Medical Assistance Advisory Committee Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for May 30

The following is an update of selected state health policy developments in Pennsylvania from May 26 – 30. (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro joined Department of Community & Economic Development (DCED) Secretary Rick Siger in Pittsburgh this week to discuss supporting Pennsylvania’s life science and innovation economy. Governor Shapiro highlighted his administration’s FY 2025-26 budget proposal to invest $50 million to support large-scale innovation and life science sector growth. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate were recessed this week. Both chambers are scheduled to return to Harrisburg on Monday, June 2. The following is an overview of selected health care-related legislative activity currently scheduled for next week.

The House Aging & Older Adult Services Committee will meet on Monday, June 2 at 10:00 a.m. in Room G-50 of the Irvis Building for a public hearing on House Bill 1310, which establishes a minimum budget adjust factor (BAF) floor at $0.90 for skilled nursing facilities. The meeting will be livestreamed here.

The House Health Committee will meet on Tuesday, June 3 at 9:30 a.m. in Room 523 of the Irvis Building to consider the following bills. The meeting will be livestreamed here.
- House Bill 425, which establishes a J-1 visa waiver primary care physician grant program.
- House Bill 583, which requires the Department of Human Services to establish a benefit package for dental services for Medicaid.
- House Bill 1460, which provides for more oversight of health care entity merger and acquisition activities.

The House Human Services Committee will meet on Wednesday, June 4 at 9:15 a.m. in Room G-50 of the Irvis Building to consider two suicide prevention related bills, House Bill 415 and House Bill 564. The meeting will be livestreamed here.

Department of Human Services

The Office of Mental Health & Substance Abuse Services (OHMSAS) has issued a bulletin announcing it has revised the forms for voluntary and involuntary commitment evaluations and created a unified procedure for updating all forms utilized under the Mental Health Procedures Act (MHPA) to ensure consistency statewide. The revised forms include the following.

MH 781 Consent for Voluntary Inpatient Treatment
MH 783 Application for Involuntary Emergency Examination and Treatment
MH 783A Explanation of Rights under Involuntary Emergency Treatment
MH 783B Explanation of Warrant
MH 785 Petition for Involuntary Treatment (Sections 304 and 305)
MH 788 Petition to Transfer for Persons in Involuntary Treatment (Section 306)

The Department of Human Services (DHS) has shared the following materials utilized at the Medical Assistance Advisory Committee (MAAC) meeting on May 22.

Department of Health

The Department of Health (DOH) has given notice that the temporary scheduling of several Nitazene substances, compounds, and mixtures will expire on June 3, 2025. Find additional information in this Pennsylvania Bulletin notice.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has announced that it approved the State Board of Pharmacy’s final-form regulation that implements Act 140 of 2020, which establishes criteria for pharmacy technician training programs, as well as the standards of practice and registration fees for pharmacy technicians and pharmacy technician trainees.

IRRC has also approved the State Board of Medicine’s final-form regulation effectuating Act 79 of 2021. The regulation provides for definitions, written agreement requirements, responsibilities of supervising physicians, countersignature requirements, and prohibitions on practice and prescribing by physician assistants. It also updates terminology and removes outdated provisions.

State Board of Psychology

The State Board of Psychology has published proposed rulemaking to update, revise, and clarify continuing education requirements for psychologists. Find the proposed rulemaking in this Pennsylvania Bulletin notice.

Around the State

Senate President Tempore Kim Ward’s (R-Westmoreland) comments about the state budget process and commitment to not raise taxes were the focus of an article by the Tribune-Review.

Spotlight PA has published an article about the current debate to legalize recreational cannabis and whether a deal will be reached by the June 30 budget deadline.

WHYY has written an article about a rally held by health care advocates in Pennsylvania to caution about the potential impact of certain Medicaid proposals included in the federal reconciliation bill that recently passed the U.S. House of Representatives.

Stakeholder Meetings

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

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

Patient Safety Authority – June 17

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

PA Safety Net Admin2025-06-02T14:24:10+00:00May 30th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for May 9

The following is an update of selected state health policy developments in Pennsylvania from May 5 – 9. (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. The following is an overview of selected legislative activity that occurred.

The House of Representatives passed House Bill 1200, which legalizes and regulates adult-use cannabis, by a party-line vote of 102 – 101. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 926, which seeks to prevent health care workplace violence by placing several requirements on health care facilities, by a vote of 124 – 79. The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 1117, which updates language defining DDAP’s duties and responsibilities. The bill will now be sent to the Senate for consideration.

The Senate passed Senate Bill 115, which requires the Department of Human Services to offer a skills competency exam in lieu of high school diploma or GED requirements for individuals seeking employment as direct care staff in personal care homes or assisted living residences. The bill will now be sent to the House of Representatives for consideration.

The House Aging & Older Adult Services Committee held an informational meeting on Monday, May 5 regarding updates to Pennsylvania’s Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.

The House Judiciary Committee met on Monday, May 5 and favorably reported, among other bills, House Bill 282, which authorizes the Department of Corrections (DOC) to establish a medical assistance (i.e., Medicaid) reentry program for incarcerated individuals who are scheduled to be released and returning to the community. A recording of the meeting is viewable here.

The House Professional Licensure Committee met on Tuesday, May 6 and favorably reported, among other bills, House Bill 554, which authorizes the commonwealth to join the Social Work Licensure Compact.

The Senate Institutional Sustainability & Innovation Committee held an informational meeting on Wednesday, May 7 regarding hospital and health system sustainability in Pennsylvania. Testimony presented to the committee and a recording of the hearing are viewable here.

The House Health Committee met on Wednesday, May 7 and favorably reported, among other bills, House Bill 1269, which establishes a Brain Injury Advisory Board at the Department of Health (DOH). A recording of the hearing is viewable here.

The House Insurance Committee met on Wednesday, May 7 and favorably reported House Bill 1088, which expands maternal blood pressure monitoring coverage, and House Bill 1140, which expands access to contraceptives. A recording of the meeting is viewable here.

The House Judiciary Committee met on Wednesday, May 7 for an informational meeting on the Mental Health Procedures Act. A recording of the meeting is viewable here.

The House of Representatives and the Senate will return to Harrisburg for voting session Monday, May 12 through Wednesday May 14.

Department of Human Services

The Department of Human Services (DHS) has announced it will hold a listening session on May 19 from 1:00 – 2:30 p.m. entitled, “Food is Medicine: Screening and Referral.” This is part of DHS’ Keystone of Health Section 1115 demonstration waiver initiative. The listening session is intended for representatives from health care and other settings that interact with consumers that may be eligible for Food is Medicine programs. Find additional information and register here.

DHS has issued Provider Quick Tip #207 with Medical Assistance (MA) program fee schedule updates for Act 62 of 2008, the Pennsylvania Autism Insurance Act, procedure codes.

Department of Aging

The Department of Aging has announced a 30-day public comment period on its updated Intrastate Funding Formula (IFF), which is used to distribute federal funding to the commonwealth’s 52 Area Agencies on Aging. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

Around the State

The House of Representatives’ passage of an adult-use cannabis legalization measure and its prospects in the Senate is the subject of an article published by Spotlight PA. Cannabis legalization and the revenue it would generate are a hallmark of Governor Shapiro’s FY 2025-26 budget proposal.

An article written by City & State Pennsylvania highlights the Senate Institutional Sustainability & Innovation Committee’s hearing on the financial health of hospitals.

Spotlight PA has published an article about security enhancements the Pennsylvania State Police will be making in response to the arson attack at the Governor’s Residence last month.

Stakeholder Meetings

DHS – Consumer Sub-MAAC – May 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 21 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – May 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 22 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2025-05-09T20:27:09+00:00May 9th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for April 25

The following is an update of selected state health policy developments in Pennsylvania from April 21 – 25. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House of Representatives passed House Bill 269, which requires the Department of Health, in consultation with the Department of Drug & Alcohol Programs, to develop opioid overdose public education materials.

The House Insurance Committee held an informational meeting on Wednesday, April 23 to examine infertility care in Pennsylvania. A recording of the meeting is viewable here.

Senator Hughes hosted an intergovernmental roundtable with federal, state, and local policymakers and various health care stakeholders to discuss various proposals being considered in Washington, D.C. that could impact Pennsylvania’s Medicaid funding and the state’s health care system. Find additional information and a recording of the meeting in this press release.

The House of Representatives and Senate are currently in recess. Both chambers will return to Harrisburg on Monday, May 5.

Department of Human Services

The Department of Human Services (DHS) has made the Fiscal Year 25-2026 Social Services Block Grant Intended Use Plan available for public review and comment. Details on how to comment may be found in this Pennsylvania Bulletin notice.

DHS has shared the following presentations utilized at the Medical Assistance Advisory Committee (MAAC) meeting on February 27.

DHS has shared the following prior authorization guideline briefing documents that were the subjects of this week’s Pharmacy & Therapeutics (P&T) Committee meeting.

Department of Health

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 791) to alert health care providers of an expected increase in tick bite-related health care visits and to exercise a heightened clinical suspicion of tickborne illnesses.

DOH has published notice of its intent to effectuate the recommendation of the Medical Marijuana Advisory Board to add ‘Moderate to Severe Traumatic Brain Injury (TBI) with Chronic Symptoms’ and ‘Type II Diabetes Mellitus’ to the list of serious medical conditions for Chapter 20 research purposes only. Find additional information in this Pennsylvania Bulletin notice.

Around the State

The Morning Call has published an article about the impact of a potential $500 million loss of federal funding for Pennsylvania that has supported public health efforts and local health agencies.

Following the arsonist attack on the Governor’s Residence, Governor Shapiro has published a guest essay in The New York Times entitled, “Finding Moral Clarity After an Arsonists Attack.”

An article written by WHYY details the current state of operations at Crozer Health amidst its impending closure. The Philadelphia Inquirer also published an article about this.

Stakeholder Meetings

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – May 2

The Brain Injury Advisory Board will hold a public meeting on May 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA 17112 in the Cumberland conference room. Find additional details in this Pennsylvania Bulletin notice.

DOH – HIV Planning Committee – May 14

The Statewide HIV Planning Group will hold public meetings on Wednesday, May 14 from 3:00 p.m. to 6:00 p.m. and on Thursday, May 15 from 9:00 a.m. to 2:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-04-25T22:14:16+00:00April 25th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for April 18

The following is an update of selected state health policy developments in Pennsylvania from April 14 – 18. (Some of the language used below is taken directly from state documents).

Governor Shapiro

An arsonist attacked the Governor’s Residence in Harrisburg on Sunday, April 13, which forced the Governor and his family, who were present at the time of the attack, to be evacuated. The suspect has been arrested and formally charged with attempted murder, terrorism, and other charges. Find additional details, and the Governor’s statement on political violence, in this press release.

General Assembly

The state House of Representatives and Senate were recessed this week. The House of Representatives will return to Harrisburg on Tuesday, April 22. The Senate will remain recessed until Monday, May 5.

The House Majority Policy Committee held an informational meeting on Monday, April 14 examining the impact of the life science sector on advanced manufacturing and health care workforce development. Find additional details and a recording of the meeting here.

The House Majority Policy Committee also held an informational meeting on Tuesday, April 15 examining midwifery modernization and maternal health deserts in Pennsylvania. Find additional details and a recording of the meeting here.

The House Insurance Committee has scheduled an informational meeting on Wednesday, April 23 at 9:15 a.m. to examine infertility care in Pennsylvania. The meeting will be held in Room 523 of the Irvis Building and livestreamed here.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers enrolled on the Medical Assistance (MA) program of updates to the MA program fee schedule, including the addition of new procedure codes and the end-dating of certain codes based on provider request and clinical review. These changes will take effect May 1.

DHS has issued a Medical Assistance Bulletin to advise federally qualified health centers (FQHCs) and rural health clinics (RHCs) of the procedure codes, modifiers, and places of service to utilize when billing for covered services provided to Medicaid beneficiaries.

DHS Secretary Val Arkoosh along with other health-related cabinet officials participated in the Western Pennsylvania Regional Rural Healthcare Summit to discuss opportunities and challenges communities face accessing health care services. Find more information in this press release.

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

Department of Health

The Department of Health has announced that an individual from another state tested positive for measles while visiting Lancaster County after a trip to Texas, creating a potential for exposure to others. Find additional details and information about measles from DOH here.

The Newborn Screening and Follow-up Technical Advisory Board had voted to recommend the addition of Metachromatic leukodystrophy (MLD), a lysosomal storage disorder, to the commonwealth newborn screening panel effective January 1, 2026. Find additional information in this Pennsylvania Bulletin notice.

DOH has announced it will hold four public comment sessions to provide stakeholders an opportunity to comment on the development of the 2026 State Plan for the Pennsylvania Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Around the State

Crozer Health’s ongoing challenges, as well as efforts to transition certain service lines were the subject of an article published by The Philadelphia Inquirer.

PA has published an article about measles, the increasing cases nationally, and growing vaccine hesitancy.

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here.

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

The Patient Safety Authority – April 29

DOH – Brain Injury Advisory Board – May 2

The Brain Injury Advisory Board will hold a public meeting on Friday, May 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA 17112 in the Cumberland conference room. Find additional details in this Pennsylvania Bulletin notice.

PA Safety Net Admin2025-04-18T17:47:31+00:00April 18th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for April 11

The following is an update of selected state health policy developments in Pennsylvania from April 7 – 11. (Some of the language used below is taken directly from state documents).

General Assembly

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

The House of Representatives passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.

The House of Representatives passed House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. The bill will now be sent to the Senate for consideration.

The House Aging & Older Adult Services Committee held an informational meeting on Monday, April 7 to examine potential updates to the Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.

The House Human Services Committee met on Tuesday, April 8 and favorably reported House Bill 561, which expands Act 80 to include all FDA-approved medication assisted treatment, and House Bill 1117, which updates language defining DDAP’s duties and responsibilities. A recording of the meeting is viewable here.

The House Insurance Committee met on Tuesday, April 8 and favorably reported House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. A recording of the meeting is viewable here.

The House Health Committee met on Wednesday, April 9 and favorably reported, among other legislation, the following pertinent bills. A recording of the meeting is viewable here.

- House Bill 69, which expands the existing Cancer Drug Repository program to other prescription drugs.
- House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements.
- House Bill 1104, which caps the costs of obtaining electronic medical records.

The House of Representatives and the Senate have now recessed. The House will reconvene Tuesday, April 22 and the Senate will reconvene Monday, May 5.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to remind physicians, physician assistants (PAs), and certified registered nurse practitioners (CRNPs) enrolled in Medicaid that they are able render topical fluoride varnish (TFV) services to Medicaid beneficiaries.

DHS has issued a reminder to all participating Medicaid providers of the need to complete a “MA 112 Form” after the birth of a child to a mother enrolled in Medicaid in order to notify the mother’s respective county assistance office (CAO). The “MA 112 Form” should be completed and submitted within three working days of the child’s birth.

DHS has published final notice of its funding allocation for FY 2024-25 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to Medicaid-enrolled, qualifying inpatient acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice.

Around the State

CBS News has published an article about the continued challenges facing Crozer Health in Delaware County. An attorney for Prospect Medical Holdings, the parent company of Crozer, indicated Crozer would start transitioning certain service lines to other providers.

Pennsylvania’s home care industry and its need for additional funding was the focus of an article by Politics PA this week.

The Pennsylvania Capital-Star has published an article about increasing measles cases in the state and some counties’ lagging vaccination rates.

Stakeholder Meetings

DOH – WIC State Advisory Board – April 22

The WIC State Advisory Board will hold a public meeting on April 22 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here.

DHS – Consumer Sub-MAAC – April 23

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Renal Disease Advisory Committee – April 25

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 25 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 of Health’s programs related to care and treatment. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

The Patient Safety Authority – April 29

PA Safety Net Admin2025-04-11T22:36:44+00:00April 11th, 2025|Governments, Medical Assistance Bulletin, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for January 10

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

General Assembly

The General Assembly convened on Tuesday, January 7 to officially commence the 2025-2026 legislation session. Members of the state House of Representatives and Senate who were newly elected or re-elected were sworn in. In addition, the two chambers elected their respective presiding officers, adopted rules, and established standing committees.

At the conclusion of Tuesday’s legislative business, the House and Senate recessed until Monday, January 27. Following are their respective 2025 session calendars.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has approved the remainder of the commonwealth’s request for a five-year section 1115 demonstration – Bridges to Success: Keystones of Health for Pennsylvania. You will recall Pennsylvania received approval from CMS back in November to implement multi-year continuous eligibility for Medicaid-eligible children through age six and one year of continuous coverage for Medicaid-eligible citizens returning from a state correctional facility. The Department of Human Services (DHS) has stated it, “will work through the state budget process to determine next steps for potential implementation.” Find CMS’ approval letter to DHS here.

Department of Human Services

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of November.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has released the Intensive Behavioral Health Services (IBHS) Regulatory Compliance Guide (RCG) in an effort to provide clear explanations of the regulatory requirements of Title 55 Pa. Code, Chapter 5240, “Intensive Behavioral Health Services” regulations.

DHS has issued updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Anticonvulsants submitted for prior authorization. Find additional information in this Medical Assistance Bulletin.

DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the Admissions Notice Packet (MA 401) form due to an increase in the personal needs allowance (PNA) deduction amount. This bulletin applies to nursing facilities, intermediate care facilities, and long-term care facilities enrolled in the Medical Assistance program.

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that 259 Pennsylvanians successfully appealed denied health service claims through PID’s new Independent External Review process. Of the total health service denials submitted for review in 2024, 50.1 percent were overturned.

PID has also shared information related to its efforts to increase health insurance transparency through several reports available to the public, including its annual Transparency in Coverage Report for ACA Health Plans, which outlines data on claims, denials, and appeal information, and its inaugural ACA and Qualified Health Plans (QHP) Summary. Find additional information in this press release.

Around the State

WHYY has written about the Pennsylvania Insurance Department’s external review program which received 517 health service denial appeals in 2024. 259 of those denials were overturned.

City & State Pennsylvania has published an article about the General Assembly’s first session day of 2025.

The Pittsburgh Post-Gazette has written an article about a study released by Pennsylvania Partnerships for Children that kids largely stayed insured despite uncertainties during the Medicaid eligibly redetermination process following the conclusion of the COVID-19 public health emergency.

Stakeholder Meetings

DOH – WIC Advisory Board – January 14

The WIC State Advisory Board will hold a meeting on January 14 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Special Pharmaceutical Benefits Advisory Council – January 30

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, January 30 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 Safety Net Admin2025-01-10T20:27:58+00:00January 10th, 2025|Federal Medicaid issues, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for December 13

The following is an update of selected state health policy developments in Pennsylvania December 9 – 13. (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 2025 session calendars. Find the House’s calendar here and the Senate’s calendar here.

Department of Human Services

The Department of Human Services (DHS) has announced the addition of doula services to the Medical Assistance (MA) program fee schedule and the submission of a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS). DHS will issue an MA Bulletin to inform providers enrolled in the MA program of the addition of doula services and how to bill for the provision of doula services. Find additional information in this Pennsylvania Bulletin notice.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the Partial Hospitalization Regulatory Compliance Guide. The guidance is intended to help agencies providing partial hospitalization services with the goal of ensuring safe environments and effective services to individuals.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on December 5.

DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.

Department of Health

The Department of Health (DOH) and the Pennsylvania Insurance Department (PID) have reminded Pennsylvanians of the importance of HIV pre-exposure prophylaxis (PrEP) medication for HIV prevention. The Affordable Care Act (ACA) requires that HIV PrEP be covered at zero cost-sharing for insured consumers. Find additional resources and information in this press release.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has released a “Family Members Training Needs Survey.” DDAP has requested feedback from family members and/or significant others of individuals who may be suffering from drug or alcohol use, receiving substance use disorder (SUD) treatment, or in recovery to better understand what would help them navigate SUD services. The survey will remain open until January 6, 2025.

Around the State

The Pittsburgh Post-Gazette has written an article about the expected increase in the number of Pennsylvanians diagnosed with Alzheimer’s Disease in the next 15 years and the challenges the current treatment system will face according to a recent analysis conducted by the Center for Rural Pennsylvania.

The Pennsylvania Capitol-Star published an article about the potential increase in insurance premiums for Pennsylvanians on Pennie, the state’s health insurance marketplace, if federal subsidies expire.

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Board – December 16

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 16 from 2:00 to 3:30 p.m. For connection information or any questions, please contact Megan McDaniel (memcdaniel@pa.gov).

DOH – Health Policy Board – December 19

The Health Policy Board will hold a meeting on Thursday, December 19 at 12:30 p.m. The purpose of the meeting is to consult with the board of the department’s draft proposed hospital regulations. The meeting will be held virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Safety Net Admin2024-12-13T21:47:50+00:00December 13th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for November 22

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

Governor Shapiro

Governor Shapiro has signed Executive Order 2024-04 creating the Pennsylvania Permit Fast Track Program to streamline the state’s permitting process for key economic development and critical infrastructure projects. Find additional information in this press release.

General Assembly

The state House of Representatives and Senate have recessed until the call of their respective chair.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Medical Assistance (MA) Program Vaccine Desk Reference. This bulletin applies to all providers enrolled in the MA program that may administer vaccines to MA beneficiaries in the fee-for-service or managed care delivery system.

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

Insurance Department

The Pennsylvania Insurance Department (PID) has announced the publication of the first Pennsylvania Affordable Care Act and Qualified Health Plans (QHP) Summary Report. This report examines how PID reviews health insurance products and enforces laws to ensure a fair insurance market and equitable treatment of consumers. Find more information in this press release.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has announced it received the following final form regulations, which will be considered at its public meeting on December 5, 2024.

State Board of Medicine Opioid Treatment Programs: this final-omitted rulemaking amends the Board of Medicine’s regulations to allow the initial physical examination required for prescribing, administering, and dispensing controlled substances to be done via telehealth under certain conditions.
State Board of Osteopathic Medicine Licensure Requirements: this final rulemaking includes amendments to licensure requirements that are, in part, necessary to reflect the merger of the post-graduate training bodies for osteopathic (DO) and allopathic (MD) medical school graduates into a single accreditation system.

Around the State

The New York Times has written about President Donald Trump’s plan to nominate Pennsylvania resident Dr. Mehmet Oz to serve as the administrator of the Centers for Medicare and Medicaid Services.

WKBN 27 has written an article about the Commonwealth’s continued efforts related to the potential sale of Sharon Regional Medical Center, part of Steward Health Care which filed for bankruptcy in May.

City & State Pennsylvania has published an article about the five bills signed into law by Governor Shapiro this week and his signing of an executive order on permitting.

Stakeholder Events

DHS – Long-Term Services and Supports Subcommittee – December 4

The Long-Term Services and Supports Subcommittee (LTSS) will hold a public meeting on December 4 from 10:00 a.m. to 1:00 p.m. The meeting will be held in person and virtually. Click here for more information.

DHS – Consumer Sub-MAAC – December 4

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 4 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – December 5

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on December 5 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

PA Safety Net Admin2024-11-22T22:10:10+00:00November 22nd, 2024|Affordable Care Act, long-term care, Medical Assistance Advisory Committee, Meetings and notices|Comments Off

PA Health Policy Update for September 13

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

Governor Shapiro

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.

Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release.

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA). These changes are effective for dates of service on or after September 9, 2024.

DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.

DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.

DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

DHS has released an updated Medicaid Managed Care Organization (MCO) Directory.

Department of Health

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here.

Department of Drug & Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here.

Stakeholder Events

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

PA Safety Net Admin2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for June 21

The following is an update of selected state health policy developments in Pennsylvania from June 17 – 21. (Some of the language used below is taken directly from state documents).

General Assembly

The state House of Representatives and Senate will reconvene for voting session next Monday, June 24. Both chambers are currently scheduled to remain in session until Monday, June 30, which is Pennsylvania’s constitutional deadline to enact a budget.

The House Children & Youth Committee is scheduled to meet on Tuesday, June 25 at 9:00 a.m. to consider House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The meeting will be held in Room B-31 of the Main Capitol. It will be livestreamed here.

The House Health Committee is scheduled to meet on Wednesday, June 26 at 9:30 a.m. to consider House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. The meeting will be held in Room G-50 of the Irvis Building. It will be livestreamed here.

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 July 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.

DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death. Find the notice here.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will offer a virtual “Implementation, Improvement, Sustainability and Coaching of the ASAM Criteria – A How-To Science Based Approach” training in conjunction with Train for Change. The training will be offered in three series. It will teach the NIATx model for process improvement in conjunction with the ASAM Criteria Implementation Guide. Find the three series’ dates and additional information here.

Around the State

The Pennsylvania Capital-Star has reported about the state’s looming budget deadline and Senator Majority Leader Joe Pittman’s assertion that “[negotiations] could perhaps use… a kick in the pants to get moving.”

The New York Times has published an article about the role of pharmacy benefit managers (PBMs) and how they contribute to the cost of prescription drugs.

Spotlight PA has published an article about efforts to legalize recreational marijuana and the likelihood of legalization being a part of this year’s budget package.

Stakeholder Events

DHS – Consumer Sub-MAAC – June 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 26 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – June 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 27 at 10:00 a.m. Find the agenda here and register to participate here.

PA Safety Net Admin2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off

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