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PA Health Policy Update for Friday, December 23

The following is an update of selected state health policy developments in Pennsylvania for the week of December 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers about new procedures for dispensing 340B-purchased drugs to Medical Assistance beneficiaries and about the implementation of the program’s 340B drug exclusion list.  Find the bulletin here.  Find the policies this new bulletin replaces here.
  • DHS has extended its schedule for sending Remittance Advice documents, Medicaid payment checks, and electronic transfers of payments into early February.  Find the updated schedule here.
  • DHS has announced that it will add several prescription drugs to the Medical Assistance program’s list of services and items requiring prior authorization:  corticotropin; targeted systemic immunomodulators for atopic dermatitis, designated as preferred on the program’s preferred drug list (PDL); PCSK9 inhibitor lipotropics, designated as preferred on the PDL; and obesity treatment agents designated as preferred on the PDL.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has posted revisions of the participating drug company list for the Medicaid drug rebate program.
  • DHS has announced its intent to allocate funds in FY 2023 for several classes of inpatient disproportionate share hospital (DSH) payments (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  See the announcement, including information about the different purposes for which Medicaid DSH payments will be made, in this Pennsylvania Bulletin notice.
  • DHS has circulated the following materials from the December 7 meeting of the Medical Assistance Advisory Committee meeting.

Department of Health

  • The Department of Health (DOH) has announced that Pennsylvania will receive $98 million in federal funding to enhance public health infrastructure, including staffing, health planning, and equity and data modernization efforts.  A portion of the funding, from the CDC’s Public Health Infrastructure grant program will be allocated to 10 county and municipal health departments.   Learn more from this Department of Health news release.
  • DOH has issued a health advisory informing providers to be aware of possible increases in group A streptococcal infections.  The alert also informs providers about symptoms, testing, and treatment; provides instructions for laboratories that identify cases; and reminds providers and laboratories that they are required to report such cases to DOH.  Find the alert here.
  • DOH has issued a health advisory with interim guidance for clinicians on how to prioritize antiviral flu treatment at a time when there is limited availability of the drug oseltamivir (Tamiflu).  Find the advisory here.
  • DOH has revised long-term-care nursing facility regulations recently approved by the Independent Regulatory Review Commission to correct typographic errors.  Find the revised, final regulations in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs remained steady over the past week but the number on ventilators rose 17 percent.
  • The CDC reports no change over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 21, 46 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 15 were experiencing substantial rates of community transmission; and six counties were experiencing a moderate rate of community transmission.
  • As 2022 draws to a close, Pennsylvania has now experienced 3.4 million confirmed, reported cases of COVID-19 and suffered nearly 49,000 deaths from the virus.
2022-12-23T21:11:29+00:00December 23rd, 2022|COVID-19, long-term care, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 23
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PA Health Policy Update for Friday, November 10

The following is an update of selected state health policy developments in Pennsylvania for the week of November 7-10, 2022.  (Some of the language used below is taken directly from state documents.)

2022 Election Update

While the results are not official, current Democratic Lieutenant Governor John Fetterman has defeated Republican Mehmet Oz to replace retiring U.S. Senator Pat Toomey. Pennsylvania’s congressional incumbents all won another term. The state’s two open congressional seats (PA-12 and PA-17) were captured by Summer Lee (D) and Chris Deluzio (D), respectively.

At the state level, Democrat Josh Shapiro, the state’s current Attorney General, defeated Republican State Senator Doug Mastriano and will be Pennsylvania’s next governor.

Republicans will retain control of the state Senate with 28 of the chamber’s 50 seats; they have been in the majority in the Senate since 1994.  In an unanticipated outcome, Democrats made significant gains in the state House, and as of Thursday afternoon, November 10, are in striking distance of having a majority.  A handful of House races remain too close to officially call and may be headed for a recount. Except for a four-year period from 2007 through 2010, Republicans have been in the majority in the House since 1995.

Come January, Pennsylvania will have a new governor, a vacancy at Attorney General, and nearly a quarter of the General Assembly’s members will be new so there will be changes in caucus and committee leadership.

General Assembly

As of Thursday afternoon, the state House is schedule to return to session on Monday, November 14 and the Senate is scheduled to return on Tuesday, November 15.

The Senate Health and Human Services Committee will hold a public hearing next Tuesday, November 15th at 10:00 a.m.. to review the recently released Behavioral Health Commission report. The hearing can be livestreamed here.

Department of Human Services

Department of Health

The Department of Health has written to nursing home administrators to inform them that temporary nurse aides (TNAs) hired on or before June 6, 2022 have until the end of the federal public health emergency or April 5, 2023, whichever date comes first, to successfully pass the nurse aide exams and have their name enrolled on the Nurse Aide Registry.  Find that letter here.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania continues to fall in the 1700-1800 a day range while the number of deaths is generally between 17 and 20 a day.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs because of the disease remained relatively steady over the past week.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

2022-11-14T21:35:19+00:00November 10th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, November 10
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PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

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

  • The House of Representatives unanimously passed House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.  The bill was received in the Senate and referred to the Aging & Youth Committee.
  • The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
  • The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania.  A recording of the hearing and witness testimony may be viewed here.
  • The Senate Banking & Insurance Committee favorably reported Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
  • The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

  • The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
  • The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
  • The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
  • DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered.  This policy took effect on September 20.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix.  The update took effect on September 19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered.  Go here to learn more.
  • DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax.  The update is effective as of July 13.  Find that bulletin here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2.  Find that notice here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1.  Find that notice here.
  • DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the state’s nursing facility assessment program beginning in FY 2023.  Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers.  Learn more from this Pennsylvania Bulletin notice.
  • DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

  • DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding.  The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead.  Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of about 10 percent.
  • To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 195 admissions a day over the past week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

  • DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26.  Find that notice here.
  • The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures:  coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement.  The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay.  It also documents case volumes, hospital charges, and statewide trends and offers other statistics.  To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00.  The meeting will be held virtually. An agenda will be available here 24 hours in advance.  Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 23
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PA Health Policy Update for the Week of January 10-14

The following is an update of selected state health policy developments in Pennsylvania for the week of January 10-14, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has announced the creation of the Long-Term Care Resiliency, Infrastructure Supports, and Empowerment program, or LTC RISE, which seeks to give long-term-care facilities “…the support they need to battle COVID-19, recover, and rebuild.”  Under the program, long-term-care facilities can pursue improvement projects in the areas of infection prevention and control and emergency preparedness; building a sustainable outbreak response operation; and promoting professional development and a resilient long-term-care facility workforce.  The program is funded by a federal grant and replaces the state’s Regional Congregate Care Assistance Teams program, which expired at the end of 2021.  Learn more about LTC RISE from this Wolf administration news release and from the LTC RISE web page.

General Assembly

  • The House of Representatives unanimously passed House Bill 1280, which amends the Patient Test Result Information Act.  This bill eliminates the definition of “significant abnormality” and revises the written notice requirement for health care providers in an effort to provide clarity and eliminate conflicting interpretations of the act.  The bill was received in the Senate and referred to the Health and Human Services Committee.
  • The House Health Committee convened on Tuesday, January 11 and favorably reported House Bill 1630, which would grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.  The committee also reported Senate Bill 709, which would create public awareness of cytomegalovirus (CMV) and provide for CMV screening for certain newborns.
  • The House Republican Policy Committee is scheduled to hold a public hearing on rural health care issues next Wednesday, January 19 at 9:30 a.m.  The hearing will take place at the University of Pittsburgh at Bradford.
  • The state Senate will hold voting session during the week of January 17 on Tuesday (1/18) and Wednesday (1/19).
  • The Senate Health and Human Services Committee will convene on Tuesday, January 18 to consider Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The Senate Appropriations Committee is scheduled to convene on Tuesday January 18 to consider, among other bills, Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS); Senate Bill 861, which enters Pennsylvania into the EMS interstate compact; and Senate Bill 927, which expands eligibility for the Medical Officer Health Incentive Program.
  •  The Senate Aging and Youth Committee will convene on Tuesday, January 18 at 11:30 a.m. to consider the following bills:
    • Senate Bill 936, which mandates the reporting and tracking of infants born with an addiction to opioids or other illegal substances within the state.
    • House Bill 996, which requires the departments of Health and Human Services to establish protocols to allow a resident of a long-term-care facility to receive visits by a member of the clergy during a disaster emergency.
    • House Bill 1737, which enables a county children and youth agency to petition the court for an order to compel a drug screening when there is evidence that substance use may be a contributing cause of child abuse or neglect.

Department of Human Services

  • Various Department of Human Services (DHS) regulations were suspended to facilitate the state’s response to the COVID-19 pandemic.  Some of those suspensions have been lifted, so some of the temporarily suspended regulations are being enforced again.  For an updated list of regulations and their current status, organized by offices within DHS and with the most recent changes highlighted, go here.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of booster doses of COVID-19 vaccines.  To find those new codes and the rates to be paid, see this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes to the Medical Assistance fee schedule for the administration of the Pfizer pediatric COVID-19 vaccine.  Find the procedure codes, rates, and more in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin informing providers of changes in billing procedures for certified registered nurse practitioners and physician assistants serving fee-for-service patients.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that the fee-for-service program will require prior authorization for prescribing Aduhelm (aducanumab), the new drug to treat Alzheimer’s disease.
  • DHS has issued a Medical Assistance Bulletin informing providers and pharmacies that it has issued updated handbook pages presenting the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Xyrem (sodium oxybate)/Xywav (calcium, magnesium, potassium, and sodium oxybates) for fee-for-service patients.  Find the notice here.
  • DHS announced that it intends to continue making Medical Assistance Day One Incentive payments to qualified non-public nursing facilities in FY 2022.   These payments seek to give incentives to non-public nursing facilities to serve individuals who are Medical Assistance-eligible on the day of admission.  Learn more about how and when the payments will be made and how they will be calculated in this Pennsylvania Bulletin notice.
  • DHS is making available for public review and comment its proposed renewal application for extension of the Section 1115 Medicaid demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration.”  The effective dates of the current approved demonstration are October 1, 2017 through September 30, 2022.  The extension requested will be for an additional five years, through September 30, 2027.  Learn more about the program and the state’s planned request from this Pennsylvania Bulletin notice.
  • DHS’s Office of Child Development and Early Learning has updated its FAQ on its guidance for tuberculin skin testing and COVID-19 vaccinations for providers participating in its licensed programs.  Find that FAQ here.

Department of Health

In the past week the Department of Health announced the opening of a new COVID-19 testing site in Cambria County to go along with other recently opened testing sites in Berks, Blair, Centre, Clinton, Delaware, Luzerne and Mifflin counties.  In addition, the state has announced that a new high-volume and high-throughput COVID-19 testing site will be opening soon in Delaware County at Mercy Fitzgerald Hospital.  This site will be staffed by U.S. Department of Health and Human Services contractors with additional support from the host location, the costs for which will be eligible for reimbursement by FEMA.  The Department of Health continues to talk to federal officials about the possibility of opening an additional high-volume testing site in the south-central part of the state.

The Department of Health has announced that Credentia will serve as its new contractor to operate the Pennsylvania nurse aide registry previously operated by Pearson Vue.  Go here for the nurse aide registry search.  The Pearson Vue link no longer works as of January 3.

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

The Pennsylvania Rural Health Redesign Center Authority Board will hold its next virtual meeting on Tuesday, January 18 at 10:00 a.m.  The meeting will provide updates on a variety of topics, including model status updates, federal grant deliverables, global budget methodology, and more.  It also will address current and upcoming activities.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Infant Hearing Screening Advisory Committee – January 20

The Infant Hearing Screening Advisory Committee will hold a public meeting both in person and virtually on Thursday, January 20 at 1:00 p.m.  Agenda items will include reports by the cytomegalovirus and audiology subcommittees, an assessment of audiology training currently in development, and a review of upcoming program activities.  For information about how to join the meeting, either virtually or in person, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, January 26 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – January 27

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 27 at 10:00 a.m.  Go here to register to participate.

Medical Marijuana Advisory Board – January 27

The Medical Marijuana Advisory Board will hold a virtual meeting on Thursday, January 27 at 10:00 a.m.  This meeting will be broadcast live through Commonwealth Media Services.  Check www.medicalmarijuana.pa.gov and click on the Medical Marijuana Advisory Board tab for live streaming information on the day of the virtual meeting.  Learn more from this Pennsylvania Bulletin notice.

Patient Safety Authority – January 27

The Patient Safety Authority will hold a virtual public meeting on Thursday, January 27 at 1:00 p.m.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Special Pharmaceutical Benefits Program Advisory Council – January 27

The Statewide Special Pharmaceutical Benefits Program Advisory Council will hold a public teleconference meeting on Thursday, January 27 at 10 a.m.  To participate, call 412-648-8888 or 866-588-4789.  The meeting ID is 487 872 318#.  Learn more from this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 2

The DHS Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet virtually on Wednesday, February 2 at 10:00 a.m.  Interested parties can join the meeting here or call in at 914-614-3221, access code 300-175-489.

Office of Long-Term Living – Financial Management Services Stakeholder Meeting – February 4

The DHS Office of Long-Term Living’s financial management services stakeholder group will hold a virtual public meeting on Friday, February 4 at 1:00 p.m. to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA                     Waiver, and Act 150 programs.  Go here to participate or join by phone at 1-408-418-9388.

 

2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 10-14
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PA Health Policy Update for the Week of November 29-December 3

The following is an update of selected state health policy developments in Pennsylvania for the week of November 29 to December 3, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced a plan to spend approximately $1.2 billion in American Rescue Plan Act federal funding to support Medicaid’s home and community-based services (HCBS) system, giving more Pennsylvanians access to critical services in their communities.  This temporary funding enhancement will be directed toward Medicaid-funded essential care services to seniors, adults with intellectual and physical disabilities, adults with behavioral health needs such as substance use disorder or mental illness, and children with chronic complex medical needs.  The American Rescue Plan Act provides states with a temporary, one-year, 10 percent increase in the rate at which the federal government matches state spending for certain Medicaid-covered home and community-based services.  To learn more about how Pennsylvania plans to spend this money, see this Wolf administration news release.  For more on Pennsylvania’s plan, go here.  A week after this announcement, the federal government approved the state’s plan for using this money, as the Department of Human Services reported to stakeholders.

General Assembly

The House Republican Policy Committee held a hearing this week examining the health care staffing crisis.  Representatives from the Hospital & Healthsystem Association of Pennsylvania (HAP), Penn State Health, Geisinger, the Pennsylvania Health Care Association (PHCA), SEIU Healthcare, and the Pennsylvania State Nurses Association testified.  Hearing testimony and a video recording may be viewed here.

Two members of the General Assembly – House majority leader Kerry Benninghoff (R-Mifflin) and Representative Mark Gillen (R-Berks) – have tested positive for COVID-19.

Financial paperworkState Revenue Update

Revenue collections continue to exceed estimates. The Department of Revenue reported this week that Pennsylvania collected $6.6 billion in General Fund revenue in November, which was $217.9 million, or 3.4 percent, more than anticipated.  For the year to date Pennsylvania has collected $18.7 billion in General Fund revenue, which is $1.0 billion, or 5.7 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin explaining that it intends to allocate $106.130 million in total funds for disproportionate share hospital payments (Medicaid DSH payments) to qualifying acute-care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the state and $88.994 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms.  Go here to see the Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin updating its dental fee schedule.  The update is effective as of August 23, 2021.

Department of Health

The state Supreme Court has temporarily restored the Department of Health’s (DOH) order requiring students, teachers, and staff to wear masks in Pennsylvania school districts.  Read the court’s ruling here.  The ruling only put a hold on Commonwealth Court’s decision to issue a stay of the order; the Supreme Court will still need to consider the governor’s appeal of the Commonwealth Court decision.

DOH has established new walk-in COVID-19 testing sites in Berks, Centre, Clinton, Crawford, Jefferson, and Susquehanna counties.  Learn more from this news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts are on the rise in Pennsylvania.  Wednesday’s 7606 new cases and Thursday’s 9143 new cases are the highest single-day totals in the state since the second week of January.  To date, more than 1.75 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.  To date, more than 33,000 Pennsylvanians have died from COVID-19.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which declined during the first two weeks of November, rose significantly during the last two weeks of the month.  As the month came to a close, COVID-19 related hospitalizations were up 43 percent over the beginning of the month, ventilator cases were up 32 percent, and COVID-19 patients in hospital ICUs also were up 32 percent.
  • 231,000 Pennsylvanians were recorded as completing a vaccine regimen during the month of November.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs released Policy Bulletin 21-05, which documents modifications to the Standard General Terms & Conditions, Fiscal and Operations Manual, and Substance Abuse Prevention and Treatment Block Grant (SAPTBG) provisions.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, December 8 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m.  Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m.  Go here for information about registering and participating.

2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 29-December 3
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PA Health Policy Update for the Week of September 6

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

General Assembly

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

Department of Health

Department of Human Services

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

Pennsylvania Rural Health Model

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

COVID-19:  By the Numbers

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

Around the State

Independent Regulatory Review Commission

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

Stakeholder Events

  • The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm.  Go here to register to participate remotely.
  • The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am.  Go here to register to participate remotely.
  • The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.
2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 6
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PA Health Policy Update for the Week of July 12-16

The following is an update of selected state health policy developments in Pennsylvania for the week of July 12-16, 2021.  (Some of the language used below is taken directly from state documents.)

General Assembly

The House Democratic Policy Committee’s Subcommittee on Progressive Policies for Working Families held an informational hearing this week on “Pricing Out Pennsylvanians:  How to Drive Down Drug Prices.”  Various stakeholders, including PhRMA, the National Academy for State Health Policy, patient advocates, and pharmacists, spoke to the committee.  Find their testimony here.

On Wednesday, July 21 at 10:30 a.m. the Senate Health & Human Services Committee and the Senate Communications & Technology Committee will hold a joint public hearing examining the Department of Health’s COVID-19 contact tracing emergency procurement.  Go here to stream the hearing.

Department of Human Services

  • DHS has published a notice in the Pennsylvania Bulletin announcing its intention to discontinue Medical Assistance stability payments beginning with FY 2022 and to revise the payment reconciliation process to account for the discontinuation of these payments.  Find the notice here.
  • DHS has updated its Remittance Advice (RA) calendar to add August dates.
  • DHS has published a notice in the Pennsylvania Bulletin announcing revisions of the Medical Assistance program fee schedule that take effect for dates of services on and after December 21, 2020.  It also has added procedure code and modifier combinations to the fee schedule.  Find the notice here.
  • DHS has published a notice in the Pennsylvania Bulletin addressing its FY 2022 Nursing Facility Assessment Program announcing the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment.  Find the notice here.
  • DHS has announced that all of its county assistance offices resumed serving clients in person on July 12, 2021.  The services that have been available to clients online during the COVID-19 emergency will remain available online through DHS’s Compass web site.  Learn more from this DHS announcement.

COVID-19:  By the Numbers

  • The Department of Health announced that it had overcounted the number of Pennsylvanians who have received their first of two COVID-19 injections but undercounted those who are now completely vaccinated.  The announcement was included in this department news release and explained in greater detail in this Lancaster Online article.
  • According to the state’s revised figures, 61.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated.
  • 5.6 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard, but only 105,000 completed the full vaccination regimen in the past week; another 813,000 Philadelphians are now fully vaccinated but only 11,000 reached that status in the past week.
  • The daily number of new COVID-19 cases rose slightly over the past week, with the total from Tuesday through Friday the highest four-day figure in more than a month.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital ICUs declined slightly in the past week.
  • For the week from July 2 through July 8 the state’s overall COVID-19 test positivity rate was 1.2 percent, up from 1.1 percent last week and the first increase the state has experienced in two months.

Pennsylvania Health Care Cost Containment Council (PHC4)

As directed by Act 15 of 2020, PHC4 has issued a report with data on the effect of the COVID-19 disaster emergency on Pennsylvania hospitals and health care facilities.  According to the report, Pennsylvania hospitals and health systems reported $1.4 billion in COVID-19 related expenses and revenue losses for the period October 2020-March 2021.  These expenses and revenue losses, according to PHC4, were attributable to COVID-19 and used to prevent, prepare for, and respond to the pandemic.  Total COVID-19-related expenses and lost revenue reported by Pennsylvania hospitals and health systems through March 2021 (January 2020-March 2021) were $6.5 billion.  Learn more from the PHC4’s “COVID-19 Disaster Emergency Report.”

Around the State

  • With no public health department of its own, Delaware County enlisted Chester County’s public health department to lead its pandemic response.  Now, Delaware County is addressing this shortcoming in its local governance:  its new board of health held its first meeting last month and hiring for the county’s new health department will begin in the fall.  The Philadelphia Inquirer tells the story.
  • With a new goal of cutting HIV diagnoses 75 percent over the next five years, Philadelphia public health officials are trying a new HIV testing strategy:  focusing testing on high-risk groups rather than focusing on sheer numbers of tests administered.  The Philadelphia Inquirer explains the why and the how.
  • The Lycoming County commissioners have awarded River Valley Health & Dental, a federally qualified health center, $25,000 in Pennsylvania Emergency Management Agency money to educate the public about COVID-19 and vaccinations.  The Williamsport Sun-Gazette provides the details.
  • The office of Delaware County’s medical examiner is getting a makeover:  a new medical examiner, a new or renovated facility, new policies and procedures, and more, according to the Delaware County Times.

Stakeholder Events

  • Medical Assistance Advisory Committee

July 22 at 10:00 am

To register, go here.

  • Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

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

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

Phone Conference ID: 785 376 728#

Stakeholder Meeting Materials

Materials from the June 24 meeting of the Office of Medical Assistance Programs’ Medical Assistance Advisory Committee (MAAC):

2021-07-16T21:06:12+00:00July 16th, 2021|Coronavirus, DSH hospitals, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of July 12-16
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PA Health Policy Update for the Week of June 1

Safety-Net Association of Pennsylvania logoBeginning today, SNAP is expanding its regular COVID-19 updates to encompass a broader scope of Pennsylvania state health policy endeavors.  As efforts to address COVID-19 prove more effective and the state moves from focusing almost exclusively on the public health emergency back to its usual, much broader array of health policy concerns, we hope this update will be a useful resource on matters of importance to the hospital community.  Please feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is an update of selected state health policy developments in Pennsylvania for the week of June 1-4, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has issued a reminder to Pennsylvanians that all businesses, events, and venues can return to 100 percent capacity with the lifting of COVID-19 mitigation orders starting Monday, May 31 at 12:01 a.m.  The current order requiring masks for unvaccinated and partially vaccinated individuals will remain in place until June 28 or when 70 percent of Pennsylvanians age 18 and older get their second dose of Pfizer or Moderna vaccine or the single-dose Johnson & Johnson vaccine, whichever comes first.  Individuals are still required to wear masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs, such as airports and stations.  Individuals should still follow guidance at workplaces, local businesses, long-term-care facilities, hospitals, prisons, and homeless shelters.  See the reminder here.

State Finances

  • The Department of Revenue announced that state General Fund collections for May totaled $3.9 billion, which was $1.6 billion, or 65.4 percent, more than projected. This significant increase is attributed to the one-month delay for personal income tax collections.  Personal income tax revenue in May was $1 billion above estimate.  So far this year the state has collected $2.9 billion, or 8.5 percent, more than anticipated.
  • Last week the state Independent Fiscal Office (IFO) released its updated FY 2021-2022 revenue estimate. In contrast to FY 2020-2021, which is ending on a strong note, the IFO projects that FY 2021-2022 will be more challenging once all of the COVID-19 federal funds are exhausted.  The IFO projects that the state’s economy and revenues generated from various sources will revert to the path they were on prior to COVID-19.  The IFO forecast estimates that Pennsylvania will collect $37.96 billion, a decline of $2.152 billion from FY 2020-2021.  Learn more from the presentation given by Matthew Knittel, the IFO’s director.

House Chamber of the State HouseIn the Legislature

  • A bill already passed by the state Senate and currently before the House would give parents the option of having their children repeat their current grade in school because of the challenges children have faced learning remotely. The Johnstown Tribune-Democrat tells the story.
  • A bill has been introduced in the Senate that would permit young people 14 years of age and older to receive COVID-19 vaccines without the consent of their parents. KDKA provides further information.
  • For a comprehensive summary of health care legislation currently under consideration in the Pennsylvania General Assembly, contact SNAP at info@pasafetynet.org.

Department of Health

  • The Department of Health has issued an advisory with information and reporting requirements about patients presenting with myocarditis and pericarditis after receiving Pfizer or Moderna COVID-19 vaccines.
  • The Department of Health circulated a reminder to long-term-care facilities with information on CMS’s requirement to report to the federal government on COVID-19 vaccinations and therapeutic treatments they provide.  Facilities also are required to educate staff and residents on the importance of getting vaccinated.
  • The Department of Health issued a health advisory on COVID-19 treatment options that incorporates updated guidance from the FDA on monoclonal antibody treatments and combination therapies.
  • The Department of Health revised its order regarding skilled nursing facility data reporting requirements to require weekly rather than daily reporting. While facilities will be required to complete data surveys on a weekly basis, the data they submit will be cumulative.  See the Department of Health announcement here and the full amended order here.
  • The Department of Health revised its interim guidance for skilled nursing facilities during COVID-19 to incorporate changes in data reporting requirements and other recently issued federal and state guidance.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases continues to decline and has been in three digits for seven days in a row.
  • The number of COVID-19 deaths is declining but not as swiftly as the number of cases.
  • For the week from May 21 through May 27 the state’s overall COVID-19 test positivity rate was 3.8 percent, down from 4.5 percent last week and 5.5 percent the week before.
  • Twenty-eight counties had a positivity rate lower than five percent, up from 12 last week, and no counties had a positivity rate greater than 20 percent for the fifth consecutive week.
  • Ten counties (Cameron, Clarion, Elk, Forest, Fulton, Montour, Potter, Snyder, Sullivan, and Warren) are currently experiencing low levels of community transmission of COVID-19, up from four last week; 56 counties are experiencing moderate levels of community transmission, down from 58 last week and but up from 41 two weeks ago; and only one county (Wyoming) is currently experiencing a substantial level of community transmission, down from five counties last week and 22 the week before.
  • The numbers of Pennsylvanians hospitalized with COVID-19 fell 55 percent from May 1 to June 1; the number on a ventilator fell 47 percent from May 1 to June 1; and the number in hospital intensive care units fell 49 percent from May 1 to June 1.
  • 4.8 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number slowed significantly over the past week. Another 709,000 have been vaccinated in Philadelphia.  According to the state, 54.7 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 58.7 percent of the entire population has now received at least the first dose of a vaccine.
  • Governor Wolf has stated that Pennsylvania needs to reach 70 percent of adults vaccinated before he will lift the state’s remaining mask mandates.

Department of Human Services

  • On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal CARES Act to assist providers with COVID-19-related costs they incurred between March 1, 2020 and November 30, 2020. Providers that accepted Act 24 funding agreed to provide documentation to DHS and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021.  With this in mind, DHS’s Office of Long-Term Living (OLTL) has asked providers to take the following actions:
    • Review the list of providers. OLTL has compiled a list of providers that received Act 24 funding but for which it has no record of submission of a cost report or the return of funds.  Organizations on this list should complete an Act 24 cost report and submit it to RA-PWOLTLCOVID-19@pa.gov no later than Friday, June 11, 2021.  The applicable cost reports can be found here.  Those that believe they submitted an Act 24 report yet are on this list should forward a screenshot of their submission to RA-PWOLTLCOVID-19@pa.gov.
    • Return Unused Funding. Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating that the check is for the return of CARES Act 24 funding they did not use.  Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg PA 17105-8025, Attn: Daniel Sharar.  Providers should include their EIN on the memo line of the check to ensure that refunds are traceable to the correct provider.

Providers that fail to submit a cost report or return their funding by the deadline will be deemed to have no COVID-related expenses and the state will proceed to recoup the Act 24 funding that was distributed to them.

  • DHS’s Office of Medical Assistance Programs has issued a notice advising all county administrators, brokers, and all contracted Medical Assistance Transportation Program (MATP) agencies of updated guidance to ensure the safe provision of non-emergency medical transportation services to Medical Assistance beneficiaries during the COVID-19 public health emergency.  The announcement directs the affected parties to federal CDC guidance for further information. See the DHS announcement here.
  • The Office of Medical Assistance Programs has posted a notice informing individuals who are eligible to participate in the Medical Assistance Transportation Program but who can provide or arrange for transportation assistance on their own that it has temporarily increased the mileage rate for the remainder of the COVID-19 pandemic. See the notice here.

Pennsylvania Health Care Cost Containment Council

PHC4 has published its annual report on the financial performance of the state’s acute-care hospitals.  Among the highlights (taken directly from a PHC4 news release):

  • Uncompensated Care: The statewide percentage of uncompensated care to net patient revenue increased from 1.72% in FY19 to 1.73% in FY20. The foregone dollar value for statewide uncompensated care has decreased from $820 million in FY19 to $809 million in FY20.
  • Net Patient Revenue: The revenue hospitals received for patient care decreased 2.0% during FY20. Statewide net patient revenue was $46.8 billion during FY20, making up 91% of statewide hospital total operating revenue.
  • Operating Margin: Statewide operating income decreased from $2.8 billion in FY19 to $1.9 billion in FY20. As a result, the statewide average operating margin decreased from 5.61% in FY19 to 3.73% in FY20. Total operating revenue increased to $51.5 billion and operating expenses increased to $49.6 billion in FY20.
  • Total Margin: The statewide total margin realized by the hospitals decreased by 2.70 percentage points, from 6.63% in FY19 to 3.93% in FY20.

To learn more, go here for links to the PHC4 news release about the report, downloadable data, and the report itself.

Around the State

  • Philadelphia has added COVID-19 to its list of vaccines for which children do not need parental consent under a new Philadelphia Board of Health regulation.
  • In the face of declining COVID-19 cases, Philadelphia lifted most of its COVID-19 restrictions, including density limits, maximum capacity limits, and distancing rules, on Wednesday, June 2.
  • The city’s indoor mask mandate and 11 p.m. last call for dining orders will continue to be enforced until its Department of Public Health reviews the state of the pandemic and may drop those restrictions on Friday, June 11, according to a city news release. It was previously announced that the city would lift restrictions on Friday, June 11.
  • Berks County has the third highest rate in the state for children suffering from lead poisoning. It is particularly a problem in the city of Reading and in communities of color.  Local officials and doctors are coming together to try to do something about it.  WFMZ tells the story.
  • Penn State is offering incentives to students and staff to get vaccinated: cash prizes, book store gift certificates, and a football signed by coach James Franklin.  The Centre County Times offers the details.
  • The Delaware County Council met in person for the first time in 14 months, the Delaware County Daily Times reports.
  • Erie’s city hall has reopened after a year, according to GoErie.
  • The number of flu cases in Pennsylvania fell 97 percent from last year. The AP offers the facts and figures.
  • Eighteen Pennsylvania colleges and universities (so far) are requiring students and staff to have COVID-19 vaccines for the fall semester. Scroll down this link to find the list.
  • Most hospitals, on the other hand, are holding off on imposing such requirements, PennLive reports.

Stakeholder Events

  • Medical Assistance Advisory Committee – Managed Care Delivery Systems Subcommittee Meeting

June 10 at 10:00 a.m.

Join Meeting

Meeting number (access code):  132 168 3592

Meeting password:  Managed

Join by phone:  +1-408-418-9388 United States (Toll)

  • Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Register here

  • Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

Register here

  • DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes.  Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholde

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

 

 

 

 

2021-06-04T20:20:09+00:00June 4th, 2021|Coronavirus, COVID-19, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Uncategorized|Comments Off on PA Health Policy Update for the Week of June 1
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Minutes of MAAC Fee-For-Service Subcommittee Meeting

The Fee for Service Subcommittee of Pennsylvania’s Medical Assistance Advisory Committee (MAAC) has approved the minutes of the subcommittee’s February 11 meeting.
Pennsylvania State MapThat meeting addressed the introduction of in-house radiology review in the state’s Medicaid fee-for-service program, Medicaid expansion in the state, provider enrollment and revalidation efforts as required by the Affordable Care Act, and more.
See those minutes here.

2015-05-07T06:00:28+00:00May 7th, 2015|Pennsylvania Medicaid policy|Comments Off on Minutes of MAAC Fee-For-Service Subcommittee Meeting
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DHS Presents Update on Medicaid Provider Enrollment Efforts

With the state still struggling to enroll and revalidate Medicaid providers, the Pennsylvania Department of Human Services (DHS) presented an update on its efforts to improve that process at the April 23 meeting of its Medical Assistance Advisory Committee (MAAC).
According to the presentation, DHS is focusing its improvements in three primary areas:  introducing a new electronic enrollment web portal this fall; standardizing its processes and procedures; and adding staff next month to facilitate enrollments.
DHS staff made a presentation on its latest efforts at the April 23 MAAC meeting.  See that presentation here.

2015-04-27T06:00:56+00:00April 27th, 2015|Pennsylvania Medicaid policy|Comments Off on DHS Presents Update on Medicaid Provider Enrollment Efforts
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  • 2020 Safety-Net Association of Pennsylvania

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

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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