PA Health Policy Update for September 8

The following is an update of selected state health policy developments in Pennsylvania from September 4 – 8.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

General Assembly

  • The House Commerce Committee held an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. A recording of the hearing can be viewed here.
  • The House Republican Policy Committee held a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” More information on the hearing can be found here.
  • The House Health Committee will hold a public hearing on Wednesday, September 20 at 9:30am on HB 1657, which amends the Clean Indoor Air Act. The legislation would clarify the definition of a workplace, expand the definition of smoking to include e-cigarettes, and give all localities the ability to enact smoke-free ordinances that exceed minimum state standards. The hearing will be held in Room 523 of the Irvis Office Building and will be livestreamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule for the provision of pediatric home health aide services by family members employed by home health agencies. Learn more in this Pennsylvania Bulletin notice.
  • DHS has published Provider Quick Tip #207 advising health care providers of updates to the procedure codes that are subject to the MA cost avoidance process under Act 62. The purpose of the updates is to bring procedure code descriptions in alignment with national procedure code descriptions. The changes became effective September 5, 2023.
  • The Office of Long-Term Living (OLTL) has announced that Public Partnerships, LLC, has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA) for financial management services for Fee-for-Service OLTL-administered programs related. The new contract became effective September 1, 2023.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the start of its state-wide stakeholder engagement tour. The kick-off event was held in northeastern Pennsylvania in partnership with the Columbia, Montour, and Snyder Drug and Alcohol Program. DDAP’s goal is to gather feedback that will help craft the agency’s plan for increased community and treatment provider engagement while also gaining stakeholder insight to assist the agency’s work on regulation reform.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $27.1 million, or 0.9 percent, less than anticipated. Fiscal year-to-date collections total $5.8 billion, which is $27.2 million, or 0.5 percent, below estimate.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

2023-09-08T20:37:35+00:00September 8th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 8

PA Health Policy Update for July 7

The following is an update of selected state health policy developments in Pennsylvania from July 3 – 7.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update 

The Fiscal Year (FY) 2023-2024 budget remains in flux. Earlier this week the House of Representatives voted to concur with the Senate-passed General Appropriations bill (House Bill 611) by a vote of 117-86. The vote occurred after Governor Shapiro issued a statement announcing his intent to line-item veto the full $100 million intended for the Pennsylvania Award for Student Success (or PASS) voucher program – an initiative adamantly opposed by House Democrats and among the chief points of contention leading to the budget impasse. House Bill 611 was subsequently signed in the House and is awaiting signature in the Senate before it can be sent to the governor.

It is unclear when the Senate will return to Harrisburg or when a final agreement between the various parties will be reached. Senate Republican leadership released a statement criticizing Governor Shapiro and indicating they will “continue to await legislative action by the House on the remaining budgetary components.” 

Governor Shapiro

Governor Shapiro held a press conference touting House Bill 611’s $45.5 billion spending plan and its critical investments in mental health, education, and law enforcement. The governor implored the Senate to return to Harrisburg and sign the bill so it can be sent to his desk. Governor Shapiro also urged the Senate Republicans and House Democrats to meaningfully engage and enact enabling legislation (Fiscal Code, etc.) that would allow the budget to be fully implemented.

Governor Shapiro signed SB 262 into law on Thursday July, 6, which is now known as Act 5 of 2023. Act 5 amends the Maternal Mortality Review Act to require the Maternal Mortality Review Committee to annually publish severe maternal mortality data. 

General AssemblyHouse Chamber of the State House

The House returned to Harrisburg this week for voting session and adjourned to the call of the chair, noting that they do not anticipate returning for voting session in the immediate future. The following are selected health-related proceedings.

  • The House Human Services Committee held a voting meeting July 5 to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The bill was reported as committed. A recording of the meeting can be viewed here.
  • The House passed HB 1515 to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments and HB 1218 which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bills now go to the Senate for consideration.
  • The House Aging and Older Adult Services Committee previously scheduled a voting meeting Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting was not held.

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin announcing its intent to reimburse health care providers for services rendered to Medicaid beneficiaries experiencing homelessness. Eligible services include but are not limited to, “primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder, and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.” DHS has updated the MA Program Fee Schedule accordingly. Find additional information in the department’s press release announcing the policy change.

  • DHS has announced it will require prior authorization of all prescriptions for Amyloid-Targeted Monoclonal Antibodies and certain drugs not included on the Statewide Preferred Drug List (PDL). These prior authorization requirements will apply to prescriptions dispensed on or after July 10, 2023.
  • DHS has provided final notice of its funding allocation for FY 2022-2023 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to general acute care hospitals. The department is not otherwise changing the qualifying criteria or payment methodology for these payments.
  • DHS has announced the end-dating of three procedure codes related to COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #267 with additional information regarding the department’s delayed implementation of Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals. 

Revenue Collection Update 

The Department of Revenue announced the commonwealth ended FY 2022-2023 with $44.9 billion in General Fund revenue collections, which is $1.3 billion, or 3.1 percent, above estimate.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published the public comments it received regarding DHS’ adult protective services proposed rulemaking. The comments may be viewed in this Pennsylvania Bulletin notice. 

Stakeholder Events

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Renal Disease Advisory Committee – July 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 21 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – August 3

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 3 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for June 23

The following is an update of selected state health policy developments in Pennsylvania from June 20 – 23.  (Some of the language used below is taken directly from state documents.)

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings.

  • The Senate voted to confirm Governor Josh Shapiro’s nominees for the Department of Drug and Alcohol Programs, Dr. Latika Davis-Jones, and Pennsylvania Insurance Department, Michael Humphreys. A recording of the Senate Health and Human Services Committee confirmation hearing can be viewed here. A recording of the Senate Banking and Insurance Committee confirmation hearing can be viewed here.
  • The General Assembly passed SB 262, which requires the Maternal Mortality Review Committee to publish severe maternal mortality data. The bill will now be sent to the governor.
  • The House unanimously passed HB 1209 and HB 1407, which enable Pennsylvania to meet its obligations under the 1998 Master Settlement Agreement (MSA) with tobacco product manufacturers and ensure the state is able to continue receiving funds from the tobacco settlement for health-related programs.
  • The Senate adopted SR 46 to establish the Task Force on Women Veterans’ Health Care to study the health care and access issues facing women veterans.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which requires an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition. The bill was reported as amended, to include xylazine.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership. The bill was reported as committed.
    • SB 817, which creates a primary care workforce initiative for Federally Qualified Health Centers (FQHCs). The bill was reported as committed.

A recording of the meetings can be viewed here.

  • The House Human Services Committee held a voting meeting Wednesday, June 22 at 11:30am to consider HB 850, which requires the Departments of Health and Human Services to apply for a waiver if the U.S. Department of Agriculture’s Food and Nutrition Service creates and makes a waiver available to the states that would allow those receiving SNAP and WIC to use those programs for menstrual hygiene products. The bill was reported as amended. A recording of the meeting can be viewed here.

The House and Senate will return to Harrisburg for voting session Monday, June 26.

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to inform Medical Assistance (MA) providers that DHS has added CPT code 0174A to the MA Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July. Find the updated calendar here.
  • DHS has announced the proposed Nursing Facility Assessment Program details for FY 2023-24, including the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program. Find additional information in this Pennsylvania Bulletin notice. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume one of its annual analysis of the financial performance of Pennsylvania’s acute-care hospitals.  The analysis found that hospital total margins across the state decreased 7.59 percentage points in FY 22. Go here to find a PHC4 news release describing the agency’s report, the report itself, and a link to downloadable data from the report. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) submitted comments to the Department of Human Services on their regulation #14-543Protective Services for Adults. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Go here for details on how to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-23T21:27:26+00:00June 23rd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 23

PA Health Policy Update for June 9

The following is an update of selected state health policy developments in Pennsylvania from June 5 – 9.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

General AssemblyHouse Chamber of the State House

The state House and Senate returned to Harrisburg for voting session Monday, June 5. The following are selected health-related proceedings.

  • The House Human Services Committee held a joint hearing with the House Veteran Affairs and Emergency Preparedness Committee Monday, June 5 on the next generation of emergency and mental health response. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held a voting meeting Monday, June 5 and considered the following bills and resolution:
    • HB 1184, which extends the Act 92 COLA moratorium until December 2025. The bill was reported as committed.
    • HB 1300, which adds a member of the Pennsylvania Long-Term Care Ombudsman’s Office to the Pennsylvania Long-Term Care Council. The bill was reported as amended.
    • HR 77, recognizing the month of June 2023 as “Alzheimer’s and Brain Awareness Month” in Pennsylvania. The resolution was reported as committed.

A recording of the meeting can be viewed here.

  • The House Health Committee held a voting meeting Tuesday, June 6 to consider HB 106, the Patient Safety Act, which sets nursing staffing ratios and HB 754, which provides a standard notice to each nursing home resident and their designated representatives at the time of their admission into a nursing home facility that they have the option of having legal representation to assist with the application for Medicaid benefits. HB 106 was reported as amended along party lines and HB 754 was reported as committed. A recording of the meeting can be viewed here.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 6 and considered the following bills and resolution.
    • SB 514, which requires a blood screening for lead exposure of all children by the age of two. The bill was reported as committed.
    • SB 520, which addresses Medicaid coverage for Assisted Living Residences. The bill was reported as amended.
    • SR 120, which directs the Legislative Budget and Finance Committee to conduct a study on the financial impact to EMS providers due to non-reimbursement from Medicaid for “treat and release” services. The bill was reported as amended.

A recording of the meeting can be viewed here.

  • The Senate Health and Human Services Committee held a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. A recording of the hearing can be viewed here.
  • The House Human Services Committee held a voting meeting Wednesday, June 7 to consider HB 1305, to establish funding for Pennsylvania’s 988 Suicide and Crisis Lifeline. A recording of the meeting can be viewed here. 

The Senate now stands in recess until Monday, June 19. The House will return to Harrisburg Monday, June 12 for voting session. The following are selected health-related proceedings.

  • The House Insurance Committee will hold a voting meeting Monday, June 12 at 11:00am to consider HB 1050, requiring health insurers to cover preventive health care services without cost-sharing. The meeting will be held in Room 60 East Wing and will be live streamed here. The Insurance Committee will reconvene on Wednesday, June 14 to consider HB 1140, expanding access to contraceptives. The meeting will be held in Room B31 of the Main Capitol. 

Department of Health

  • The Acting Secretary of Health wrote to hospitals this week to explain that the Department of Health (DOH) order requiring hospitals to make daily reports of specific data regarding supplies and equipment, dated March 24, 2020, will be terminated effective June 9, 2023. CMS requirements for reporting will remain. View the secretary’s letter here.
  • DOH has issued updated guidance for health care settings on how to identify and report COVID-19 outbreaks originating within the facility.
  • DOH has issued a Health Advisory (2023 – PAHAN – 703) with currently available information regarding the status of the ongoing fungal meningitis outbreak and highlights interim recommendations for diagnosis and treatment.
  • DOH has issued a Health Advisory (2023 – PAHAN – 702) regarding poor air quality conditions resulting from wildfires in Canada and current weather conditions.
  • DOH has issued a Health Advisory (2023 – PAHAN – 699) regarding Pennsylvania’s 2023 West Nile Virus (WNV) season and notifying providers that the first WNV-positive mosquito pools of were identified in Delaware, Fayette, and York counties.

Department of Human Services

The Department of Human Services (DHS) announced this week it has “completely eliminated [the] backlog of Medicaid provider enrollment and revalidation applications.” Additional information may be found in this press release.

DHS has released the minutes of the Medical Assistance Advisory Committee (MAAC) meeting held on May 25, 2023. 

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Advisory Board – June 15

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Thursday, June 15, 2023, from 9 a.m. to 10:30 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here. 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

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