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PA Health Policy Update for June 14

The following is an update of selected state health policy developments in Pennsylvania from June 10 – 14.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

Governor Shapiro signed, among other bills, Senate Bill 721 into law this week. Senate Bill 721, now known as Act 22 of 2024, establishes the Women, Infants and Children (WIC) State Advisory Board. Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The House of Representatives passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to the Senate and reported favorably from the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1783, which requires the Department of Health to develop and publish educational material about opioid-related overdose and requires the Department of Drug & Alcohol Programs to establish a grant program from the development, expansion, or improvement of recovery support services. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2127, which allows clinicians to distribute information related to postpartum depression and counseling resources. It also requires the Department of Health to publish those resources on its website. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed  House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational hearing on Senate Bill 840 and House Bill 2400, which both create an Alzheimer’s Disease and related disorders division within the Department of Aging and establish an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the hearing is viewable here.
  • The House Children & Youth Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, June 11 and favorably reported House Bill 1140, which expands access to contraceptives, and House Bill 2268, which provides coverage for speech therapy for stuttering. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, June 11 and favorably reported Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions, and Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. A recording of the meeting is viewable here.
  • The Senate Banking & Insurance Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 1664, which prohibits insurers from restricting their method of payment to solely credit card, and House Bill 1754, which requires public and private insurers to cover biomarker testing. A recording of the meeting is viewable here.
  • The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 12 and favorably reported, among other bills, Senate Bill 1251, which aligns Pennsylvania’s nursing statute with federal rules regarding accreditation. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee and the Senate Aging & Youth Committee held a combined hearing on Wednesday, June 12 regarding the status of the state’s Aging Our Way plan. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, June 12 and favorably reported the following bills.
    • House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients,
    • House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance.
    • House Bill 2363, which expands the existing Cancer Drug Repository Program to allow both health care facilities and individuals to donate prescription drugs (other than cancer drugs) to the program.

A recording of the meeting is viewable here.

  • The House Human Services Committee met on Wednesday, June 12 and favorably reported House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, June 12 and favorably reported, among other bills, House Bill 2198, which caps the fees for obtaining electronic medical records. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee met for a voting meeting on Wednesday, June 12 and favorably reported, among other bills, House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the meeting is viewable here.

The state House of Representatives and Senate will be in recess next week. Both chambers are scheduled to return to Harrisburg, Monday June 24.

Department of Human Services 

The Department of Human Services (DHS) has announced it is making available for public review and comment the Office of Long-Term Living’s proposed amendment for the OBRA waiver. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced it is making available for public comment and review the Office of Long-Term Living’s proposed renewal for the Community HealthChoices (CHC) waiver. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 753) regarding testing for influenza in persons with severe respiratory illness given the potential for severe human infections with influenza A(H5N1) viruses and the recent spread into dairy cattle. 

Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

2024-06-14T21:14:14+00:00June 14th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for June 14

PA Health Policy Update for May 17

The following is an update of selected state health policy developments in Pennsylvania from May 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

  • The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
  • The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024. 

Department of Health 

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page. 

State Board of Medicine 

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice 

State Board of Osteopathic Medicine 

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.
  • City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.
  • The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120. 

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

PA Health Policy Update for May 10

The following is an update of selected state health policy developments in Pennsylvania from May 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed Senate Bill 739 by a vote of 47-1. Senate Bill 739, which was amended before final passage, provides for coverage of telemedicine services. The bill will now be sent to the House for consideration.
  • The Senate unanimously passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system. The bill will now be sent to the House for consideration.
  • The House passed House Bill 1632, which amends the Workers’ Compensation Act to recognize post-traumatic stress injuries as eligible for workers’ compensation claims, by a vote of 154-46. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries, by a vote of 164-37. The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, May 6 and favorably reported, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.
    • House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange.

A recording of the meeting is viewable here.

  • The House Labor & Industry Committee met on Tuesday, May 7 and favorably reported House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee held an informational meeting on the nursing workforce crisis. A recording of both meetings is viewable here.

The state House of Representatives and Senate are now recessed. The House will return to session Monday, May 20 and the Senate will return Monday, June 3.

Department of Human Services 

The Department of Human Services (DHS) has announced its intent to increase the funding for a class of supplemental payments to qualifying hospitals for Fiscal Year (FY) 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional information in this Pennsylvania Bulletin notice. 

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on April 25.

Department of Health 

The Department of Health (DOH) has announced it will hold a public hearing on its proposed Preventive Health and Health Services Block Grant application for Federal Fiscal Year 2024. The hearing will take place on May 28 from 10:00 – 11:00 a.m. Find additional details on how to attend and comment in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Pharmacy’s proposed pharmacy technician registration regulations. Find additional information and IRRC’s comments in this Pennsylvania Bulletin notice 

Around the State 

  • The Pennsylvania Capital-Star has reported about legislation that would cover post-traumatic stress injuries for first responders under the state’s Workers’ Compensation Act.
  • Governor Shapiro has indicated he will sign legislation criminalizing the misuse of xylazine, which is contributing to a growing number of overdose deaths, according to a Philadelphia Inquirer article. 
  • PennLive has published an article about House Democrats’ efforts to pass legislation that would enact a key part of Governor Shapiro’s budget proposal to provide assistance to individuals purchasing insurance of the commonwealth’s state-based insurance exchange, Pennie.

Stakeholder Events 

PA Chamber – Healthcare Summit – May 22

The Pennsylvania Chamber of Business and Industry is holding its inaugural health care summit on Wednesday, May 22. The event will feature conversations about leading health care topics, including innovations in pharmaceuticals, workforce development, the medical malpractice landscape, and the role of AI in health care. To view additional details and register click here 

DOH – Preventive Health and Health Services Block Grant Committee – May 28

The Preventive Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, May 28 from 2:00 – 4:00 p.m. The purpose of the meeting is to present the Federal Fiscal Year 2024 workplan and budget information. The meeting will be held virtually and in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for May 3

The following is an update of selected state health policy developments in Pennsylvania from April 29 – May 3.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The House unanimously passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to the Senate.
  • The House Human Services Committee met on Monday, April 29 and favorably reported, among other bills, House Bill 1783, which requires the development of opioid-related overdose public information, and House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program. A recording of the meeting is viewable here.
  • The House Health Committee met on Tuesday, April 30 and favorably reported the following bills.
    • House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
    • House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana.
    • Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board.

A recording of the meeting is viewable here.

  • The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 30 at 10:00 a.m. regarding local Area Agencies on Aging. A recording of the meeting is viewable here.
  • The House Human Services Committee held an informational meeting on Wednesday, May 1 regarding performance-based contracting for the Department of Human Services’ Office of Developmental Programs. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session in Harrisburg next Monday, May 6 through Wednesday, May 8. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Insurance Committee will convene on Monday, May 6 at 10:00 a.m. in Room 60 of the East Wing to consider, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.

The meeting will be livestreamed here.

  • The House Labor & Industry Committee will meet on Tuesday, May 7 at 9:30 a.m. in Room 523 of the Irvis Office Building to consider House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee will hold an informational meeting on the nursing workforce crisis. The meeting will be livestreamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (PA-HAN 746) with important information about Lyme Disease and other tickborne diseases in the commonwealth. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers of additions and updates to the Medical Assistance (MA) program fee schedule.
  • DHS has provided final notice of its funding allocation for FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to qualifying acute care general hospitals enrolled in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the final annual case-mix per diem payment rates for FY 2023-2024 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin regarding the removal of lifetime employment bans for individuals convicted of certain criminal offenses in the Older Adults Protective Services Act.
  • DHS has added information to its website about the Technology Assessment Group (TAG), which reviews requests for new and emerging technologies and recommends coverage decisions for the MA program. Find the TAG’s website here.
  • DHS has announced the peer group, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities. Find additional information in this Pennsylvania Bulletin notice.

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $373.3 million, or 7.0 percent, more than anticipated. Fiscal year-to-date General Fund collections total $38.5 billion, which is $739.3 million, or 2.0 percent, above estimate. 

Around the State   

  • The Tribune-Review reported about the many professional counselors that could be approved for associate licenses soon due to the implementation of Act 4, which establishes two new license types in Pennsylvania.
  • Spotlight PA has published an article about the counties’ use of tens of millions of dollars in opioid settlement funds.
  • A news segment published by KDKA highlighted the drug shortage challenges that health care providers and patients are currently confronting in Pennsylvania and across the country.  

PA Health Policy Update for March 22

The following is an update of selected state health policy developments in Pennsylvania from March 18 – 22.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened for a voting session this week. Following is a selection of health care policy-related legislative activity that occurred.

  • The House passed House Bill 1201, a consumer data privacy bill, by a vote of 139-62 on third and final consideration. The bill includes exemptions for protected health information under HIPAA and patient-identifying information related to certain research. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee held an informational meeting on Monday, March 18 to discuss House Bill 1354, which enables boards and commissions within the Department of State’s Bureau of Professional and Occupational Affairs to issue advisory opinions to licensees. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee convened for a voting meeting on Tuesday, March 19 and favorably reported House Bill 1795, which aligns state statute with federal requirements for source plasma donation centers. A recording of the meeting is viewable here.
  • The House Health Subcommittee on Health Care and Judiciary Subcommittee on Crime and Corrections held an informational meeting on Wednesday, March 20 regarding the criminal justice implications of adult-use cannabis legalization. A recording of the meeting is viewable here.
  • The House Children & Youth Committee held an informational meeting on Wednesday, March 20 to review the Office of the Child Advocate. A recording of the meeting is viewable here.
  • Rep. Patty Kim (D – Dauphin County) was appointed chairman of the House Insurance Committee. She replaces former chairman, Rep. Kevin Boyle (D – Philadelphia). Rep. Maureen Madden (D – Monroe) was subsequently appointed chairman of the House Aging & Older Adult Services Committee. 
  • The Legislative Budget & Finance Committee has released a report on the impact of “treat and release” calls on emergency medical services (EMS), specifically for patients covered by Medicaid. Find highlights from the report here and the full detailed report here. 

The state House of Representatives will convene again for voting session on Monday, March 25. The Senate is now in recess until Monday, April 8. Following is an overview of selected health care policy-related legislative activity currently scheduled next week.

  • The House Insurance Committee is scheduled to meet on Monday, March 25 at 10:00 a.m. in Room 60 of the East Wing. The committee will consider, among other bills, House Bill 1512, which provides for the coverage of telemedicine services. The meeting will be livestreamed here.
  • The House Health Committee will convene on Wednesday, March 27 at 9:00 a.m. to consider a number of bills and resolutions, including the following.
    • House Bill 1633, which prohibits the use of non-compete agreements in health care employment.
    • House Bill 2084, which establishes a license for prescription drug virtual manufacturers.
    • Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. 

Department of Health

The Department of Health (DOH) has issued a request for applications (RFA) for community health worker care coordination in four rural regions of the commonwealth, including northeast central, northwest central, northwest, and southwest. The RFA may be viewed online at eMarketplace or here.

DOH has issued a Health Advisory (PA-HAN 741) with new guidance for preventing respiratory virus diseases. 

Department of Human Services 

  • The Department of Human Services (DHS) has provided final notice of its funding allocation for FY 2023-2024 inpatient disproportionate share hospital (DSH) payments, outpatient supplemental payments, direct medical education payments, and certain DSH and supplemental payments to new hospitals. DHS is not otherwise changing the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through April 2024. Find the updated calendar here. 
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it is conducting a survey related to the department’s work on regulatory reform. DDAP has requested stakeholders complete the survey, which may be found here, to help guide this initiative. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it has contacted individuals that had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • 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.

Stakeholder Events  

DHS – Consumer Sub-MAAC – March 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – March 28

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 28 at 10:00 a.m. Register to participate here.

2024-03-22T20:16:41+00:00March 22nd, 2024|Governments, Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for March 22

PA Health Policy Update for February 16

The following is an update of selected state health policy developments in Pennsylvania from February 12 – 16.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

  • The Senate Republican Policy Committee held an informational meeting on Wednesday, February 14 examining challenges in rural health care. A recording of the meeting, as well as copies of the testimony offered to the committee, are viewable here.
  • The House Democratic Policy Committee held an informational meeting on Wednesday, February 14 to discuss the future of artificial intelligence, including how it may impact the field of medicine. A recording of the hearing in its entirety is viewable here, while testimony can be viewed here.
  • Next week the state House of Representatives and Senate Appropriations Committees will begin their hearings to examine Governor Shapiro’s proposed FY 2024-2025 spending plan. The Department of Aging is the only health-related agency that will have a budget hearing next week – it will be held on Thursday, February 22 at 10:00 a.m. Find the House Appropriations Committee’s complete schedule here and the Senate Appropriations Committee’s complete schedule here.
  • The House Republican Policy Committee will hold an informational meeting on Thursday, February 22 at 1:00 p.m. regarding, “A State Lost in Addiction: Pennsylvania’s Path to Recovery.” The meeting will take place at The Crane Room Grille (3009 Wilmington Rd.) in New Castle, PA. 

Department of Human Services 

  • Last week DHS announced that pharmacists may enroll in the Medical Assistance (MA) program to provide services to MA beneficiaries effective March 1, 2024. The following guidance has subsequently been issued by DHS related to pharmacists’ enrollment in the MA program.
  • DHS has issued a Medical Assistance Bulletin indicating the procedure codes that can be billed for pharmacists services. DHS also published notice of intent to add procedure codes for pharmacists to the MA program fee schedule in the Pennsylvania Bulletin, which is viewable here.
  • Additional information related to the enrollment requirements and application process, pharmacists should refer to the DHS website here.
  • DHS has issued a remittance advice alert notifying providers of a claims recovery that was done to recoup monies paid in error due to the department’s eligibility records indicating recipients being deceased prior to the dates of service being billed.

Department of Health 

The Department of Health (DOH) has issued a revised template for nursing facilities to use in calculating their nursing staffing ratios. Click here to download the updated spreadsheet tool. 

DOH has published a Pennsylvania Bulletin notice, as required, with a list of hospitals that have provided notice to the department that they may not provide emergency contraception or sexual assault emergency services due to various factors.  

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published comments in response to the proposed regulations submitted by DHS that would make changes to comply with CMS’ final rule – ”Medicaid Program; Covered Outpatient Drugs.” The proposed regulation also makes technical changes to add diabetic supplies, opioid overdose agents, and immunizations to the list of services excluded from copayments. In addition, it recognizes the prescriptive and dispensing authority of certified nurse practitioners (CRNP) and midwives. Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • 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.

Stakeholder Events

DHS – Consumer Sub-MAAC – February 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 21 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – February 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 22 at 10:00 a.m. Register to participate here.

DOH – Preventive Health & Health Services Block Grant Advisory Board – February 27

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, February 27 from 3:00 p.m. to 4:00 p.m. The purpose of the meeting is to discuss the status of the funding for the block grant. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 28

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, March 28 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual teleconference. Find additional information in this Pennsylvania Bulletin notice.

Long-Term Care Council – 2024 Meeting Dates

The Long-Term Care Council has published its 2024 bi-monthly meeting dates. Council meetings are open to the public and held virtually unless otherwise specified. Find additional information in this Pennsylvania Bulletin notice.

PA Health Policy Update for January 12

The following is an update of selected state health policy developments in Pennsylvania from January 8 – 12.  (Some of the language used below is taken directly from state documents). 

General Assembly 

  • The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that, effective February 1, 2024, doulas may enroll in the Medical Assistance (MA) Program, which will enable MA managed care organizations (MCOs) to enter into network agreements with doulas. The bulletin also contains information on provider enrollment.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through February 2024. Find the updated calendar here. 

Department of Health

DOH has requested input from stakeholders on what the state’s priorities should be for its Title V Maternal and Child Health Services Block Grant, which is intended to improve the health and wellbeing of mothers, infants, children, and youth, including children and youth with special health care needs, and their families. Interested stakeholders can find additional information and details on how to submit feedback here. 

Board of Nursing 

The State Board of Nursing, along with DHS and DOH, has issued a joint statement of policy to clarify nursing standards and qualifications in the commonwealth for licensed practical nurses (LPNs) and registered nurses (RNs) as it relates to the Nurse Licensure Compact (NLC). Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the establishment of a state-administered independent appeal process that allows Pennsylvanians to submit for an independent external review if they believe their insurer wrongly denied a claim for covering medical service, treatment, or other items. This is part of Act 146 of 2022, which reformed the state’s prior authorization and step therapy procedures. 

PID has also announced that Pennie’s open enrollment period for 2024 health care coverage will be extended until January 19. Pennie is Pennsylvania’s official health insurance marketplace. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced the Drug-Free Communities Program, which provides community coalitions with grant funding for substance use prevention efforts, will release its FY 2024 notice of funding opportunities on www.grants.gov in February 2024.   

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new report – COVID-19, The Impact on Health Care in Pennsylvania – examining how the coronavirus pandemic affected Pennsylvania and its health care system. Find additional information in this press release issued by PHC4. 

Medicaid Continuous Coverage Unwinding

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.

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here. 

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for January 5

The following is an update of selected state health policy developments in Pennsylvania from December 21 – January 5.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The commonwealth’s Behavioral Health Council held its first meeting the week of December 18. Created by Executive Order 2023-20 in October, the council is tasked with developing and recommending a state-wide action plan to address deficiencies in access, affordability, or delivery of behavioral health services. Find additional information about the council’s first meeting and a list of council members in this press release. 

General Assembly 

  • The state House of Representatives and Senate briefly convened for session on Tuesday, January 2. Both chambers are now in recess until Tuesday, February 6 when they will convene for Governor Shapiro’s annual budget address.
  • Senator Kim Ward (R-Westmoreland) was reelected by her colleagues on Tuesday to serve as President Pro Tempore of the Senate.
  • The House and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that the department is providing coverage and payment for interprofessional consultation services in the Medical Assistance (MA) Program, beginning January 1, 2024.
  • DHS has also issued a Medical Assistance Bulletin to inform providers about the department’s coverage policy for routine patient care costs associated with qualifying clinical trials and the updated requirements.
  • DHS has published a Pennsylvania Bulleton notice announcing its intent to submit a state plan amendment to the Centers for Medicare & Medicaid Services to implement Act 15 of 2023, which increases ground ambulance rates for the MA fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate funds in FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to MA enrolled, qualifying acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has published its approved and required medications list for emergency medical service agencies and emergency medical service providers. Find additional information in this Pennsylvania Bulletin notice.
  • DOH has published a Pennsylvania Bulletin notice with the scope of practice for emergency medical responders, emergency medical technicians, advanced emergency medical technicians, paramedics, prehospital registered nurses, prehospital physician extenders, and prehospital physicians.

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs’ (DDAP) new training management system (TMS) is now live and DDAP has migrated all training records from the old TMS and TrainPA. Find more information and access the new TMS here. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.7 billion in General Fund revenue in December, which was $69.6 million, or 1.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $19.8 billion, which is $70.7 million, or 0.4 percent, below estimate. 

Medicaid Continuous Coverage Unwinding

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.

Stakeholder Events

DOH – Renal Disease Advisory Committee – January 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, January 19 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the department’s programs related to care and treatment. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 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 – Medical Marijuana Advisory Board Meetings – 2024    

The Medical Marijuana Advisory Board has provided notice of its 2024 board meeting schedule. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice.

 

PA Health Policy Update for December 15

The following is an update of selected state health policy developments in Pennsylvania from December 11 – 15.  (Some of the language used below is taken directly from state documents.)

FY 2023-2024 Budget 

The General Assembly and Governor Shapiro enacted the remaining pieces of the FY 2023-2024 budget this week, including the Fiscal Code – House Bill 1300. The enactment of the Fiscal Code will enable approximately $1.1 billion that has been delayed since July to begin to be distributed. This includes $50 million for hospital financial relief, tobacco settlement funds, etc.  Find a summary of the various provisions in the Fiscal Code here. 

Governor Shapiro 

Governor Shapiro signed several bills into law this week. Following is a selection of health care-related laws enacted.

  • Senate Bill 414 (Act 59 of 2023) authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.
  • Senate Bill 683 (Act 43 of 2023) requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
  • Senate Bill 941 (Act 66 of 2023) enables certain flexibilities for addiction treatment providers.
  • House Bill 1131 (Act 50 of 2023) removes the requirement for counties to operate state health centers in counties establishing their own local health departments. 

General Assembly 

The state House of Representatives and Senate convened for their final voting session of 2023 this week. In addition to the bills noted above that were enacted by the General Assembly and the governor, following is an overview of selected health care-related legislative activity from this week.

  • The House of Representatives passed House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania, by a vote of 163-40. The bill will now be sent to the Seante for consideration.
  • The House of Representatives amended House Bill 181, known as the Family Medical Leave Act, on second consideration. The bill was subsequently referred to Appropriations and re-reported as amended. The bill still needs to be passed on third and final consideration before heading to the Senate.
  • The House Health Subcommittee on Health Care met on Wednesday, December 13 for an informational meeting on the “cannabis regulatory landscape.” Find a recording of the proceeding here. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of interprofessional consultation services to the Medical Assistance (MA) program fee schedule. These changes are effective for dates of services on and after January 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvaniais open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.
  • DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Medical Assistance (MA) program fee schedule related to the administration of COVID-19 vaccines.

Department of Health

  • The Department of Health (DOH) has sent a message to long-term care facilities regarding the methodology for calculating staffing ratios for licensed practical nurses (LPNs) and nurse aides. The new methodology will go into effect January 1, 2024.
  • DOH has published an addendum to its solicitation for substance use disorder navigation services to increase emergency department capacity. Find the addendum and additional information regarding the solicitation here.
  • DOH has asked health care providers to report individuals with blood lead levels of 3.5 μg/dL or higher detected through venous, capillary or unspecified testing within three months after consuming a WanaBana, Schnucks, or Weis brand cinnamon applesauce or apple purée product containing cinnamon by securely emailing the following information to RA-DHBOE-RESPONSE@pa.gov or by fax: 717-772-6975. Find additional information in this Health Advisory issued by DOH. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its 2022 Hospital Performance Report. The report includes risk-adjusted, hospital-specific mortality and readmission ratings as well as volume of cases and average charges for patients discharged from Pennsylvania’s acute care hospitals between October 1, 2021, through September 30, 2022 

State Board of Medicine 

The State Board of Medicine has published proposed rulemaking submitted by the Board of Medicine effectuating Act 79 of 2021, which among other things, enables physician assistant written agreements to be effective upon being filed rather than approved. Find additional information in this Pennsylvania Bulletin notice. 

Department of Labor & Industry 

The Department of Labor & Industry has determined the maximum compensation payable under the Workers Compensation Act shall be $1,325 per week for injuries occurring on or after January 1, 2024. Find additional information in this Pennsylvania Bulleton notice. 

Medicaid Continuous Coverage Unwinding

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.

Stakeholder Events

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

PA Health Policy Update for November 17

The following is an update of selected state health policy developments in Pennsylvania from November 13 – 17.  (Some of the language used below is taken directly from state documents.) 

General AssemblyHouse Chamber of the State House

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health-related legislative activity.

  • The House of Representatives unanimously passed Senate Bill 500, which provides Medicaid coverage for pasteurized donor human milk, as amended. The Senate subsequently concurred with the House amendments and sent it to the governor’s desk.
  • The Senate unanimously passed House Bill 507, which requires health care providers to obtain informed consent, both verbal and written, before performing a pelvic examination, a rectal examination, or a prostate examination while the patient is anesthetized or unconscious. The House subsequently concurred with the Senate amendments and sent it to the governor’s desk.
  • The Senate unanimously passed Senate Bill 668, which permits certified nurse aides to become certified medication aides (CMA) in long-term care facilities, assisted living residences, and personal care homes. Following Senate passage the bill was received in the House and referred to the Health Committee.
  • The House Human Services Committee held a meeting on Monday, November 15 and favorably reported House Bill 1650, which authorizes the establishment of a grant program for recovery houses, and House Bill 1690, which establishes a public awareness campaign about the growing threat of Xylazine.
  • The House Health Committee held a meeting on Wednesday, November 15 and favorably reported House Bill 1657, which eliminates exemptions in the state’s Clean Indoor Air Act and expands the definition of smoking to include e-cigarettes, and Senate Bill 414, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through December. Find the updated calendar here.
  • DHS has announced it will add sexually transmitted infection (STI) test kits for at-home specimen collection to the Medical Assistance (MA) Program fee schedule, effective with dates of services on and after December 1, 2023. Find additional information in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health is soliciting applications from hospitals and health systems for up to $325,000 in grant funding to support care navigators in emergency departments as part of the Pennsylvania Substance Use Navigation Program. One grantee will be selected in each of four regions, based on the location of the emergency department where care will be provided, and funds can be used to build and implement health system-wide clinical capacity to screen, diagnose, and support longitudinal care for opioid use disorder and stimulant use disorder and support recovery for adults and adolescents. The RFA closes on January 16, 2024.

In anticipation of the holiday season, DOH has issued vital safety tips to avoid holiday accidents. On behalf of DeBrunner & Associates, we hope you don’t burn the turkey and wish you a very happy Thanksgiving. 

Medicaid Continuous Coverage Unwinding

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.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Patient Safety Authority – December 7

The Patient Safety Authority will hold a public board meeting on Thursday, December 7 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

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