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PA Health Policy Update for the Week of September 6

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

General Assembly

The House of Representatives announced it will return to session a week early to address the Wolf administration’s implementation of a mask mandate for K-12 schools and child care facilities.  The House, which was originally scheduled to return on September 27, has added September 20, 21, and 22 as voting session days.

Department of Health

Department of Human Services

  • The Department of Human Services has issued a Medical Assistance Bulletin announcing the addition of CPT codes 0003A and 0013A to the Medical Assistance Program Fee Schedule for the administration of a third dose of the Pfizer and Moderna COVID-19 vaccines.  See the notice here.
  • The Department of Human Services has posted a notice announcing FY 2022 rates for selected services provided by the state’s Office of Mental Health and Substance Abuse Services (OMHSAS).
  • The Department of Human Services has announced that it will allocate $255.556 million in total funds in FY 2022 for inpatient disproportionate share hospital (Medicaid DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals, outpatient supplemental payments to qualifying inpatient acute-care general hospitals, and direct medical education payments to qualifying inpatient acute-care general hospitals.  The department is not changing the state plan provisions addressing the qualifying criteria or payment methodology for these payments.  Learn more from this Pennsylvania Bulletin notice.
  • The Department of Human Services has announced its intention to make COVID-19-related Medicaid DSH payments to qualified hospitals and how much it will pay hospitals based on their Medical Assistance days and their degree of Medicaid dependence.  See the Pennsylvania Bulletin notice here.
  • The Department of Human Services is adding and end-dating procedure codes as a result of implementing the 2021 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS).  The department also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance Program Fee Schedule, including fee adjustments.  Learn more from this Pennsylvania Bulletin notice.
  • The Department of Human Services has published its latest monthly physical health managed care enrollment report.  Find it here.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first report on the performance of its Pennsylvania Rural Health Model.  Find that report here and go here for further information about the program.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained high this week, including the first day (today) with more than 5000 new cases since mid-April.
  • The number of new COVID-19-related deaths increased over the past week.
  • For the week ending September 9 in Pennsylvania, every county in the state is experiencing a high level of COVID-19 transmission.  The CDC classifies transmission as follows:
    • Low:  0-10 new cases per 100,000 residents over the past week or 0-5% positivity rate
    • Moderate: 15-50 new cases per 100,000 residents over the past week or 5-8% positivity rate
    • Substantial:  50-100 new cases per 100,000 residents over the past week or 8-10% positivity rate
    • High: 100+ new cases per 100,000 residents over the past week or 10%+ positivity rate
  • The number of Pennsylvanians hospitalized because of COVID-19 has risen 17 percent since the beginning of the month, the number on ventilators has risen 14 percent, and the number in hospital intensive care units has risen 11 percent.
  • According to the state’s revised figures, 66.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.0 million people – up from 66.0 percent last week.  Only 11,000 Philadelphians and 65,000 other Pennsylvanians (fewer than last week) completed a vaccine regimen in the past week.

Around the State

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has rejected regulations proposed by the state’s Department of Drug and Alcohol Programs for the licensure or certification of drug and alcohol recovery houses that receive funds or referrals from the department or a federal, state, or other county agency to ensure that a drug and alcohol recovery house provides a safe environment for residents.  See the commission’s explanation of its decision in this Pennsylvania Bulletin notice.

Stakeholder Events

  • The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm.  Go here to register to participate remotely.
  • The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am.  Go here to register to participate remotely.
  • The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.
2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, 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 laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 6
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PA Health Policy Update for the Week of July 5-9

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-9, 2021.  (Some of the language used below is taken directly from state documents.)

State Revenue Collections

According to the Independent Fiscal Office’s Monthly Revenue Update, the state collected $3.77 billion in June, the last month of the fiscal year; that was $350.7 million, or 10.3 percent, more than projected.  This strong monthly performance was led by growth in corporate net income tax collections, which were 42.2 percent higher than anticipated.  Pennsylvania ended FY 2020-21 with the largest budget surplus in the state’s history:  $3.4 billion more than anticipated.

Department of Human Services

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases and deaths remained down and steady over the past week.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital ICUs because of it remained down and steady.
  • To date, nearly 1.2 million Pennsylvanians have contracted COVID-19, among them 29,000 health care workers and 88,000 residents and staff of nursing facilities and personal care homes.  27,700 Pennsylvanians have died from the virus.
  • For the week from June 25 through July 1 the state’s overall COVID-19 test positivity rate was 1.1 percent, down from 1.2 percent last week and 1.4 percent the week before.
  • 5.5 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard, but only 82,000 have completed the full vaccination regimen in the past week; another 9000 Philadelphians have done so as well.  According to the state, 60.5 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 63.0 percent of the entire population has now received at least the first dose of a vaccine.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has sent a reminder to stakeholders that under the federal Health Resources and Services Administration’s (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment Program, HRSA will provide up to $250,000 in loan repayment to substance abuse disorder health professionals in exchange for a six-year, full-time service commitment in rural and underserved areas.  Facilities interested in hiring or supporting current substance use disorder health professionals who receive loan repayment must apply to become an approved facility.  Learn more about the HRSA program here and apply to become an approved facility to employ current substance use disorder professionals here.  Applications are due July 22.

Around the State

  • The Department of Health is hiring a new contractor to run its COVID-19 contact tracing program after firing its old contractor after a major data breach.  Spotlight PA explains who, why, and how much.
  • Western Pennsylvania hospitals, nursing homes, assisted living facilities, personal care homes, and home care agencies are experiencing a major shortage of nurses.  The Pittsburgh Tribune-Review details the extent of the problem.
  • A new law passed late last month gives Pennsylvania parents the right to have their children repeat the grade they just finished because of the learning loss they believe their children experienced during remote schooling while the COVID-19 pandemic raged.  Parents must make a decision and file appropriate paperwork by July 15.  The Pittsburgh Post-Gazette offers the details.
  • The Butler County commissioners have unanimously voted to end their emergency declaration, KDKA Pittsburgh reports, “… because the vaccination site at the county mall is closed and they no longer require the state’s emergency funding.”
  • A new law in Pennsylvania “…will require treatment facilities to notify a patient’s emergency contacts if they leave a rehab center against medical advice,” the Pittsburgh Post-Gazette reports, adding that “Heather’s Law, as it’s called, will take effect in 60 days and is named after a woman who overdosed and died 12 hours after leaving a treatment facility in Pennsylvania.  Her family wasn’t aware she had left.”  Learn more here.
  • “After more than five months of discussions and one meeting with Tower Health’s board of directors, Lehigh Valley Health Network and StoneBridge Healthcare have decided not to make an offer to acquire the financially ailing Reading-based health system,” according to the Philadelphia Business Journal.  Tower Health’s hospitals include Reading Hospital, Brandywine Hospital, Chestnut Hill Hospital, Jennersville Hospital, Phoenixville Hospital, Pottstown Hospital, and St. Christopher’s Hospital for Children, a partnership of Tower Health and Drexel University.
  • “Geisinger Health Plan has expanded its Children’s Health Insurance Program (CHIP) coverage to eight more Pennsylvania counties including all five in the Philadelphia region.  GHP Kids coverage is now available for uninsured children and teens, up to age 19, in 48 of Pennsylvania’s 67 counties,” the Philadelphia Business Journal writes

Stakeholder Events

  • Health Research Advisory Committee Meeting

July 12 at 10:00 a.m.

The public meeting will be held virtually by means of Microsoft Teams at (267) 332-8737 with Conference ID: 689 378 043#.

  • Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting.  The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

  • Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728#   United States, Pittsburgh

(866) 588-4789,,785376728#   United States (Toll-free)

Phone Conference ID: 785 376 728#

 

2021-07-09T20:01:40+00:00July 9th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for the Week of July 5-9
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SNAP Asks PA Delegation for COVID-19 Aid

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

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

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

Read SNAP’s message to Congress.

 

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

Eliminate Medicaid disproportionate share hospital cuts (Medicaid DSH), appropriate additional resources for the Provider Relief Fund, and extend the current suspension of the two percent sequestration of Medicare spending, the Safety-Net Association of Pennsylvania asked members of Pennsylvania’s congressional delegation in a letter SNAP sent earlier this week.

Safety-Net Association of Pennsylvania logoThe request comes as Congress returns to Washington to take up the funding of the federal government at a time when authorization for spending under a continuing resolution ends on December 11.  In addition to addressing federal funding, Congress also may consider COVID-19 legislation.

Learn more from SNAP’s letter to Pennsylvania’s congressional delegation.

2020-11-19T06:00:26+00:00November 19th, 2020|COVID-19, DSH hospitals, Federal Medicaid issues, Safety-Net Association of Pennsylvania|Comments Off on SNAP Seeks Help From End-of-Year Federal Legislation
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MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The October 2020 MACPAC meeting opened with a panel discussion on restarting Medicaid eligibility redeterminations when the public health emergency ends.  It included Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities; René Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services; and Lee Guice, director of policy and operations at the Department for Medicaid Services, Kentucky Cabinet for Health and Family Services.

After a break, Commissioners heard a panel discussion with Kevin Prindiville, executive director at Justice in Aging; Mark Miller, executive vice president of healthcare at Arnold Ventures; and Charlene Frizzera, senior advisor at Leavitt Partners, on creating a new program for dually eligible beneficiaries. Later, staff presented preliminary findings from a mandated report on non-emergency medical transportation. The day concluded with a report on nursing facility acuity adjustment methods.

On Friday, the day began with a session on access to mental health services for adults in Medicaid. It was followed by a related panel discussion on mental health services with Sandra Wilkniss, director of complex care policy and senior fellow at Families USA; Melisa Byrd, senior deputy director for the District of Columbia Department of Health Care Finance; and Dorn Schuffman, director of the CCBHC Demonstration Project at the Missouri Department of Mental Health.

Next, the Commission considered the merits of extending Medicaid coverage for pregnant women beyond 60 days postpartum. Staff then provided an update on a statutorily required analysis of disproportionate share hospital (DSH) allotments, as well as an analysis of addressing high-cost drugs and the challenges they present to Medicaid.

The meeting concluded with comment on the Secretary’s report to Congress on Reducing Barriers to Furnishing Substance Use Disorder (SUD) Services Using Telehealth and Remote Patient Monitoring for Pediatric Populations under Medicaid. The Commission decided to send a letter to Congress and the Secretary commenting on this report.

Supporting the discussion were the following briefing papers:

  1. Mandated Report on Non-Emergency Medical Transportation: Work Plan and Preliminary Findings
  2. Changes in Nursing Facility Acuity Adjustment Methods
  3. Access to Mental Health Services for Adults in Medicaid
  4. Considerations in Extending Postpartum Coverage
  5. Required Annual Analysis of Disproportionate Share Hospital (DSH) Allotments
  6. Addressing High-Cost Drugs and Pipeline Analysis
  7. Comment on Secretary’s Report to Congress on Reducing Barriers to Substance Use Disorder Services Using Telehealth for Pediatric Populations under Medicaid

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department  of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program.  Find its web site  here.

2020-11-17T15:00:47+00:00November 5th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off on MACPAC Meets
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Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11.

The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11.  With the latest continuing resolution, the cuts will be delayed yet another month.

SNAP worked hard to encourage Congress to include the Medicaid DSH delay in the continuing resolution, doing so most recently in this September 14 letter to members of Pennsylvania’s congressional delegation.  Medicaid DSH payments are an important tool in helping Pennsylvania safety-net hospitals serve their predominantly low-income communities, so SNAP also is urging Congress to eliminate the Medicaid DSH cut entirely.

Learn more about the delay of Medicaid DSH cuts and other aspects of the continuing resolution that affect hospitals in the Healthcare Dive article “Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law.”

2020-10-08T13:00:02+00:00October 8th, 2020|Federal Medicaid issues, Medicaid supplemental payments|Comments Off on Congress Gives Hospitals Medicaid DSH Relief
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Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders.

Safety-Net Association of Pennsylvania logoThe cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to the delegation, SNAP wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with COVID-19. When these people are sick or injured, most will turn to the state’s 41 private safety-net hospitals for care. These hospitals depend heavily on their Medicaid DSH payments to underwrite the cost of care for their uninsured patients, so they have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never permitted those cuts to go into effect. The most recent delay expires after November 30..

Because they serve so many uninsured and underinsured patients, Medicaid DSH payments from the state are especially important for Pennsylvania’s safety-net hospitals.

Learn more from SNAP’s Medicaid DSH letter to Pennsylvania’s congressional delegation.

2020-09-15T06:00:16+00:00September 15th, 2020|Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation
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CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services.

In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy.

In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its Office of Medical Assistance Programs have not yet indicated how they will respond to the options CMS has presented.

Learn more from this Medicaid notice and from its accompanying CMS informational bulletin “Treatment of Third Party Payers (TPP) in Calculating Uncompensated Care Costs (UCC).”

2020-08-31T19:55:39+00:00August 27th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on CMS Provides Guidance on Medicaid DSH Calculations
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SNAP Asks PA Senators for COVID-19 Help

Pennsylvania’s safety-net hospitals need help with the challenges posed by the COVID-19 public health emergency, SNAP wrote yesterday in a letter to Pennsylvania senators Pat Toomey and Bob Casey.

Safety-Net Association of Pennsylvania logoIn its letter, SNAP asked the senators to advocate:

  • An additional $100 billion for hospitals.
  • Forgiveness for money provided to hospitals through the federal CARES Act’s Accelerated and Advance Payment Program.
  • An increase in the federal Medicaid matching rate (FMAP).
  • An increase in states’ Medicaid disproportionate share (Medicaid DSH) allotments and a delay in the scheduled implementation of Medicaid DSH allotment cuts to the states.
  • Action to prevent implementation of the Medicaid fiscal accountability regulation.
  • A moratorium on changes in hospital eligibility for the 340B prescription drug discount program, Medicare indirect medical education program, Medicare disproportionate share (Medicare DSH) program, and other programs.

See SNAP’s letter here.

2020-07-08T06:00:13+00:00July 8th, 2020|340b, Coronavirus, COVID-19, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Asks PA Senators for COVID-19 Help
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SNAP to PA Delegation: Help Us Fight Coronavirus

Pennsylvania safety-net hospitals need help fighting COVID-19, the Safety-Net Association of Pennsylvania declared in a letter to members of the state’s congressional delegation.

Safety-Net Association of Pennsylvania logoIn addition to the resources sought by hospitals everywhere – equipment, supplies, funding for expanded capacity to accommodate patients suffering from COVID-19 – SNAP emphasized three specific types of assistance in its letter to the delegation:

  • Help with cash flow.  As requested by the federal government and others, SNAP hospitals have limited or suspended elective surgery so they can focus their resources on COVID-19 patients.  This will create a cash-flow problem for them:  while they will be doing everything they can to care for their patients and will be expending considerable resources doing so, their revenue will decline.  These hospitals need up-front funding to replace the revenue they will lose and to help compensate them for the considerable costs they are incurring to prepare for the surge of patients they have been told to expect so they can keep the lights on, patient rooms and supply closets adequately stocked, and staff paid.
  • The elimination of Affordable Care Act-mandated reductions of Medicaid DSH allotments to the states.  Congress has already delayed these reductions on numerous occasions and late last year there was every indication that Congress would do so again.  At a time when hospitals are facing the gravest threat to the public health that they have seen in many years they should not be forced to waste valuable time planning the reductions in staffing and spending they would need to make if the cuts are implemented as scheduled on May 23.
  • No new programs or requirements in future COVID-19-related legislation that would increase hospitals’ regulatory burden.  In recent weeks Congress and the administration have appropriately reduced certain regulatory requirements on a temporary basis and it would be counterproductive to offset this much-needed regulatory relief by introducing new regulations and requirements.

See SNAP’s letter to the Pennsylvania congressional delegation here.

2020-03-23T13:00:25+00:00March 23rd, 2020|Coronavirus, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP to PA Delegation: Help Us Fight Coronavirus
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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