Finance Committee (LBFC) met on Wednesday, June 11 and released its report on the effect of home and community-based workforce shortages on commonwealth-supported Medicaid waiver programs. The full report is viewable here and highlights from the report are viewable here.

The state House of Representatives will reconvene in Harrisburg for voting on Monday, June 16. The Senate is recessed until Monday, June 23.

Department of Human Services

The Department of Human Services (DHS) has announced it will hold another listening session in its “Food is Medicine Stakeholder Engagement Series,” which is part of the Bridges to Success: Keystones of Health demonstration waiver. The next session, which will focus on medically tailored meals, will take place on June 16 at 1:00 p.m. Find additional information and registration details here.

DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Statewide Preferred Drug List (PDL) related to glucose sticks made at the April 23 Pharmacy & Therapeutics (P&T) Committee meeting. The PDL changes are effective July 7, 2025.

DHS has announced changes to the Medical Assistance (MA) program fee schedule. The department is adding and end-dating codes as a result of the 2025 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The changes are effective for dates of service on and after June 16, 2025. Find additional information in this Pennsylvania Bulletin notice.

DHS has released a document with revisions to the participating drug companies list for the Medicaid Drug Rebate Program.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of July. Find the updated calendar here.

DHS has issued a Remittance Advice Alert regarding action needed to continue submitting claims and eligibility requests electronically with PROMISe™.

Department of Health

The Department of Health (DOH) has published notice of intent to issue a final notice to temporarily schedule any material, compound, mixture, or preparation which contains any quantity of the several Nitazene substances. This final notice to temporarily schedule will place this group of substances in Schedule I under The Controlled Substance, Drug, Device and Cosmetic Act.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has published a budget brief highlighting Pennsylvania Medicaid enrollment and funding trends from FY 2018-19 through the administration’s proposal for FY 2025-26. It also provides projections of the impact for certain Medicaid provisions included in the federal reconciliation bill passed by the U.S. House of Representatives.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that the largest health insurers operating in the commonwealth are taking steps to expand coverage for medications used to treat postpartum depression and related maternal mental health conditions. Find additional information in this press release.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has shared an opportunity from the Health Resources and Services Administration (HRSA), the Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program. The program offers up to $250,000 in student loan repayment for eligible professionals who commit to six years of full-time work providing direct SUD treatment or recovery support at an approved facility. The program is open to a range of providers, including medical, behavioral health, and peer support professionals. Applications are due July 10, 2025.

Around the State

Spotlight PA has published an article on the potential impact of the budget reconciliation bill being considered by the U.S. Congress on the state’s Medicaid program.

The Wall Street Journal has written an article about the Pennsylvania General Assembly’s efforts to enact legislation creating more scrutiny over health care entity transactions involving private equity.

LancasterOnline covered Senate Appropriations Committee Chairman Scott Martin’s comments about the state budget unpredictability created federal budget discussions.

Stakeholder Meetings

Pharmaceutical Assistance Advisory Board – June 16

The Department of Aging has announced the Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, June 16 from 1:00 p.m. to 2:30 p.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – June 17

The Patient Safety Authority has announced it will hold a meeting of the Authority’s board on Tuesday, June 17 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Preventative Health Services Block Grant Advisory Committee – June 17

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, June 17 from 9:30 a.m. to 10:30 a.m. The purpose of the meeting is to present the Federal Fiscal Year 2025 Workplan and budget information. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-06-13T19:46:49+00:00June 13th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for May 23

The following is an update of selected state health policy developments in Pennsylvania from May 19 – 13. (Some of the language used below is taken directly from state documents).

Primary Election Update

Voters went to the polls on Tuesday, May 20 for Pennsylvania’s 2025 Primary Election. On the ballot there were judicial candidates seeking to fill vacancies on the Commonwealth and Superior Courts, along with municipal races. Find the Department of State’s unofficial election results here.

General Assembly

The state House of Representatives and Senate were recessed this week. Both chambers are scheduled to return to Harrisburg on Monday, June 2.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule and Coding Matrix. This bulletin applies to all providers enrolled in the Medical Assistance program who provide EPSDT screens for Medical Assistance (MA) beneficiaries.

Board of Nursing

The State Board of Nursing has announced that it has adopted temporary regulations, which can be found here, necessary to implement the Nurse Licensure Compact. The temporary regulations are effective upon their publication in the Pennsylvania Bulletin. Additional information about the Nurse Licensure Compact is available on the Department of State’s website here.

Insurance Department

The Pennsylvania Insurance Department (PID), along with the Department of Health, the Department of Human Services, and the Department of Drug and Alcohol Programs (DDAP), has announced the launch of a women’s health survey to identify challenges and questions women have about their health insurance benefits, and to remind women about preventive health services that are available to them at no cost through their insurance.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has released its initial revenue estimate for FY 2025-26. The IFO has estimated Pennsylvania’s General Fund revenues will total $47 billion in FY 2025-26. The IFO has also revised the current fiscal year’s deficit to $3.6 billion, an increase of $280 million. Find the full report here and the IFO’s presentation here.

Around the State

The Tribune-Review has published an article about the potential spike in the number of Pennsylvanians without health insurance that will occur if the reconciliation bill passed by the U.S. House this week moves forward.

Spotlight PA has continued to report about state legislative efforts to implement additional oversight of health care facility mergers and acquisitions.

The mayoral elections that featured prominently in Tuesday’s Primary Election were the focus of an article by City & State Pennsylvania.

Spotlight PA has published an article about the Commonwealth and Superior Court candidates advancing to November’s General Election.

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – June 4

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on June 4 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Safety Net Admin2025-05-23T20:21:35+00:00May 23rd, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for November 15

The following is an update of selected state health policy developments in Pennsylvania November 4 – 15. (Some of the language used below is taken directly from state documents).

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it approved an amendment to Pennsylvania’s section 1115 Medicaid demonstration waiver to provide continuous Medicaid eligibility for children until the age of six, and 12 months of continuous eligibility for individuals aged 19 through 64 leaving incarceration, who meet certain high-risk criteria. Find additional information about Pennsylvania’s section 1115 demonstration amendment approval here.

General Assembly

The state House of Representatives and Senate briefly convened for voting session this week to conclude legislative business for the 2023-2024 session and elect caucus leadership for the upcoming 2025-2026 legislative session. Following is the comprehensive list of each caucus’ leadership team.

* Denotes majority party.

Department of Human Services

The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it released an updated Psychiatric Outpatient Clinic Regulatory Compliance Guide (RCG). The changes made were primarily to language and updates based on comments received from stakeholders on the original document issued in 2021. OMHSAS has been working on developing RCGs for each licensed level of care. The RCG is designed to be a tool for providers, OMHSAS staff, and the public to better understand pertinent regulations. The guide is a companion piece to 55 Pa. Code Chapter 5200.

The Department of Human Services (DHS) has issued an updated Pennsylvania Medicaid Managed Care Directory.

DHS has issued a Medical Assistance Bulletin entitled Statewide Preferred Drug List (PDL) Updates – Pharmacy Services.

DHS has issued several Medical Assistance bulletins with updated handbook pages that include the requirements for prior authorization for various pharmacy services. Following is a comprehensive list of prior authorization bulletins recently issued by DHS.

Department of Health

The Department of Health (DOH) has published notice of the Secretary of Health’s decision not to effectuate the recommendation of the Medical Marijuana Advisory Board that certified registered nurse practitioners (CRNPs) and podiatrists be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana. Find the notice regarding CRNPs here and podiatrists here.

Insurance Department

The Pennsylvania Insurance Department (PID) has released a comprehensive study of the accuracy of health insurer provider directories. The report highlights persistent inaccuracies in health insurer provider directories that can delay care, hinder scheduling, or result in surprise out-of-network charges. PID is planning to initiate stakeholder outreach to gather input and develop solutions that reduce inaccuracies in provider directories. Find additional information in this press release.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has released its Economic and Budget Outlooks for FYs 2024-2025 to 2029-2030. This annual fiscal outlook report, which includes projections of state revenues and expenditures, also considers economic and demographic trends that will impact tax revenues and expenditures over the next five fiscal years. Find the IFO’s presentation here and its full report here.

Office of Administration

The Office of Administration has recently announced the launch of a new resource page on PA.gov that makes it easier for residents, businesses, non-profits, and local government entities to find and apply to various grant programs from state agencies. Find additional information in this press release.

Around the State

The Hill has published an article about Governor Shapiro’s national political prospects following the 2024 election.

WHYY has written an article about this year’s open enrollment for health insurance coverage in 2025. The Pittsburgh Post-Gazette has also written about open enrollment and the potential for premiums to increase.

An article published by the Patriot-News highlights the continued partisan split in Harrisburg for the upcoming 2025-2026 legislative session. The Pennsylvania Capital-Star also wrote about this dynamic but noted House Democrats’ hope for greater cooperation with the Republican Senate.

Stakeholder Events

DOH – Newborn Screening Advisory Committee – November 21

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 21 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual conference. Find additional information in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-11-15T20:57:21+00:00November 15th, 2024|Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for the Week of June 1

Beginning today, SNAP is expanding its regular COVID-19 updates to encompass a broader scope of Pennsylvania state health policy endeavors. As efforts to address COVID-19 prove more effective and the state moves from focusing almost exclusively on the public health emergency back to its usual, much broader array of health policy concerns, we hope this update will be a useful resource on matters of importance to the hospital community. Please feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is an update of selected state health policy developments in Pennsylvania for the week of June 1-4, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has issued a reminder to Pennsylvanians that all businesses, events, and venues can return to 100 percent capacity with the lifting of COVID-19 mitigation orders starting Monday, May 31 at 12:01 a.m. The current order requiring masks for unvaccinated and partially vaccinated individuals will remain in place until June 28 or when 70 percent of Pennsylvanians age 18 and older get their second dose of Pfizer or Moderna vaccine or the single-dose Johnson & Johnson vaccine, whichever comes first. Individuals are still required to wear masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs, such as airports and stations. Individuals should still follow guidance at workplaces, local businesses, long-term-care facilities, hospitals, prisons, and homeless shelters. See the reminder here.

State Finances

The Department of Revenue announced that state General Fund collections for May totaled $3.9 billion, which was $1.6 billion, or 65.4 percent, more than projected. This significant increase is attributed to the one-month delay for personal income tax collections. Personal income tax revenue in May was $1 billion above estimate. So far this year the state has collected $2.9 billion, or 8.5 percent, more than anticipated.
Last week the state Independent Fiscal Office (IFO) released its updated FY 2021-2022 revenue estimate. In contrast to FY 2020-2021, which is ending on a strong note, the IFO projects that FY 2021-2022 will be more challenging once all of the COVID-19 federal funds are exhausted. The IFO projects that the state’s economy and revenues generated from various sources will revert to the path they were on prior to COVID-19. The IFO forecast estimates that Pennsylvania will collect $37.96 billion, a decline of $2.152 billion from FY 2020-2021. Learn more from the presentation given by Matthew Knittel, the IFO’s director.

In the Legislature

A bill already passed by the state Senate and currently before the House would give parents the option of having their children repeat their current grade in school because of the challenges children have faced learning remotely. The Johnstown Tribune-Democrat tells the story.
A bill has been introduced in the Senate that would permit young people 14 years of age and older to receive COVID-19 vaccines without the consent of their parents. KDKA provides further information.
For a comprehensive summary of health care legislation currently under consideration in the Pennsylvania General Assembly, contact SNAP at info@pasafetynet.org.

Department of Health

The Department of Health has issued an advisory with information and reporting requirements about patients presenting with myocarditis and pericarditis after receiving Pfizer or Moderna COVID-19 vaccines.
The Department of Health circulated a reminder to long-term-care facilities with information on CMS’s requirement to report to the federal government on COVID-19 vaccinations and therapeutic treatments they provide. Facilities also are required to educate staff and residents on the importance of getting vaccinated.
The Department of Health issued a health advisory on COVID-19 treatment options that incorporates updated guidance from the FDA on monoclonal antibody treatments and combination therapies.
The Department of Health revised its order regarding skilled nursing facility data reporting requirements to require weekly rather than daily reporting. While facilities will be required to complete data surveys on a weekly basis, the data they submit will be cumulative. See the Department of Health announcement here and the full amended order here.
The Department of Health revised its interim guidance for skilled nursing facilities during COVID-19 to incorporate changes in data reporting requirements and other recently issued federal and state guidance.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline and has been in three digits for seven days in a row.
The number of COVID-19 deaths is declining but not as swiftly as the number of cases.
For the week from May 21 through May 27 the state’s overall COVID-19 test positivity rate was 3.8 percent, down from 4.5 percent last week and 5.5 percent the week before.
Twenty-eight counties had a positivity rate lower than five percent, up from 12 last week, and no counties had a positivity rate greater than 20 percent for the fifth consecutive week.
Ten counties (Cameron, Clarion, Elk, Forest, Fulton, Montour, Potter, Snyder, Sullivan, and Warren) are currently experiencing low levels of community transmission of COVID-19, up from four last week; 56 counties are experiencing moderate levels of community transmission, down from 58 last week and but up from 41 two weeks ago; and only one county (Wyoming) is currently experiencing a substantial level of community transmission, down from five counties last week and 22 the week before.
The numbers of Pennsylvanians hospitalized with COVID-19 fell 55 percent from May 1 to June 1; the number on a ventilator fell 47 percent from May 1 to June 1; and the number in hospital intensive care units fell 49 percent from May 1 to June 1.
4.8 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number slowed significantly over the past week. Another 709,000 have been vaccinated in Philadelphia. According to the state, 54.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 58.7 percent of the entire population has now received at least the first dose of a vaccine.
Governor Wolf has stated that Pennsylvania needs to reach 70 percent of adults vaccinated before he will lift the state’s remaining mask mandates.

Department of Human Services

On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal CARES Act to assist providers with COVID-19-related costs they incurred between March 1, 2020 and November 30, 2020. Providers that accepted Act 24 funding agreed to provide documentation to DHS and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021. With this in mind, DHS’s Office of Long-Term Living (OLTL) has asked providers to take the following actions:
- Review the list of providers. OLTL has compiled a list of providers that received Act 24 funding but for which it has no record of submission of a cost report or the return of funds. Organizations on this list should complete an Act 24 cost report and submit it to RA-PWOLTLCOVID-19@pa.gov no later than Friday, June 11, 2021. The applicable cost reports can be found here. Those that believe they submitted an Act 24 report yet are on this list should forward a screenshot of their submission to RA-PWOLTLCOVID-19@pa.gov.
- Return Unused Funding. Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating that the check is for the return of CARES Act 24 funding they did not use. Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg PA 17105-8025, Attn: Daniel Sharar. Providers should include their EIN on the memo line of the check to ensure that refunds are traceable to the correct provider.

Providers that fail to submit a cost report or return their funding by the deadline will be deemed to have no COVID-related expenses and the state will proceed to recoup the Act 24 funding that was distributed to them.

DHS’s Office of Medical Assistance Programs has issued a notice advising all county administrators, brokers, and all contracted Medical Assistance Transportation Program (MATP) agencies of updated guidance to ensure the safe provision of non-emergency medical transportation services to Medical Assistance beneficiaries during the COVID-19 public health emergency. The announcement directs the affected parties to federal CDC guidance for further information. See the DHS announcement here.
The Office of Medical Assistance Programs has posted a notice informing individuals who are eligible to participate in the Medical Assistance Transportation Program but who can provide or arrange for transportation assistance on their own that it has temporarily increased the mileage rate for the remainder of the COVID-19 pandemic. See the notice here.

Pennsylvania Health Care Cost Containment Council

PHC4 has published its annual report on the financial performance of the state’s acute-care hospitals. Among the highlights (taken directly from a PHC4 news release):

Uncompensated Care: The statewide percentage of uncompensated care to net patient revenue increased from 1.72% in FY19 to 1.73% in FY20. The foregone dollar value for statewide uncompensated care has decreased from $820 million in FY19 to $809 million in FY20.
Net Patient Revenue: The revenue hospitals received for patient care decreased 2.0% during FY20. Statewide net patient revenue was $46.8 billion during FY20, making up 91% of statewide hospital total operating revenue.
Operating Margin: Statewide operating income decreased from $2.8 billion in FY19 to $1.9 billion in FY20. As a result, the statewide average operating margin decreased from 5.61% in FY19 to 3.73% in FY20. Total operating revenue increased to $51.5 billion and operating expenses increased to $49.6 billion in FY20.
Total Margin: The statewide total margin realized by the hospitals decreased by 2.70 percentage points, from 6.63% in FY19 to 3.93% in FY20.

To learn more, go here for links to the PHC4 news release about the report, downloadable data, and the report itself.

Around the State

Philadelphia has added COVID-19 to its list of vaccines for which children do not need parental consent under a new Philadelphia Board of Health regulation.
In the face of declining COVID-19 cases, Philadelphia lifted most of its COVID-19 restrictions, including density limits, maximum capacity limits, and distancing rules, on Wednesday, June 2.
The city’s indoor mask mandate and 11 p.m. last call for dining orders will continue to be enforced until its Department of Public Health reviews the state of the pandemic and may drop those restrictions on Friday, June 11, according to a city news release. It was previously announced that the city would lift restrictions on Friday, June 11.
Berks County has the third highest rate in the state for children suffering from lead poisoning. It is particularly a problem in the city of Reading and in communities of color. Local officials and doctors are coming together to try to do something about it. WFMZ tells the story.
Penn State is offering incentives to students and staff to get vaccinated: cash prizes, book store gift certificates, and a football signed by coach James Franklin. The Centre County Times offers the details.
The Delaware County Council met in person for the first time in 14 months, the Delaware County Daily Times reports.
Erie’s city hall has reopened after a year, according to GoErie.
The number of flu cases in Pennsylvania fell 97 percent from last year. The AP offers the facts and figures.
Eighteen Pennsylvania colleges and universities (so far) are requiring students and staff to have COVID-19 vaccines for the fall semester. Scroll down this link to find the list.
Most hospitals, on the other hand, are holding off on imposing such requirements, PennLive reports.

Stakeholder Events

Medical Assistance Advisory Committee – Managed Care Delivery Systems Subcommittee Meeting

June 10 at 10:00 a.m.

Join Meeting

Meeting number (access code): 132 168 3592

Meeting password: Managed

Join by phone: +1-408-418-9388 United States (Toll)

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholde

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

jsteinbock2021-06-04T20:20:09+00:00June 4th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Uncategorized|Comments Off

DPW Says Fiscal Office Understates Cost of Medicaid Expansion

The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.

PA Safety Net Admin2013-05-22T06:00:40+00:00May 22nd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Uncategorized|Comments Off

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