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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 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.

2024-12-13T21:47:50+00:00December 13th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for December 13
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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.

2024-11-22T22:10:10+00:00November 22nd, 2024|Affordable Care Act, long-term care, Medical Assistance Advisory Committee, Meetings and notices|Comments Off on PA Health Policy Update for November 22
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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.

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.

2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 13
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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.

2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off on PA Health Policy Update for June 21
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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.

2024-05-18T00:20:37+00:00May 17th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 17
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PA Health Policy Update for April 19

The following is an update of selected state health policy developments in Pennsylvania from April 15 – 19.  (Some of the language used below is taken directly from state documents). 

General Assembly

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

  • The House passed House Bill 1633, which prohibits non-compete agreements for health care practitioners and establishes certain notification requirements, by a vote of 150-50. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee met on Monday, April 15 and favorably reported 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. A recording of the meeting is viewable here.
  • The House Children and Youth Committee met on Tuesday, April 16 and favorably reported House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 321, which establishes an implementation deadline for the Department of Human Services’ enterprise case management system. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. A recording of the meeting is viewable here.
  • The House Democratic Policy Committee held a roundtable discussion on Tuesday, April 16 examining maternal health deserts. Find the agenda and testimony presented to the committee here.
  • The Senate Democratic Policy Committee held an informational meeting on Monday, April 15 examining pharmacy deserts. Find a recording of meeting and testimony presented to the committee here.

The state House of Representatives and the Senate are in recess until Monday, April 29. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 745) with information regarding recent increases in reported congenital syphilis. The department is recommending that pregnant individuals be offered a test for Syphilis at the first prenatal visit, at the third trimester of pregnancy, and at delivery. 

Department of Human Services 

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin with the 2024 recommended child and adolescent immunization schedule.
  • DHS has published a Medical Assistance Bulletin to advise providers that the department will begin paying for ground ambulance mileage for each loaded mile in addition to increasing the fees for certain ambulance services on the Medical Assistance (MA) program fee schedule, effective with dates of service on or after January 1, 2024.
  • DHS has published the minutes of the March 28, 2024 Medical Assistance Advisory Committee (MAAC) meeting.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through May 2024. Find the updated calendar here. 

Stakeholder Events  

DHS – Consumer Sub-MAAC – April 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 1:00 p.m. Find the agenda here and register to participate here. 

DHS – Medical Assistance Advisory Committee – April 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 25 at 10:00 a.m. Find the agenda here and register to participate here. 

DOH – HIV Community Prevention Planning Committee – May 1

The Human Immunodeficiency Virus (HIV) Prevention Planning Committee will hold a public meeting on Wednesday and Thursday, May 1-2, 2024. The meeting will be held in person and virtually. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Organ Donation Advisory Committee – May 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, May 2 from 10:15 a.m. to 1:15 p.m. The meeting will be held virtually and in person. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – May 3

The Brain Injury Advisory Board will hold a public meeting on Friday, May 3, 2024 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional details in this Pennsylvania Bulletin notice.

2024-04-19T20:14:21+00:00April 19th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 19
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PA Health Policy Update for March 15

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

Governor Shapiro 

The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.  

General Assembly

The state House of Representatives and Senate will convene for a voting session next week. Following is a selection of health care policy-related legislative activity currently scheduled.

  • The House Professional Licensure Committee will hold an informational hearing on Monday, March 18 at 10:00 a.m. 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. The meeting will be held in Room 515 of the Irvis Office building. It will also be livestreamed here.
  • The House Health Subcommittee on Health Care and Judiciary Subcommittee on Crime and Corrections will hold an informational meeting on Wednesday, March 20 at 9:00 a.m. regarding the criminal justice implications of adult-use cannabis legalization. The meeting will take place in Room G50 of the Irvis Office building. It will also be livestreamed here.
  • The House Children & Youth Committee will hold an informational meeting on the Office of the Child Advocate. The meeting will be held on Wednesday, March 20 at 10:00 a.m. in Room 60 of the East Wing. It will also be livestreamed here. 

Department of Health

The Department of Health (DOH) has issued a health advisory regarding elevated levels of lead in certain ground cinnamon products from discount retail stores. Prolonged exposure to these products may be unsafe. Find additional information here.

DOH also issued a Health Advisory (PA-HAN 740) to make clinicians aware of updated recommendations for prenatal hepatitis B and hepatitis C testing. These infectious conditions can lead to profound consequences for pregnant individuals and their infants. Hepatitis B and C testing and linkage to care in pregnancy is critical to the prevention and control of viral hepatitis in Pennsylvania. 

Department of Human Services 

The Department of Human Services (DHS) has announced the extension of an alternative payment methodology for services provided by Federally Qualified Health Centers (FQHCs), including FQHC look-alikes in Philadelphia, that serve a high volume of Medicaid beneficiaries. The alternative payment methodology will be extended through March 31, 2029. Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department

The Insurance Department has announced it will hold a public informational hearing regarding Highmark Health’s request to modify the department’s 2013 order and terms approving the merger of Allegheny Health Network and Highmark Health. Find additional information, including details on how to participate in this Pennsylvania Bulletin notice. 

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.

2024-03-15T21:29:51+00:00March 15th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for March 15
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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.

2024-02-16T20:34:54+00:00February 16th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 16
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PA Health Policy Update for February 9

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

Governor Shapiro

Governor Shapiro delivered his second annual budget address to a joint session of the General Assembly this week. In total, Governor Shapiro’s proposed FY 2024-2025 budget spends $48.3 billion, a $3.7 billion or 8.4 percent increase over the current fiscal year. The budget does not propose any broad-based tax increases, but it uses new revenue sources and the commonwealth’s budget surplus.

The themes outlined in Governor Shapiro’s budget address and the budget proposal’s supporting documents largely reflect a continuation of the policy priorities championed by his administration throughout its first year, including education, public safety, government reform, and economic competitiveness. Following are selected health care highlights in the budget proposal.

  • Invests $100 million in mental health funding for K-12 schools, which builds upon one-time federal funds to ensure schools have the resources to provide mental health services to students and staff.
  • Increases funding for community-based mental health services by an additional $20 million this year and calls for additional funds in successive years (up to $60 million).
  • Invests $50 million of state funding into the state’s reinsurance program to create an additional subsidy wrap for low- and middle-income Pennsylvanians that are on the cusp of being able to afford health insurance.
  • Governor Shapiro highlighted the need to reform pharmacy benefit manager (PBM) operations and called on the General Assembly to enact legislation to that effect.
  • Although the budget proposal doesn’t include specific funding for rural health, Governor Shapiro noted the need to address rural hospital closures and indicated his administration would develop a plan soon.
  • Dedicates $4 million for medical debt relief for low-income Pennsylvanians and calls for health care providers to implement transparent practices to limit medical debt.
  • Includes $1.9 million toward the creation of the Alzheimer’s Disease and Related Disorders Division at the Department of Aging.

Find additional budget documents released by the Office of the Budget below.

General Assembly 

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

  • The Senate passed House Bill 1564, which provides for the creation of an associate license for marriage and family therapists and an associate license for professional counselors, on third and final consideration. The bill will now be sent back to the House for concurrence.
  • The House Health Subcommittee on Health Care held an informational meeting on Monday, February 5 on adult-use cannabis. Find a recording of the meeting here.
  • The Senate Veterans Affairs & Emergency Preparedness Committee favorably reported, among other bills, Senate Bill 1054, which adds EMS providers as required reporters to the Overdose Information Network (ODIN) system.
  • The House Health Committee met for a voting meeting on Tuesday, February 6 and favorably reported the following bills.
  • House Bill 1853, which requires the Department of Health to meet with licensed nursing facilities under their jurisdiction to discuss and share information on survey results, patterns, trends, best practices, etc.
  • House Bill 1931, which establishes a registry of medical directors in nursing facilities, personal care homes, and assisted living residences.
  • House Bill 1956, which makes certain amendments to the Patient Test Results Act.
  • The House Human Services Committee held an informational meeting on Wednesday, February 7 examining Centers of Excellence for Opioid Use Disorder. Find a recording of the meeting here. 

Department of Human Services 

The Department of Human Services (DHS) has announced the addition and end-dating of certain procedure codes to and from the Medical Assistance (MA) program fee schedule for pharmacist services. These changes are effective for dates of service on and after March 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin with updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for opioid use disorder treatments submitted for prior authorization. 

Department of Health 

The Department of Health (DOH) Bureau of Epidemiology’s COVID-19 Infection Control and Outbreak Response team has updated the COVID-19 LTC Toolkit. 

Medicaid Continuous Coverage Unwinding

  • DHS reported that it has 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 21The 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.

2024-02-09T20:45:39+00:00February 9th, 2024|Governments, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 9
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PA Health Policy Update for September 22

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

General AssemblyHarrisburg, PA capital building 

  • The state Senate convened for voting session this week. The following bills were passed on third and final consideration.
    • House Bill 1209 and House Bill 1407 make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. Both bills will now be sent to Governor Shapiro for his signature.
    • Senate Bill 712 allows clinical laboratories certified by the federal government to directly or indirectly advertise or solicit business for diagnostic laboratory testing under certain terms and conditions. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
    • Senate Bill 773 makes various changes to the Medical Marijuana Act. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
  • The House Health Committee held a public hearing on Wednesday, September 20 on House Bill 1657, which amends the Clean Indoor Air Act. A recording of the hearing may be viewed here.
  • Democrat Lindsay Powell won a special election Tuesday, September 19 to fill the vacancy created by the resignation of Representative Sara Innamorato (D – Allegheny), who’s running for Allegheny County Executive. Powell’s victory will preserve the Democrat’s one-seat majority in the House of Representatives.
  • The state House of Representatives will convene next Monday, September 26 and Tuesday, September 27 for voting session. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to electronic visit verification requirements for pediatric home health aide services in the fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate $258 million for FY 2023-2024 inpatient disproportionate share hospital (DSH) 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 October. Find the updated calendar here.

Department of Health 

The U.S. Centers for Disease Control and Prevention (CDC) reported this week that a team of epidemiologists from the Pennsylvania Department of Health (DOH) was the first to identify the transmission of Legionella from an organ directly to a transplant patient. This finding will help protect transplant recipients from serious lung infections. The published research can be viewed in the CDC’s Morbidity and Mortality Weekly Report.

DOH has released a Health Advisory (PAHAN – 719) with recommendations regarding the updated (2023-2024) Monovalent mRNA COVID-19 vaccines. 

Medicaid Continuous Coverage Unwinding 

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

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

Stakeholder Events 

DHS – Consumer Subcommittee of the MAAC – September 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, September 27 at 1:00 p.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – September 28

The MAAC will hold a meeting on Thursday, September 28 at 10:00 a.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here. 

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

2023-09-22T18:52:13+00:00September 22nd, 2023|Medicaid Eligibility Redetermination , Medicaid supplemental payments, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for September 22
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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