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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

Daily COVID-19 case counts are higher than they have been at any time since the pandemic began. The state’s total of 33,650 new cases last Saturday, January 8 was the highest single-day total since the pandemic began.
The number of new COVID-19-related deaths remains very high.
To date, Pennsylvania has had nearly two million confirmed cases of COVID-19, more than 400,000 cases that have been classified as “probably” COVID-19, and more than 38,000 deaths attributed to the disease.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
Since January 1, the number of Pennsylvanians hospitalized because of COVID-19 has risen 42 percent; the number in hospital ICUs because of COVID-19 has risen 20 percent; and the number on ventilators because of the virus has risen 20 percent.
This situation is reflected in the high rate of occupancy in the state’s hospitals. In Pennsylvania today there currently are only 475 unoccupied adult ICU beds – 13.3 percent of the total of such beds in the state; 2097 unoccupied medical/surgical beds – 10.3 percent of such beds; 35 unoccupied pediatric ICU beds (9.5 percent); 276 unoccupied pediatric beds (25.5 percent); and 914 unoccupied airborne isolation beds (28.5 percent).
On January 11 the Department of Health elaborated on some of these figures, reporting that approximately 31 percent of all staffed adult ICU beds are occupied by COVID-19 patients, up from 28 percent last week, and that 33 percent of all ventilators state-wide are currently in use, up from 32 percent last week.
Media reports confirm the challenges some communities and hospitals are facing, including Delaware County, where every hospital bed is filled and one hospital is closing its ER; a report than an especially high proportion of hospital patients in Lehigh County need intensive care; a report that some Philadelphia-area hospitals are overwhelmed with patients while hospitals in the Erie area are seeing record numbers of COVID-19 patients, hospitals in the Lancaster area are seeing record numbers of COVID-19 patients, and a mid-state health system has instituted new policies to limit how many people may visit its hospitals’ patients.

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.

jsteinbock2022-01-14T22:33:59+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

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.

State 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.

jsteinbock2021-12-03T22:12:20+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

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

The Department of Health has issued a health alert updating guidance about tuberculin skin testing for tuberculosis for individuals who have been vaccinated against COVID-19. The department no longer recommends waiting four weeks from the final COVID-19 vaccination for immune-based TB testing.
The Department of Health has published notices in the Pennsylvania Bulletin authorizing expanded scope of practice for various professionals functioning as part of an emergency medical services agency that has been licensed as a critical care transport ambulance service.
The Department of Health will offer free potassium iodide, or KI, tablets on Thursday, September 16 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants. Learn more from this department news release.

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

The Delaware County Board of Health is now hiring people to staff the county’s new health department, which is scheduled to begin operations in January, the Delaware County Times reports.
The city of Reading has been awarded $3.3 million by the federal government to remove lead paint from homes, according to the Reading Eagle.
The mayor of Scranton will propose legislation to the city’s council to decriminalize possession of fentanyl test strips, which are currently considered drug paraphernalia under state law. The Scranton Times-Tribune explains why.
Children ages 12 and under constituted 12 percent of Allegheny County’s COVID-19 cases in August, the county’s health director told the Pittsburgh Tribune-Review.

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.

jsteinbock2021-09-10T21:48:42+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

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):

jsteinbock2021-07-16T21:06:12+00:00July 16th, 2021|Coronavirus, DSH hospitals, Medicaid supplemental payments, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of June 1

Beginning 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.

In 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.

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

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

jsteinbock2021-06-04T20:20:09+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

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.
That 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.

PA Safety Net Admin2015-05-07T06:00:28+00:00May 7th, 2015|Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2015-04-27T06:00:56+00:00April 27th, 2015|Pennsylvania Medicaid policy|Comments Off

MAAC Meets

The Medical Assistance Advisory Committee that works with the Pennsylvania’s Department of Public Welfare met recently in Harrisburg.
Among the subjects discussed during the meeting were the state’s recently passed budget, the Medical Assistance program, the prospects for Medicaid expansion, and more.
Read the official state file note summarizing the meeting here .

PA Safety Net Admin2013-08-07T06:00:18+00:00August 7th, 2013|Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

MAAC to Meet

The next meeting of Pennsylvania’s Medical Assistance Advisory Committee (MAAC) will be held on Thursday, May 24 in Harrisburg. The MAAC advises the Pennsylvania Department of Public Welfare on Medicaid policy. Its meetings are open to the public.

PA Safety Net Admin2012-05-17T06:00:41+00:00May 17th, 2012|Meetings and notices|Comments Off

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