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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 Friday, September 2

The following is an update of selected state health policy developments in Pennsylvania for the week of August 29-September 2, 2022.  (Some of the language used below is taken directly from state documents.)

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for August.  General Fund revenue collection exceeded estimate by $63.8 million, or 2.3 percent, for the month.  Fiscal year-to-date General Fund collections total $5.6 billion, which is $60.4 million, or 1.1 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to notify providers of updates to the Medical Assistance fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to expand the scope of eligible providers that may render certain services to include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and physicians and to add behavioral health providers to certain procedure codes and make other procedure code changes.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from the implementation of the 2022 Healthcare Common Procedure Coding System (HCPCS) procedure codes updates.  In addition, it also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance fee schedule, including setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 29, 2022.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics of updates to the Medical Assistance fee schedule for the distribution of take-home supplies of nasal or injectable naloxone to Medicaid
    beneficiaries.  Find the bulletin here.
  • DHS has published brief notices addressing extra recoupments it has returned to some providers and provider enrollment summary enhancements.
  • DHS has posted federal financial participation rate changes and continued billing requirements for community support service providers.  Find the notice here.
  • DHS has posted HealthChoices enrollment and Medical Assistance Transportation Program utilization data for July.  Find the information here.

Department of Health

  • The Department of Health (DOH) has updated its “Innovative Hospital Model” guidance to make requested changes about locations eligible to operate outpatient emergency departments.  Find that updated information here.
  • DOH has revised its guidance for contacting the Division of Acute and Ambulatory Care prior to an event or change that requires advance notification, such as addition of new equipment or occupancy.  The updated guidance includes email subjects that providers should use when sending these notices to expedite review by the Division of Acute and Ambulatory Care.  Find the updated guidance here.
  • DOH’s annual Pennsylvania Long Term Care Questionnaire is now open until Friday, October 28.  Providers that have not received an email containing login information and instructions should contact Thomas Gavrish at tgavrish@pa.gov.
  • DOH will offer free potassium iodide, or KI, tablets on Thursday, September 15 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants as part of routine preventive efforts in case of future emergencies.  Learn more from this department news release.

COVID-19:  By the Numbers

Monkeypox

  • DHS has published a Medical Assistance Bulletin to advise providers of the addition of procedure codes to use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of the monkeypox vaccines.  Find the bulletin here.
  • The CDC has posted an updated map showing the distribution of 19,465 confirmed cases of monkeypox in the U.S. as of September 1, up from 16,926 cases on August 25.  561 of those cases were in Pennsylvania, up from 465 a week ago.
  • As of August 29, 327 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Mental and Behavioral Health Considerations for Long-Term Care – September 8

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 mental and behavioral health considerations for long-term care on Thursday, September 8 at 2:00.  This presentation will explore the most common behavioral health diagnoses seen among residents living in nursing facilities and will share approaches to managing appropriate use of psychotropic medication and best practices around deprescribing.  Learn more about the event and how to participate from this notice.

Pennsylvania Health Care Cost Containment Council – September 8

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, September 8 at 10:00.  Agendas will be available here 24 hours.  The public is invited to participate. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Patient Safety Authority – September 8

The Patient Safety Authority will meet virtually on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

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.

 

2022-09-02T18:45:52+00:00September 2nd, 2022|COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 2
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PA Health Policy Update for Friday, June 17

The following is an update of selected state health policy developments in Pennsylvania for the week of June 13-17, 2022.  (Some of the language used below is taken directly from state documents.)

Bookshelf with law booksGeneral Assembly

  • The state House and Senate convened for voting session this week in Harrisburg.
  • The Senate passed on final consideration Senate Bill 967, which creates the Women, Infants, and Children State Advisory Board.  The bill will now be sent to the House for consideration.
  • The House passed Senate Bill 709 on third consideration and final passage.  This bill establishes the CMV Education and Newborn Testing Act to create public awareness of cytomegalovirus and provide for CMV screening for certain newborns.  The bill will now be sent back to the Senate for concurrence.
  • The House also passed Senate Bill 915, which is the capital budget bill, on third consideration and final passage.  This will be sent back to the Senate for concurrence as well.
  • The House Health Committee convened on Monday, June 13 and favorably reported, among others, the following health care-related bills:
    • House Bill 2357, the Kratom Consumer Protection Act, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2579, which seeks to increase the number of EMTs and paramedics in Pennsylvania by requiring the Department of Health to develop state-specific examinations for EMTs, EMRs, and paramedics and no longer rely on the National Registry exam.
    • House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.
  • House Bill 2604 was subsequently amended on the House floor during second consideration.  The amendment, which makes certain changes and adds a definition of “health system,” was agreed to by stakeholders and the Department of Health.
  • The House Insurance Committee convened on Tuesday, June 14 and favorably reported Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.
  • The House Veterans Affairs & Emergency Preparedness Committee met on Wednesday, June 15 and favorably reported, among other bills, Senate Bill 861 which enters Pennsylvania into the EMS Compact.
  • The state House and Senate will convene next Monday (6/20) through Friday (6/24) for voting session.

Department of Human Services

  • The Department of Human Services has issued a Medical Assistance Bulletin to notify dentists, federally qualified health centers, and rural health clinics that Medical Assistance will pay for teledentistry, effective with dates of service on and after May 2, 2022, and to announce that procedure codes for counseling services have been added to the MA program fee schedule.  Find the bulletin here.
  • The Department of Human Services has posted the contract into which it has entered HealthChoices physical health managed care organizations effective January 1, 2022.  Find that contract here.

COVID-19:  By the Numbers

  • For the third consecutive week COVID-19 case counts fell, declining from a seven-day average of 3223 on June 8 to 2143 on June 15, a 34 percent decline.
  • The seven-day average of COVID-19-related deaths also fell, from 23 to 16, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units all declined over past week.
  • Fifty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 65 counties last week.  Two counties experienced moderate rates of community transmission and nine experienced a substantial rate.

Stakeholder Events

Rural Health Redesign Center Authority – June 21

The board of the Pennsylvania Rural Health Redesign Center Authority will meet virtually on Tuesday, June 21 at 10:00.  Learn more about the board and how to participate in this meet from this Pennsylvania Bulletin notice.

Department of Health – Preventative Health and Health Services Block Grant Application for Federal Fiscal Year 2022; Public Hearing – June 21

The Department of Health is making available copies of its proposed Preventive Health and Health Services Block Grant Application for federal FY 2022.  This block grant application shall serve as the state’s request to the U.S. Department of Health and Human Services for block grant funding to address the Healthy People 2030 Health Status Objectives.  A public hearing will be held virtually on June 21 at 10:00.  Learn more about the hearing, how to participate, and how to obtain a copy of the grant funding application from this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – June 21

The Department of Health’s Health Research Advisory Committee will meet virtually on Tuesday, June 21 at noon.  The purpose of the meeting is to vote on 2022 priorities and to plan for future health research priorities.  For information about how to join the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – June 22

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, June 22 at 1:00.  For information about how to join the meeting, go here.

Department of Human Services – Medical Assistance Advisory Committee – June 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, June 23 at 10:00.  Go here to register to join the meeting.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

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 “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

Patient Safety Authority – June 23

The board of the Patient Safety Authority will meet virtually on Thursday, June 23 at 1:00.   Registration is required.  Learn about how to participate in the meeting from this Pennsylvania Bulletin notice.

Department of Health – Public Health Advisory Council – June 27

The Department of Health’s Public Health Advisory Council will meet virtually on Monday, June 27 at 2:00.  The purpose of the meeting is to discuss the Preventive Health and Health Services Block Grant Federal Fiscal Year 2022 work plan.  For additional information about the meeting and how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

2022-06-17T21:32:45+00:00June 17th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, June 17
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PA Health Policy Update for the Week of May 2-6

The following is an update of selected state health policy developments in Pennsylvania for the week of May 2-6, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The Center for Rural Pennsylvania, a legislative agency of the state’s General Assembly, has issued a report on access to mental health services in rural Pennsylvania that identifies barriers and challenges to obtaining mental health care in rural areas and offers proposals for addressing them, including expanding and funding telehealth services.  Learn more from the report “Access to Mental Health Services in Rural Pennsylvania.”

The House Democratic Policy Committee held an informational hearing this week examining the opioid epidemic.  Find the hearing’s agenda and testimony here.

Revenue Collection Update

Pennsylvania’s General Fund revenue collections in April totaled $6.5 billion, which is $1.8 billion, or 38.7 percent, above estimate.  Fiscal year-to-date General Fund revenue collections are $4.5 billion, or 12.4 percent, above estimate.  Governor Wolf issued a press release noting that April’s revenue collection was the most ever collected by the state in a single month.

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2022 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  Specifically, DHS intends to allocate $9.510 million in total funds for DSH payments to qualifying acute-care general hospitals that provide a high volume of services to the Medicaid population to promote continued access to inpatient and ancillary outpatient services and to support academic medical programs that provide integrated, patient-centered medical services; to allocate $5.917 million in total funds for DSH payments to qualifying acute-care general hospitals to promote the availability of professional medical services to Medicaid populations in less urbanized areas by supporting medical education and academic medical programs; and to allocate $40.163 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high percentage of Medicaid patients under 18 years of age.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to clarify its guidelines for the delivery of services via telemedicine through the Medical Assistance program’s fee-for-service delivery system.  The bulletin applies to all providers enrolled in the Medical Assistance program.  Providers rendering such services under the managed care delivery system should address coverage and payment questions for the delivery of services via telemedicine to the appropriate managed care organization.  Find the bulletin here.
  • DHS has shared presentations offered at the April 28 meeting of the Medical Assistance Advisory Committee (MAAC) by:
  • DHS has posted a draft file note of the April 14 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

Department of Health

The Department of Health has issued a health alert updating its vaccine recommendations for hepatitis A and B.

The Department of Health has issued a health alert about failure to disinfect assisted blood glucose monitors between uses posing a risk for blood-borne pathogen transmission.  The alert describes the problem, offers suggestions for how to prevent it, and points providers to resources for further information.  Find the alert here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the sixth consecutive week.  The state’s seven-day average of new cases rose eight percent, from 1734 on April 28 to 1834 on May 5.
  • The seven-day average of COVID-19-related deaths rose from nine on April 28 to 13 on May 5.
  • The growing number of COVID-19 cases in the state has led to a corresponding increase in COVID-19-related hospitalizations, with Pennsylvania experiencing a 22 percent increase in COVID-19-related hospitalizations for the second consecutive week.
  • While the number of these patients on ventilators rose 20 percent over the past week and the number in hospital ICUs rose 33 percent, the actual number of such patients remains modest in comparison to times earlier in the pandemic when the daily case counts were comparable.
  • During the past week 35 Pennsylvania counties, up from 22 last week, experienced high rates of community transmission of COVID-19; two counties, one fewer than last week, experienced a low rate of transmission; 21 counties, down from 22 last week, experienced a substantial rate of community transmission; and the remaining nine counties experienced a moderate rate.

Department of State

The Department of State has announced that the professional licensing waivers it issued under the COVID-19 disaster declaration will begin expiring in phases starting on May 23, with all waivers scheduled to expire by June 30.  Go here for a list of the department’s waivers and their expiration dates.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00.  To register to participate, go here.

Department of Human Services – Medical Assistance Advisory Committee Managed Care Delivery System Subcommittee – May 12

The managed care delivery system subcommittee of the Medical Assistance Advisory Committee will meet virtually on Thursday, May 12 at 10:00.  For an agenda for the meeting and information about how to participate, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 12

DHS’s 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 special population webinar on avoiding hospitalizations from nursing facilities on Thursday, May 12 at 2:00.  Recommended nursing home participants are admissions coordinators, directors of nursing, and social services staff.  For more information about the webinar and how to register, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s 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 the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS – Office of Medical Assistance Programs – Gun Violence Roundtable – date in May to be determined 

DHS’s Office of Medical Assistance Programs will convene a roundtable in May to discuss gun violence as a public health issue and to explore public health strategies that can be used by Medicaid managed care organizations to prevent and respond to gun violence.  A save-the-date will be sent out in the next week or so and the managed care organizations will be given a list of questions to come prepared to discuss.  An opportunity to present on current and planned initiatives, as well as challenges and limitations, will be offered to each managed care organization.

 

2022-05-06T20:29:10+00:00May 6th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for the Week of May 2-6
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PA Health Policy Update for the Week of April 4-8

The following is an update of selected state health policy developments in Pennsylvania for the week of April 4-8, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state Senate convened for session in Harrisburg this week.
  • The Senate passed House Bill 245 on third and final consideration this week.  House Bill 245, which will be sent back to the House for concurrence, reduces the clinical residency requirement from three years to two years for an applicant who has graduated from an international medical college to receive licensure in Pennsylvania.
  • The state House and Senate will both be in session next Monday (4/11), Tuesday (4/12), and Wednesday (4/13).
  • As indicated by the House Republican Caucus “Week Ahead,” the House is planning to consider, among other bills, House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses, and House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
  • Several committee meetings are scheduled for next week.  The following are health-related.
    • The House Health Committee will hold an informational meeting on Tuesday, April 12 at 8:00 a.m. regarding “Opioids in the Commonwealth:  Lessons learned and next steps.”
    • The House Veterans Affairs and Emergency Preparedness Committee will meet on Tuesday, April 12 at 9:00 a.m. to consider House Bill 2097, which would make permanent a COVID-19 regulatory waiver that allows certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.
    • The House Aging & Older Adult Services Committee will hold an informational meeting on Tuesday, April 12 at 9:30 a.m. to examine long-term-care facility workforce challenges.
    • The Senate Health & Human Services Committee will meet on Tuesday, April 12 at 10:30 a.m. to consider the following bills.
      • Senate Bill 749, which seeks to provide clarity for employees and employers regarding current ambiguity in the state’s medical marijuana law concerning the use of medical marijuana in the workplace.
      • Senate Bill 1121, which requires the Department of Human Services (DHS) to verify wage records from employers and the Department of Revenue for Medicaid and SNAP beneficiaries.
      • Senate Bill 1124, which requires DHS to check death certificates at the Bureau of Vital Statistics against Medicaid and SNAP beneficiaries.
      • Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.

Department of Human Services

  • The Department of Human Services (DHS) has added two procedure codes to the Medical Assistance program fee schedule for use in laboratory testing for multiple respiratory pathogens, including COVID-19, effective with dates of service on and after March 21, 2022.  Find the new codes in this Pennsylvania Bulletin notice.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a Medical Assistance Bulletin addressed to hospital emergency departments, county mental health/intellectual disability administrators, base service units, mental health review officers, and county crisis intervention programs to clarify the part of the Mental Health Procedures Act referring to the involuntary commitment process under section 302 and the 120-hour limit on holding a consumer for involuntary emergency examination and treatment.  Find the bulletin here.
  • DHS has circulated the minutes of the March 24 meeting of the Medical Assistance Advisory Committee.
  • DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include February 22 data.
  • CMS has released its 2022-2023 Medicaid managed care rate development guide.  This is a federal resource for states to use when setting capitation rates for Medicaid managed care plans.  The guide provides details about information that must be included in states’ actuarial rate certifications for CMS to review and approve for rate periods between July 1, 2022 and June 30, 2023.  Find the guide here.

Department of Health

  • The Department of Health (DOH) has introduced minor updates of its guidance for hospitals and health systems on “whether measures being implemented or contemplated are compliant with the statutory and regulatory requirements under the jurisdiction of the Department.”  Among other things, the guidance cites June 30, 2022 as the end date for certain regulatory suspensions that were continued through that date by Act 14 of 2022.  Find the updated guidance here.
  • DOH has updated its COVID-19 booster vaccine recommendations to reflect recent changes in CDC guidelines.
  • DOH has updated its reporting requirements for COVID-19 test results to bring them in line with revised federal requirements.
  • DOH has updated information about therapeutics to prevent and treat COVID-19 to reflect federal guidance barring the use of sotrovimab to treat COVID-19 because it is not effective in treating the Omicron BA.2 variant, which is the predominant COVID-19 variant in the country today.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the second consecutive week.  The state’s seven-day average of new cases rose nearly 26 percent, from 585 cases on March 31 to 737 on April 7.
  • The number of new COVID-19-related deaths declined slightly, on the other hand, with the seven-day average of new deaths down by one, from 18 on March 31 to 17 on April 7.
  • The number of Pennsylvanians receiving hospital care for COVID-19, in hospital ICU units, and on ventilators because of the virus held steady over the past week.
  • After three weeks with no counties experiencing a high rate of transmission of COVID-19, two Pennsylvania counties found themselves in that category in the past week:  Bradford and Pike.  Another eight counties – Potter, Montgomery, Philadelphia, Adams, Susquehanna, Montour, Wayne, and Northampton – experienced substantial rates of community transmission.  Five counties – up from three last week – experienced low levels of community transmission:  Forest, Cameron, Snyder, Juniata, and Fulton.  The remaining 52 Pennsylvania counties had moderate rates of community transmission over the past week.  Find community transmission and other Pennsylvania-specific COVID-19 data here.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – April 12

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, April 12 at 10:00.  To register to participate, go here.  The dial-in number is 631-992-3221 and the access code is 766121118#.

Department of Aging – Pharmaceutical Assistance Advisory Board Virtual Meeting – April 13

The Department of Aging’s Pharmaceutical Assistance Advisory Board will meet virtually on Wednesday, April 13 at 8:30.  For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00.  To register to participate, go here.

2022-04-08T20:56:17+00:00April 8th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of April 4-8
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PA Health Policy Update for the Week of March 28-April 1

The following is an update of selected state health policy developments in Pennsylvania for the week of March 28-April 1, 2022.  (Some of the language used below is taken directly from state documents.)

Bookshelf with law booksGovernor Wolf

Governor Wolf has signed into law Senate Bill 1019, which temporarily extends certain suspensions of regulations and statutes that were issued by agencies under the COVID-19 disaster declaration through June 30, 2022.

General Assembly

  • The House Health Committee convened on Tuesday, March 29 and favorably reported House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
  • The House Insurance Committee met on Tuesday and favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
  • The state Senate will be in session next Monday (4/4), Tuesday (4/5), and Wednesday (4/6). The House will be in recess next week.

Revenue Collection Update

The Independent Fiscal Office has released its March 2022 Revenue Update.  General Fund collections for March were $579.2 million or 11.6 percent above estimate.  Year-to-date General Fund revenue is $3.04 billion or 9.8 percent more than projected.

Department of Human Services

  • The Department of Human Services (DHS) has informed providers that effective Friday, April 1 at 12:00 a.m. the current Medical Assistance Provider Forms webpage will no longer be accessible.  Instead, providers may order and receive Medical Assistance provider forms here.  Find updated instructions here.  DHS also offered the following explanation to stakeholders:

Over the next few months, the Department of Human Services (DHS) is transitioning web-based forms to a new enterprise solution. While we strive to provide a seamless transition, we understand there may be issues along the way. If you have any bookmarked links, they may no longer work. If you are trying to access an old link that no longer works, please go to https://www.dhs.pa.gov/docs/Publications/Pages/Express-Forms-Transition.aspx for a list of affected forms.

We understand that there may be confusion and issues that arise during this transition, and we appreciate your patience. If you identify a problem following the transition, please reach out to DHS’s Digital Communications Team at RA-PWDHSSOCIALMEDIA@pa.gov and we will assist you as we are able.

  • DHS has issued a Medical Assistance Bulletin advising providers that the Medical Assistance program is extending postpartum coverage from 60 days to 12 months beginning on April 1 and that this applies to all providers enrolled in the Medical Assistance program.  Find the bulletin here.
  • As part of the response to the COVID-19 emergency, numerous state regulatory requirements were suspended by the legislature and DHS to facilitate an effective, timely response to the pandemic.  Over time, some of those suspended requirements have been restored.  DHS has updated its collection of regulatory requirements to reflect which suspensions remain in effect and which have been lifted.  Find that compendium here.
  • DHS has posted a notice informing providers that the Provider Electronic Solutions software they may have used to submit HIPAA-ready transactions to the PROMISe system will not be supported after June 15 and urging them to use the PROMISe Provider Portal to submit claims, validate eligibility, conduct claim inquiries, and view their weekly remittance advice.  Find that notice here.
  • DHS has posted a notice reminding Medical Assistance billing entities that federal law requires physicians and other practitioners who order, refer, or prescribe items or services for Medicaid beneficiaries to be enrolled in the Medical Assistance program and suggesting that billing entities remind unenrolled billing providers about this requirement.  Find the notice here.
  • DHS has posted a notice reminding providers that the two percent Medicare sequestration imposed in 2013 and suspended in 2020 in response to the COVID-19 pandemic will be restored partially on April 1 and fully after July 1.  Find that notice here.
  • DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include January 2022 data.
  • DHS has posted presentations delivered at the March 24 meeting of its Medical Assistance Advisory Committee (MAAC).  See the presentations from:
  • The federal Centers for Medicare & Medicaid Services (CMS) has released an informational bulletin informing state Medicaid agencies that CMS is exercising enforcement discretion during the COVID-19 public health emergency regarding state submissions of updated Medicaid access monitoring review plans.  CMS is delaying enforcement of the updated plans that are due by October 1, 2022 until October 1, 2024.  Find the CMS informational bulletin here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed slightly over the past week.  On Wednesday, March 23 the state’s seven-day average of new cases was 574 cases a day; on March 31 it was 585 cases a day.
  • The number of new COVID-19-related deaths, on the other hand, fell by more than half over the past week, with the March 24 seven-day average of 37 deaths falling to 18 on March 31.
  • For the third consecutive week, no Pennsylvania counties are experiencing a high rate of community transmission.  For the second consecutive week, just eight counties experienced a substantial rate of community transmission.  Three counties – down from four last week – are experiencing a low rate of community transmission.  The rest of the state – 56 counties – is experiencing a moderate rate of community transmission of COVID-19.
  • The number of Pennsylvanians receiving hospital care for COVID-19 fell significantly during March:  the number hospitalized declined from 1356 on March 1 to 481 on March 31; the number being treated on a ventilator from 163 on March 1 to 54 on March 31; and the number in hospital ICUs from 252 on March 1 to 75 on March 31.

Department of Drug and Alcohol Programs

The departments of Drug and Alcohol Programs (DDAP) and Community and Economic Development have announced the availability of more than $1 million in grant funding for recovery houses to provide safe housing for individuals in recovery from a substance use disorder.  The grants are designed to help existing recovery house facilities with physical upgrades to comply with all federal, state, and local laws and ordinances, including the Americans with Disabilities Act of 1990.  Grants of up to $50,000 for a 12-month period beginning July 1, 2022 will be awarded to between 22 and 25 eligible applicants for health and safety upgrades including demolition, debris removal, rehabilitation improvements, environmental remediation costs, and construction and inspections to comply with DDAP’s regulations.  Learn more from this Department of Drug and Alcohol Programs news release and go here for additional information about the grant program and the application process.  There is no application deadline; applications will be accepted until all of the available money is spent.

In September of 2021, Governor Wolf signed into law Act 73, which extended three of DDAP’s temporary regulatory suspensions through March 31, 2022 in response to the COVID-19 pandemic.  This week Governor Wolf signed Senate Bill 1019, which further extends DDAP’s regulatory suspensions that are “related to federal exemptions granted under the federal public health emergency declaration” until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.”  Three DDAP regulatory suspensions and a relevant Department of State regulation are included in this chart and also remain suspended.  In November of 2021, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) announced that methadone take-home flexibilities will be extended for one year after the eventual expiration of the federal COVID-19 public health emergency.  DDAP has submitted its written concurrence with this exemption.  SAMHSA also has indicated that it is considering mechanisms to make this flexibility permanent.  Narcotic treatment programs do not need to do anything additional at this time to continue taking advantage of this flexibility. Similarly, the U.S. Drug Enforcement Administration (DEA) also has announced that it is working to make its tele-prescribing regulations permanent.

Stakeholder Events

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues.  To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m.  Public comments will be taken after each presentation.  Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation.  There will be an additional period at the end of the meeting for additional public comments.  Go here to register to participate.

Pennsylvania Long-Term Care Learning Network – Strategies to Reduce Hospitalizations and Emergency Room Visits – April 7

The Pennsylvania Long-Term Care Learning Network, part of DHS’s Quality Strategy for Nursing
Facilities, is holding a virtual webinar “Strategies to Reduce Hospitalizations and Emergency Room Visits” on Thursday, April 7 at 2:00 p.m.  Go here to register to participate.

Department of Aging – Pharmaceutical Assistance Advisory Board Virtual Meeting – April 13

The Department of Aging’s Pharmaceutical Assistance Advisory Board will meet virtually on Wednesday, April 13 at 8:30 a.m.  For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00.  Go here to register to participate.

 

2022-04-01T20:56:41+00:00April 1st, 2022|Coronavirus, COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of March 28-April 1
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PA Health Policy Update for the Week of March 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of March 21-25, 2022.  (Some of the language used below is taken directly from state documents.)

Hospital buildingGovernor Wolf

  • The Wolf Administration has announced how the state will spend $225 million in federal American Rescue Plan money appropriated through Act 2 of 2022 to support the health care workforce needs of hospitals and behavioral health providers.  The money will be used in the following manner:
  • $100 million to be distributed to acute care, critical access, and children’s hospitals licensed by the Department of Health on a per-bed basis.  The funding will be used strictly for recruitment and retention payments to direct care staff.
  • $110 million to be distributed on a per-bed basis to high-volume Medical Assistance hospitals, designated critical access hospitals, and inpatient and residential behavioral health facilities for recruitment and retention payments to key staff.  In addition to their proportional share of the $100 million pool noted above, all SNAP member hospitals will share in this $110 million distribution as well.
  • $15 million to quadruple the funds available for the nurse loan forgiveness program at Pennsylvania Higher Education Assistance Agency (PHEAA), a high-demand program that received more than 20,000 applications by the March 1 deadline.

Learn more about the $225 million appropriation and how it will be spent from this Wolf administration news release and this list of funding recipients.

  • The governor’s office has published its regulatory agenda for 2022.  The agenda, which is published semi-annually, is intended to provide the regulated community advance notice of regulations under development or consideration.  Find the full regulatory agenda here.

General Assembly

  • The state House and Senate will return to Harrisburg for session next week.  The House has scheduled a non-voting session day for Monday (3/28) and voting session for Tuesday (3/29) and Wednesday (3/30).  The Senate is scheduled to be in voting session Wednesday (3/30).
  • The House Health Committee will convene on Tuesday, March 29 to consider House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
  • The House Insurance Committee will meet on Tuesday, March 29 to consider, among other bills, House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.

Department of Health

The Department of Health has expanded the Pennsylvania physician general’s standing order that enables people to go to pharmacies to obtain a dose of naloxone to include a form of eight milligram naloxone nasal spray.  Members of the general public can print a copy of this standing order and present it at their local pharmacy to obtain naloxone.  Learn more from this news release.

The Department of Health has issued a news release to remind stakeholders that there is a 30-day comment period for the proposed skilled nursing facility regulations it published on March 19.  These proposed regulations include updates to align with federal regulations and expand the information that applicants for licensure must provide to operate a new facility or take ownership of an existing facility.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce the addition of two procedure codes, 87636 and 87637, to the Medical Assistance fee schedule for use in laboratory testing for multiple respiratory pathogens, including COVID-19.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin informing Medical Assistance providers that it has added CPT codes 90619 for the administration of the MenQuadfi® vaccine and 90697 for the administration of the Vaxelis® vaccine to the Medical Assistance fee schedule effective for dates of service on and after June 1, 2021.  In addition, effective June 1, 2021 it has added MenQuadfi® and Vaxelis® to the list of vaccines available through the Department of Health’s Vaccines for Children Program.  Find that March 21 bulletin here.
  • DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  The revised handbook pages take effect on April 1.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to introduce updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for sedative hypnotics submitted for prior authorization.  The revised handbook pages take effect on April 1  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has updated guidance on its outpatient competency evaluation program for the psychological assessment by OMHSAS providers of incarcerated individuals awaiting adjudication.  Learn more from this updated program memo and find a referral form and a rescind form that are part of the process described in the guidance.
  • DHS has updated its list of drug companies that participate in the state’s Medicaid drug rebate program.  Find the revised list here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall in Pennsylvania.  A week ago the state’s seven-day average of new cases was 750 cases a day; today (March 25) it is 625 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 32 deaths a day a week ago but is 23 deaths a day today (March 25).
  • The decline in the number of Pennsylvania counties experiencing higher rates of community transmission of COVID-19 continues.  For the second consecutive week, no counties are experiencing a high rate of community transmission.  Last week, 21 counties were experiencing a substantial rate of community transmission; this week, just eight are.  For the first time since the fall, some Pennsylvania counties – four of them (Forest, Snyder, Sullivan, and Cameron) – are experiencing a low rate of community transmission.  The rest of the state – 55 counties – is experiencing a moderate rate of community transmission.
  • The number of Pennsylvanians hospitalized with COVID-19 has fallen 60 percent since March 1; the number in hospital ICUs because of the virus has fallen 63 percent since the beginning of the month; and the number being treated for the virus on a ventilator has fallen 69 percent since the first of the month and is at its lowest level since last July 29.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has created an informational flyer, suitable for posting in public places, with resources for individuals and their loved ones with substance use disorder, including QR code links to find treatment, order naloxone, and obtain educational materials.

Stakeholder Events

Department of Health – Advisory Health Board – March 31

The Department of Health’s Advisory Health Board will meet virtually on Thursday, March 31 at 10.00 a.m. to discuss programmatic and departmental activities.  This meeting was a previously scheduled for March 16.  For information about how to participate, see this Pennsylvania Bulletin notice, which has the original, superseded meeting date but still has the latest information on how to participate in the meeting.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy, and Critical Congenital Heart Defects subcommittees.  Learn how to join the meeting in this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues.  To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m.  Public comments will be taken after each presentation.  Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation.  There will be an additional period at the end of the meeting for additional public comments.  Go here to register to participate.

Pennsylvania Long-Term Care Learning Network – Strategies to Reduce Hospitalizations and Emergency Room Visits – April 7

The Pennsylvania Long-Term Care Learning Network, part of DHS’s Quality Strategy for Nursing
Facilities, is holding a virtual webinar “Strategies to Reduce Hospitalizations and Emergency Room Visits” on Thursday, April 7 at 2:00 p.m.  Go here to register to participate.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m.  The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

 

2022-03-25T20:01:47+00:00March 25th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of March 21-25
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PA Health Policy Update for the Week of March 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of March 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The Department of Human Services appeared before the Senate and the House appropriations committees this week.  A recording of the House budget hearing can be viewed here and a recording of the Senate hearing can be viewed here.
  • The Department of Health also appeared before the Senate Appropriations Committee for its FY 2023 budget hearing.  A recording of the hearing can be viewed here.
  • The Department of Drug and Alcohol Programs will appear before the Senate Appropriations Committee next Wednesday, March 16 at 2:00 p.m.

Department of Health

In light of the Pennsylvania Department of Environmental Protection’s confirmation of higher-than-expected rates of Powassan virus in ticks located in multiple Pennsylvania counties during the 2021 surveillance season, the Department of Health has issued a health advisory to give providers background information on POW virus disease, including transmission, clinical signs and symptoms, diagnosis, and prevention.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to inform providers enrolled in the Medical Assistance program that the state is expanding the beneficiary age for which Medical Assistance payment will be made for the administration of the Flucelvax Quadrivalent vaccine to include beneficiaries ages six months and older effective October 14, 2021.

The Department of Human Services has posted presentations delivered during the February 24 Medical Assistance Advisory Committee meeting by its:

COVID-19:  By the Numbers

  • Daily COVID-19 case counts continue to fall.  A week ago the state’s seven-day average of new cases was 1299 cases a day; yesterday (March 10) it was 954 cases a day.
  • The number of new COVID-19-related deaths is following the same downward trend:  Pennsylvania’s seven-day average of deaths was 65 deaths a day a week ago but was 40 deaths a day yesterday (March 10).
  • The decline in the number of Pennsylvania counties experiencing a substantial rate of community transmission of COVID-19 – the highest rate – continues.  Last week, 38 counties were in the highest rate of community transmission of COVID-19 cases; this week, only seven are.  Last week, 26 counties were experiencing a substantial rate of community transmission; this week, 37 are.  Last week, only three counties were experiencing only a moderate rate of community transmission; this week, 23 are.
  • March 9 was the first day fewer than 1000 Pennsylvanians were hospitalized with COVID-19 since August 12; March 11 was the first day fewer than 100 were on ventilators because of the virus since August 5; and March 7 was the first day fewer than 200 were in hospital ICUs because of COVID-19 since August 5.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released the new report “COVID-19 Hospitalizations ‒ March 2020 to June 2021.”  The paper looks at patients who were hospitalized with COVID-19 and discharged from Pennsylvania acute-care hospitals from March 2020 through June 2021.  It examines hospitalization rates and in-hospital mortality by month and for the entire period.  Go here for links to the news release announcing the report, key findings, county rates, patient characteristics and outcomes, and the report itself.

Stakeholder Events

Department of Health – Advisory Health Board – March 16

The Department of Health’s Advisory Health Board will meet virtually on Wednesday, March 16 at 2:00 p.m. to discuss programmatic and departmental activities.  For information about how to participate, see this Pennsylvania Bulletin notice.

Patient Safety Authority – March 17

The Patient Safety Authority will hold a virtual public meeting on Thursday, March 17 at 1:00 p.m.  Learn how to join the meeting from this Pennsylvania Bulletin notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees.  Learn how to join the meeting in this Pennsylvania Bulletin notice.

2022-03-11T22:00:40+00:00March 11th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of March 7-11
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PA Health Policy Update for the Week of February 14-18

The following is an update of selected state health policy developments in Pennsylvania for the week of February 14-18, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

House Chamber of the State HouseThe state House Appropriations Committee began its FY 2023 budget hearings this week.  The Senate Appropriations Committee will begin hearings next week.  Hearings will conclude on March 17.  A complete schedule of the hearings can be found here.  The following is a selection of health-related budget hearings.

  • Department of Health/Department of Drug and Alcohol Programs (House Appropriations Committee) – Thursday, March 3 at 10:00 a.m.
  • Department of Human Services (Senate Appropriations Committee) – Tuesday, March 8 at 10:00 a.m.
  • Department of Health (Senate Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.
  • Department of Human Services (House Appropriations Committee) – Wednesday, March 9 at 10:00 a.m.
  • Department of Drug and Alcohol Programs (Senate Appropriations Committee) – Wednesday, March 16 at 2:30 p.m.

Department of Human Services

Department of Health

  • Two additional state-directed health care strike teams and another long-term care regional support team are providing requested assistance for hospitals and skilled nursing facilities caring for patients with COVID-19.  Clinical staff are supporting staff at Geisinger Wyoming Valley and Lehigh Valley Hospital – Cedar Crest.  These teams are on a two-week deployment and vary in size and scope based on the daily needs of the facilities and include registered nurses and respiratory therapists provided through a staffing firm.  Another team is working with the Pleasant Valley Manor nursing home in Monroe County, providing clinical and non-clinical support staff to allow for more rapid discharge of patients from area hospitals and freeing additional acute-care space to meet COVID-19 demands.  Supplemental staff includes RNs, LPNs, and CNAs; Pennsylvania National Guard is providing non-clinical staffing to support the facility’s existing staff and the Pennsylvania Emergency Management Agency is assisting with coordination.  Learn more from this Department of Health news release.
  • The Department of Health (DOH) has updated its information about state-sponsored COVID-19 testing sites throughout Pennsylvania, including new sites in McKean, Susquehanna, Washington, and York counties.  Go here for information about locations and hours and for a link to a map with other testing sites across the state.
  • DOH has issued an alert providing guidance to long-term-care facilities on response to exposure and outbreaks of COVID-19.  This guidance incorporates recent changes made by the CDC.
  • DOH has issued guidance on core infection prevention and control measures for long-term-care facilities during the COVID-19 pandemic and incorporates recent updates made by the CDC.  This guidance also supplements previous guidance issued by DOH.
  • DOH has reminded long-term-care facilities that they can order the oral antiviral treatments molnupiravir and Paxlovid from the strategic reserve specifically for residents of those facilities and other congregate settings and has updated an FAQ about the program.
  • DOH has published a health alert about a significant increase in the number of cases of syphilis in Pennsylvania in 2021 and offering testing and treatment recommendations for providers.  Find the alert here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 17) was 3159 cases day; a week ago (February 10) its seven-day average was 5163 cases a day.
  • The number of new COVID-19-related deaths also remains high but declined again over the past week.  Pennsylvania’s seven-day average yesterday (February 17) was 83 deaths a day; a week ago (February 10) its seven-day average was 109 deaths a day.
  • The Department of Health reports that the percentage of available adult ICU beds fell from 23.6 percent to 22 percent during the past week and the percentage of available pediatric ICU beds fell from 14 percent 8.5 percent over the same period of time, leaving just 33 unoccupied pediatric ICU beds in the state.
  • The Department of Health also reports that approximately 12.7 percent of all staffed adult ICU beds in the state are occupied by COVID-19 patients this week, down from 17.3 percent last week, and that 26.6 percent of all ventilators in the state are currently in use, down from 27.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 53 percent decline since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 49 percent since the first of the month and the number in ICUs has fallen 48 percent over that same period.

Around the State

As the number of COVID-19 cases, hospitalizations, and deaths continues to decline across Pennsylvania, newspapers are reporting on changes in their own coverage areas.  Among them:

Insurance Department

Jessica Altman has resigned as commissioner of the Pennsylvania Insurance Department; her last day on the job will be February 25.  Current department chief of staff Mike Humphreys will serve as acting commissioner.  Learn more from this Wolf administration news release.

Pennsylvania Higher Education Assistance Agency (PHEAA)

PHEAA’s PA Student Loan Relief for Nurses Program makes available to qualified applicants student loan relief of up to $2,500 for each year of work (beginning with 2020) for no more than three years, with a maximum benefit of $7,500.  To learn more about eligibility, benefits, and how to apply, go here.  Applications are due March 1.

Stakeholder Events

Medical Assistance Advisory Committee Consumer Subcommittee – February 23

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, February 23 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – February 24

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 24 at 10:00 a.m.  Go here to register to participate.  Find the meeting agenda here.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

2022-02-18T22:01:36+00:00February 18th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 14-18
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PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022.  (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023.  Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds.  Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds.  Proposed spending increases include:

  • rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
  • increased Supplemental Nutrition Assistance Program benefits
  • increased supplemental payments to personal care homes
  • increased county mental health funding
  • reducing the waiting list for intellectual disability services
  • expanding court-appointed child special advocates
  • expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced.  The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate.  Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease.  It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate.  Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies.  A press release issued by the governor’s office can be viewed here.

General Assembly

  • The state House and Senate convened for voting session this week.  The following is a selection of health-related bills that received consideration.
    • House Bill 1440 passed on third and final consideration by a vote of 132 to 67.  This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals.  It will now be sent to the Senate.
    • House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66.  The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.
  • The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
  • The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
  • The House Appropriations Committee will begin budget hearings next Tuesday, February 15.  The Senate Appropriations Committee will begin budget hearings the following week, on February 22.  The hearing schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program.  The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system.  Find the bulletin here.
  • DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19.  Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action.  Such comments are due within 30 days.
  • DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting.  Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic.  The update reflects a recent revision in the CDC’s guidance.  Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state.  Learn more in this DOH news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain very high but fell significantly again over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
  • To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
  • The number of new COVID-19-related deaths also remains very high but declined slightly over the past week.  Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
  • To date, more than 42,000 Pennsylvanians have died from COVID-19.
  • The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
  • The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The decline in the number of new COVID-19 cases is reflected in a 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m.  Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

DHS – Managed Long-Term Services and Supports Subcommittee – March 1

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m.  Go here to register to participate.

 

2022-02-11T21:54:18+00:00February 11th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for the Week of February 7-11
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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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