Medical Assistance Archives - Safety-Net Association of Pennsylvania

DPW Issues DSH Notice

The Pennsylvania Department of Public Welfare (DPW) has published a notice “announcing its intent to allocate funding for several classes of disproportionate share hospital (DSH) payments made to qualifying Medical Assistance (MA) enrolled acute care general hospitals.” These allocations include funding for FY 2013 critical access, OB/NICU, trauma, burn center, academic medical center, and other supplemental DSH payments.
Find the complete Pennsylvania Bulletin notice here .

PA Safety Net Admin2012-09-25T06:00:18+00:00September 25th, 2012|Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

DPW to Launch New Claims Review Process

Come fall, the Pennsylvania Department of Welfare (DPW) will introduce a new system that performs an automated review of Medical Assistance claims before the state pays those claims.
The new system employs a computer program called InvestiClaim that will review claims for procedure or diagnosis codes with inadequate medical documentation, duplicate claims, provider types, license numbers, and other considerations.
The state projects that this new system will save $5 million a year.
The future use of a system to review claims prior to payment was included in Governor Corbett’s original Medical Assistance budget proposal for FY 2013.
Read more about InvestiClaim and how it will work in this PA Independent article .

PA Safety Net Admin2012-08-31T09:49:48+00:00August 31st, 2012|Pennsylvania Medicaid policy|Comments Off

Supreme Court Decision Has Huge Medicaid Implications

When the Supreme Court rules on the challenge to the Affordable Care Act, its decision will have enormous implications for states, low-income and uninsured people, and health care providers.
Among the many features of the health care reform act on which the Supreme Court will rule is the single biggest expansion of eligibility since Medicaid was introduced in the mid-1960s.
As they await the court’s decision, many states already are laying the groundwork for the addition of between 15 million and 20 million people to the nation’s Medicaid rolls.
Pennsylvania’s safety-net hospitals have a considerable stake in the court’s decision because the planned Medicaid expansion could add as many as a half-million people to the state’s Medical Assistance rolls.
The New York Times has taken a closer look at the stakes in the court’s upcoming decision. Read that Times article here .

PA Safety Net Admin2012-06-18T10:11:29+00:00June 18th, 2012|Health care reform, Uncategorized|Comments Off

DPW Launches “Open Government” Web Site

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

PA Safety Net Admin2012-06-01T14:58:49+00:00June 1st, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Medical Assistance Primary Care Rates to Rise

Rates for primary care services covered by Pennsylvania’s Medical Assistance program will rise upon implementation next year of a new federal regulation recently published in draft form by the Centers for Medicare & Medicaid Services (CMS).
Under the proposed regulation, Pennsylvania must pay Medicare-level rates for Medicaid-covered primary care services in 2013 and 2014. Medicare rates are higher for such services than Pennsylvania’s Medical Assistance rates, and under the proposed regulation the federal government, not the state, will pay for the difference between Medicare and Medicaid rates.
This new policy was mandated by the Affordable Care Act. In addition to raising fee-for-service rates, Pennsylvania will be expected to revise agreements with its contracted HealthChoices plans to ensure that they, too, pay the better rates.
The higher rates should be especially beneficial for Pennsylvania safety-net hospitals because of the large numbers of Medicaid patients they serve.
Proponents of the higher rates believe they will improve access to primary care services for the Medicaid population and possibly reduce future Medicaid costs by helping recipients get more timely care and thereby avoid more serious illnesses.
Learn more about the proposed Medicaid rate increase in a Commonwealth Fund blog entry and find the entire proposed regulation here . Interested parties have until June 11 to submit written comments to CMS.

PA Safety Net Admin2012-05-30T06:00:45+00:00May 30th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

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