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PA Health Policy Update for the Week of January 31-February 4

The following is an update of selected state health policy developments in Pennsylvania for the week of January 31-February 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

As part of a preview of the budget proposal Governor Wolf will deliver to the legislature on Tuesday, February 8, his office has issued a news release  announcing “…his $1.7 billion plan to help Pennsylvania fully recover from the pandemic and pave the way for a successful future with support for families and workers, small businesses, the healthcare system, and statewide community revitalization through the American Rescue Plan​ Act (ARPA).”  Included in that news release is the following:

Support for Pennsylvania’s Healthcare System, $325 million

This investment would recognize healthcare workers for their heroic dedication and hard work throughout the pandemic and give healthcare providers resources to recruit and retain a skilled workforce​:

    • $250 million for long-term care recruitment and retention incentives and workforce development initiatives to grow the critical healthcare workforce​;
    • $40 million for the behavioral health workforce to expand county mental health programs; and 
    • $35 million to expand the student loan forgiveness program at PHEAA to include additional critical healthcare workers.

Redistricting Update

This afternoon the Legislative Reapportionment Commission voted 4-1 to approve new state House and Senate legislative district maps.  The final maps can be viewed here.  Pennsylvanians who are “aggrieved” by the approved maps have one month to appeal them to the Supreme Court, which has the authority to send the maps back to the commission.  Earlier this week the state Supreme Court assumed responsibility for drawing the state’s congressional district map.

House Chamber of the State HouseGeneral Assembly

  • The General Assembly will be in session next Monday (2/7), Tuesday (2/8), and Wednesday (2/9).
  • The state House and Senate will convene for a joint session on Tuesday (2/8) for Governor Wolf’s final budget address.
  • The House of Representatives is planning to consider the following health-related bills on second and third consideration next week.  Please note that this list is subject to change.
    • House Bill 1440, which provides for the regulation and licensure of medical imaging and radiation therapy professionals.
    • House Bill 19, which creates professional licensure for behavior analysts.
    • Senate Bill 1019, which addresses COVID-19 regulatory waivers and suspensions.
  • The House Health Committee will convene on Monday, February 7 to consider House Bill 1741, which allows for the prescribing and dispensing of off-label drugs approved by the FDA to treat coronavirus infections, 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.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that the Medical Assistance program will pay for FDA-authorized over-the-counter COVID-19 tests provided to Medical Assistance beneficiaries, effective with dates of service on and after August 30, 2021.  This bulletin applies to Medical Assistance-enrolled pharmacies that serve Medical Assistance beneficiaries.  Providers serving Medical Assistance beneficiaries in physical health HealthChoices or Community HealthChoices should address any billing and payment questions with the applicable managed care organization.  Learn more from this Medical Assistance Bulletin.
  • DHS has published notice of its final $255.556 million funding allocation for various FY 2022 disproportionate share hospital (DSH) payments.  DHS is not otherwise changing the qualifying criteria or payment methodology for any of these payments.  Learn more in this Pennsylvania Bulletin notice.
  • Thirty Pennsylvania counties have received nearly $28 million in federal funding to enhance their behavioral health programs.  Administered through DHS, this one-time funding consists of money granted to states through the federal Consolidated Appropriations Act of 2021 combined with funds from Pennsylvania’s annual Community Mental Health Services Block Grant award.  The grants will target specific state priorities, including mobile crisis mental health services, telehealth, student assistance programs, start-up funding for residential treatment services and assisted outpatient treatment, and additional crisis services projects.  These projects include walk-in and remote crisis supports, expanding crisis, respite, and residential care capacity, and enhanced collaboration with law enforcement to assist with crisis response.  Learn more about the services this funding will support and which counties received grants from this news release.
  • DHS has circulated a briefing document on pharmacy prior authorization for sedative hypnotics when prescribed for Medical Assistance beneficiaries and has invited stakeholder comment.  Comments are due by February 8 and should be sent in MS Word to c-bstarr@pa.gov.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its final annual case-mix per diem payment rates for FY 2022 for non-public and county nursing facilities that participate in the Medical Assistance program.
  • DHS has published its latest “Monthly Physical Health Managed Care Enrollment Report,” which updates the report to include January 2022 enrollment data.

Department of Health

  • Leaders of the Pennsylvania Department of Health (DOH), Department of Military and Veterans Affairs, and Pennsylvania Emergency Management Agency (PEMA) announced that they would establish four long-term care regional support sites to relieve pressure on hospitals and skilled nursing facilities due to a high number of patients with COVID-19.  Each facility will receive clinical and non-clinical support staff to open up to 30 beds to allow for more rapid discharge of patients from hospitals, when clinically safe to do so, freeing additional acute care space to meet COVID-19 demands.  A staffing firm will provide clinical staff, including RNs, LPNs and CNAs; the Pennsylvania National Guard will provide non-clinical staffing to support the facilities’ existing staff; and PEMA will assist with coordination.  The four regional support sites will open at the following skilled nursing facilities:  Vincentian Home in Pittsburgh; Lutheran Home in Hollidaysburg, Blair County; Springs at the Watermark in Philadelphia; and Clarview Nursing Home and Rehabilitation in Sligo, Clarion County.  Learn more from this news release.
  • DOH this week established new COVID-19 testing sites in Clearfield, Fayette, Monroe, Somerset, and Venango counties, joining previous sites it opened in Berks, Blair, Centre, and Clinton counties.  Learn more about individual clinic locations and hours in this DOH news release.
  • DOH has posted information about two options for DHS-certified child care facilities to report positive COVID-19 cases.

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 3) was 8512 cases day; a week ago (January 27) its seven-day average was 14,025 cases a day.
  • The number of new COVID-19-related deaths also remains very high but declined over the past week.  Pennsylvania’s seven-day average yesterday (February 3) was 135 deaths a day; a week ago (January 27) its seven-day average was 166 deaths a day.
  • The Department of Health reports that the percent of available adult and pediatric ICU beds in the state rose to 18.9 percent and 14.4 percent, respectively; that in approximately 22.1 percent of all staffed adult ICU beds are COVID-19 patients; and that 30.6 percent of all ventilators state-wide are in use.
  • 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 25 percent decline over the past week in the number of Pennsylvanians hospitalized with the virus.  The number of people on ventilators fell 21 percent over the past week and the number in ICUs fell 25 percent.

Stakeholder Events

Public Health Advisory Council – February 7

The Public Health Advisory Council hold a virtual meeting on Monday, February 7 at 11:30 a.m.

to discuss the Preventive Health and Health Services Block Grant work plan.  The meeting will be held by phone.  For information about how to participate, see this Pennsylvania Bulletin notice.

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.

2022-02-04T21:42:47+00:00February 4th, 2022|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 31-February 4
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PA Health Policy Update for the Week of January 10-14

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

Governor Wolf

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

General Assembly

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

Department of Human Services

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

Department of Health

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

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

COVID-19:  By the Numbers

Stakeholder Events

Pennsylvania Rural Health Redesign Center Authority Board – January 18

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

Infant Hearing Screening Advisory Committee – January 20

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

Medical Assistance Advisory Committee’s Consumer Subcommittee – January 26

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

Medical Assistance Advisory Committee – January 27

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

Medical Marijuana Advisory Board – January 27

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

Patient Safety Authority – January 27

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

Special Pharmaceutical Benefits Program Advisory Council – January 27

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

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

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

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

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

 

2022-01-14T22:33:59+00:00January 14th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of January 10-14
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PA Health Policy Update for the Week of December 27-30

The following is an update of selected state health policy developments in Pennsylvania for the week of December 27-30, 2021.  (Some of the language used below is taken directly from state documents.)

Centers for Medicare & Medicaid Services

CMS directed state survey agencies in certain states, including Pennsylvania, to begin surveying for compliance with the agency’s November 5, 2021 final rule requiring vaccination of health care staff. Click here to read the guidance to states and find provider-specific guidance documents.  CMS has authorized state surveyors to find facilities out of compliance with the rule within 30 days of the issuance of this guidance if less than 100 percent of all staff have received at least one dose of a COVID-19 vaccine.

Department of Health

  • The Department of Health (DOH) and the Pennsylvania Emergency Management Agency announced that the federal Department of Health and Human Services will be sending “strike teams” to Scranton Regional Hospital and Wellspan York to increase acute care capacity. In addition, EMS “strike teams” will be deployed in those regions to support the increased capacity.
  • DOH, in partnership, with the Department of Human Services, announced it will be transitioning its Regional Congregate Care Teams (RCATs) to the new LTC RISE (Long-term Care Resiliency, Infrastructure Supports, and Empowerment) program, effective January 1, 2022. This program will continue to provide long-term-care facilities with COVID-19 outbreak response support.  Additional information on the LTC RISE program may be found here.
  • DOH issued updated guidance to providers on COVID-19 treatment options with direction to limit the use of sotrovimab because of a current nationwide supply shortage.  This particular monoclonal antibody should be reserved for eligible outpatients at the highest risk who are diagnosed with the omicron variant of COVID-19 or exposed to local settings where omicron is prevalent.
  • DOH updated its recommendations for when health care personnel with COVID-19 infection could return to work and its contingency and crisis strategies for providers mitigating staff shortages.
  • DOH updated its guidance on isolation and quarantine periods for COVID-19 for the general population.

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of community-based care management services to the Medical Assistance fee schedule and its intent to seek CMS approval to add to the Medicaid state plan community-based care management services provided by Centers of Excellence for opioid use disorders.  See details in the Pennsylvania Bulletin notice here.
  • DHS has issued a Medical Assistance Bulletin to add to the MA fee schedule procedures codes for the administration of  booster doses of the Janssen and Moderna COVID-19 vaccines.
  • DHS has issued a Medical Assistance Bulletin with information on two CPT codes added to the MA fee schedule for the administration of Pfizer’s pediatric COVID-19 vaccine.
  • DHS has issued a Medical Assistance Bulletin about reimbursement of licensed pharmacists administering vaccines to Medicaid fee-for-service beneficiaries.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.9 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • Nearly all Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 remains high.  There currently are only 533 unoccupied adult ICU beds – 15.1 percent of the total of such beds in the state; 2369 unoccupied medical/surgical beds – 11.9 percent of such beds in the state; 40 pediatric ICU beds (10.7 percent); 234 pediatric beds (23.4 percent); and 991 airborne isolation beds (31.0 percent).
  • DOH reports that 6.9 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than 1.05 million people fully vaccinated and that 224,000 boosters have been administered to city residents since August 13.

 

2022-01-03T16:31:32+00:00January 3rd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 27-30
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PA Health Policy Update for the Week of December 13-17

The following is an update of selected state health policy developments in Pennsylvania for the week of December 13-17, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf Administration requested support from the Federal Emergency Management Agency (FEMA) for Pennsylvania’s health care system in its continued battle against COVID-19.  In particular, it has asked for staffing support for clinical and non-clinical professionals and continued pandemic response support.  Learn more from this Wolf administration news release.

General Assembly

  • The Senate unanimously passed House Bill 1260, which expands eligibility for the PACENET prescription program from $27,500 to $33,500 for single individuals and from $35,500 to $41,500 for married couples.  The bill has been sent to the governor.
  • The House Health Committee held an informational hearing on Monday to discuss the various COVID-19 treatment options available.  House Bill 1741, which provides for prescribing and dispensing to treat COVID-19 off-label drugs approved by the FDA for other purposes, received a considerable amount of attention during the hearing.  Chairman Kathy Rapp indicated the committee may move the bill in early 2022.  You can view a recording of the hearing here.
  • The Senate Health & Human Services Committee convened on Tuesday and favorably reported the following bills:
    • Senate Bill 200, which expands early intervention services for infants and mothers;
    • Senate Bill 358, which categorizes maternal deaths and severe maternal morbidity complications as reportable events within the Department of Health and requires the Maternal Mortality Review Committee to submit a report including each reportable event to the Department of Health;
    • Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning;
    • Senate Bill 848, which creates a chief nursing officer position in the Department of Health;
    • Senate Bill 967, which establishes the Women, Infants, and Children State Advisory Board;
    • Senate Bill 970, which implements certain measures to verify that child protective services or law enforcement are notified of children age 13 or younger who receive treatment for sexually transmitted diseases, pregnancy, abortions, or contraception; and,
    • House Bill 118, which establishes requirements for the final disposition of fetal remains.

You can view the committee’s agenda and a video recording here.

  • The House Human Services Committee held an informational hearing on House Bill 1644 on Thursday.  The bill directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid and who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.  The Human Services Committee also held an informational hearing on community participation supports during COVID-19 pandemic.  You can view a recording of the hearing here.
  • The state House and Senate appropriations committees released their FY 2023 budget hearing schedules.  The schedules can be viewed here.

Department of Human Services

  • The Department of Human Services (DHS) has updated its schedule for Remittance Advices, adding January dates and pay dates that go into early February.  Find it here.
  • DHS has published a notice in the Pennsylvania Bulletin announcing its intention to allocate funds in FY 2021-2022 for several classes of Medicaid inpatient disproportionate share hospital (Medicaid DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  The department does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  The allocations include:
    • $1.057 million in total funds for DSH payments to qualifying acute-care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue, and are located in an area of the state with a disproportionate need for Medicaid services
    • $1.585 million for DSH payments to qualifying acute-care general hospitals to promote access to acute-care services for Medicaid-eligible persons in less urban areas
    • $18.293 million for DSH payments to Medicaid-enrolled acute-care general hospitals that qualify as a trauma center
    • $111.585 million for DSH payments to qualifying Medicaid-enrolled acute-care hospitals that promote access to comprehensive inpatient services for Medicaid-eligible persons by providing an adequate supply of health care professionals who have been trained in high-volume Medicaid-enrolled hospital settings
    • $9.377 million for DSH payments to qualifying acute-care general hospital burn centers
    • $14.119 million for DSH payments to qualifying acute-care general hospitals providing obstetrical and neonatal services
    • $0.500 million for DSH payments to qualifying teaching hospitals that provide psychiatric services to Medicaid beneficiaries
    • $34.356 million for DSH payments to critical access and qualifying rural hospitals
    • $0.695 million for DSH payments to qualifying acute-care general hospitals that provide surgical services to patients with cleft palate and craniofacial abnormalities
    • $0.737 million for DSH payments made to qualifying Medicaid-enrolled acute-care general hospitals that provide a high volume of inpatient services to Medicaid-eligible and low-income populations
    • $4.333 million for DSH payments to qualifying acute-care general hospitals that qualify as academic medical centers
    • $23.946 million for DSH payments to qualifying acute-care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals
    • $7.397 million for DSH payments to qualifying acute-care general hospitals that participate in an academic medical program
    • $5.290 million for supplemental payments to qualifying acute-care general hospitals that provide medical and surgical ocular services to Medicaid beneficiaries
    • $0.900 million for supplemental payments to qualifying acute-care general hospitals that provide a substantial portion of their inpatient services to Medicaid beneficiaries

Learn more from this Pennsylvania Bulletin notice.

  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for anticonvulsants submitted for prior authorization.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to update handbook pages that address 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.  Find the bulletin here.

Department of Health

  • Department of Health (DOH) acting secretary Alison Beam will leave that job at the end of the year.  She will be replaced by department deputy secretary Keara Klinepeter.  Learn more from this Wolf administration news release.
  • DOH announced that the state is opening free outdoor drive-up COVID-19 testing sites in Berks, Blair, Centre, Clinton, Jefferson, Luzerne and McKean counties.  For locations and hours, see this department news release (and this separate notice for the site in Blair County).
  • DOH has introduced a new “post-vaccination data” web page on which it will provide data on so-called breakthrough cases of COVID-19:  cases, hospitalizations, and deaths.  The web page reports that from January 1 through December 6, 2021, 85 percent of reported COVID-19 cases in Pennsylvania were in unvaccinated or not fully vaccinated people; 87 percent of reported hospitalizations with COVID-19 as the primary diagnosis/cause of admission were in unvaccinated or not fully vaccinated people; and 86 percent of COVID-19-related deaths were in unvaccinated or not fully vaccinated people.  For additional information and a more detailed breakdown of these and other numbers, see the department’s new post-vaccination data web page.
  • DOH has posted a notice on its message board about the transition from the Regional Congregate Care Teams to a new program that will support response operations at long-term-care facilities that experience COVID-19 outbreaks.  Find that message here.
  • The Independent Regulatory Review Commission (IRRC) has issued its comments on DOH’s proposed amendments of regulations governing long-term-care facilities.  In addition to specific comments, the IRRC stated its agreement with many others in the regulated community that have urged DOH to reevaluate its approach of promulgating several packages of proposed regulations and instead consider submitting a comprehensive regulatory update regarding long-term care.  Find the IRRC comments in this Pennsylvania Bulletin notice.
  • DOH has issued its monthly report detailing its nursing home inspection and sanction activities.  Learn more from this department news release and the department’s November report.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts remain at their highest levels since the beginning of the pandemic.  To date, more than 1.8 million Pennsylvanians have contracted COVID-19.
  • The number of new COVID-19-related deaths remains high.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19 has risen 18 percent since December 1; the number in hospital ICUs because of COVID-19 has risen 13 percent; and the number on ventilators because of the virus has risen 16 percent since the start of the month.
  • This situation is reflected in the high rate of occupancy in the state’s hospitals.  There currently are only 484 unoccupied adult ICU beds – 13.7 percent of the total of such beds in the state; 2106 unoccupied medical/surgical beds – 10.5 percent of such beds in the state; 34 pediatric ICU beds (9.0 percent); 191 pediatric beds (16.8 percent); and 938 airborne isolation beds (29.6).
  • Media reports confirm the challenges some communities and hospitals are facing, including this story in the Philadelphia Inquirer; a situation that the director of the 911 call center in Westmoreland County calls “desperate;” and reported capacity and hospital discharge problems in western and rural Pennsylvania.
  • DOH reports that 6.8 million Pennsylvanians, excluding those in Philadelphia, are now fully vaccinated; it appears likely, although not certain, that this figure reflects the original concept of “fully vaccinated” and not whether such individuals have received boosters.  Philadelphia’s Department of Public Health reports slightly more than one million people fully vaccinated and that 186,000 boosters have been administered to city residents since August 13.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published Hospital Performance Report – 2020 Data, which presents volume and outcome information about a variety of medical conditions and surgical procedures performed by the state’s  general acute-care hospitals.  Learn more from the following resources:

 

2021-12-17T22:37:32+00:00December 17th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of December 13-17
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PA Health Policy Update for the Week of November 29-December 3

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

Governor Wolf

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

General Assembly

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

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

Financial paperworkState Revenue Update

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

Department of Human Services

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

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

Department of Health

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

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

COVID-19:  By the Numbers

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

Department of Drug and Alcohol Programs

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

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – December 8

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

Medical Assistance Advisory Committee – December 9

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

Patient Safety Authority – December 9

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

2021-12-03T22:12:20+00:00December 3rd, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 29-December 3
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PA Health Policy Update for the Week of October 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of October 18-22, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed an executive order calling on the state’s Department of Labor & Industry to “study the feasibility of implementing Occupational Safety and Health Administration (OSHA) standards” in state offices and requiring that for profit entities that do business with the state pay “…a minimum wage that meets or exceeds” the state’s minimum wage and offer paid sick leave to their employees.  Go here to see that executive order and here to see a Wolf administration news release about it.

House Chamber of the State HouseGeneral Assembly

  • The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Navigating Healthcare Consolidation.”  Co-hosted by chairman Ryan Bizarro and northeast delegation chair Rep. Maureen Madden, the hearing focused on the market dynamics that contribute to health care consolidation and the effect consolidation has on communities, patients, and employees.  Representatives from the hospital community, organized labor, and patient advocacy groups testified.  A press release issued following the hearing may be viewed here and testimony offered at the hearing may be viewed here.
  • The House and Senate will be in session next Monday (10/25), Tuesday (10/26), and Wednesday (10/27).  As of October 22, the following health care-related committee meetings have been scheduled for next week:
    • The House Aging & Older Adult Services Committee will meet on Tuesday, October 26 to consider, among other bills, House Bill 1356, which amends the Human Services Code to increase the reimbursement rate for guardians of older adults.
    • The House Human Services Committee will meet on Tuesday, October 26 to consider House Bill 1561 and House Bill 1563.  These bills, which amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, seek to align them with HIPAA and give providers, facilities, and insurers the ability to more easily share patient mental health and substance use disorder treatment information.  The committee also will consider House Bill 1308, which enables local communities and agencies in Pennsylvania to establish overdose fatality review teams.  Finally, the committee will consider House Bill 1995, which clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.

Department of Human Services

  • The Department of Human Services (DHS) has added November dates to its calendar of when it will be issuing Remittance Advices (RAs) and corresponding checks.  Find the updated calendar here.
  • DHS has updated its information about provider enrollment and revalidation changes during the COVID-19 emergency.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin advising providers of updates of certain error status codes for personal care services subject to electronic visit verification, effective for claims received on or after October 22, 2021.  The bulletin also gives providers an updated Provider Assistance Center contact e-mail address for their use.  Go here to find this Medical Assistance Bulletin.
  • DHS’s Office of Mental Health and Substance Abuse Services has informed providers that certain regulatory requirements for on-site inspections have been reinstated as of October 18, 2021.  This includes visitation requirements, the right to enter and inspect, and the requirement to undergo an annual inspection.
  • DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) of the procedure for submitting claims to DHS for a take-home supply of naloxone distributed to Medical Assistance beneficiaries.  Find that bulletin here.
  • The federal Centers for Medicare & Medicaid Services (CMS) has issued guidance on coordinating care provided by out-of-state providers for children with medically complex conditions, including a description of best practices and other implementation considerations related to coordination of care from out-of-state providers for children with medically complex conditions.  Go here to see CMS’s guidance memo to state Medicaid programs.

Department of Health

The Department of Health has published an update on point-of-care COVID-19 antigen tests and the interpretation of test results.  The updated guidance replaces previous department guidance.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases declined slightly this week.
  • The number of new COVID-19-related deaths remains high but did not rise during the past week.
  • The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
  • 71.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people.  3000 Philadelphians and 58,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first evaluation of its Pennsylvania Rural Health Model, a federally approved program that seeks “…to improve population health outcomes, increase access to high-quality care, and improve the financial viability of acute care hospitals in rural Pennsylvania.  Designed to reduce the risk of rural hospital closures, the Model seeks to stabilize participating hospitals’ finances by providing a predictable revenue stream through global budgets.”  Go here and scroll down for information about the model and links to additional resources.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m.  Go here to register to participate.

Medical Assistance Advisory Committee – October 28

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

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m.  To participate:

Health Care Cost Containment Council – November 4

The Health Care Cost Containment Council will meet via teleconference on Thursday, November 4 at 10:00 a.m.  The public is invited to participate.  See this Pennsylvania Bulletin notice about how to join the meeting.

Organ Donation Advisory Committee Meeting – November 4

The Organ Donation Advisory Committee will hold a virtual meeting on Thursday, November 4 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Traumatic Brain Injury Advisory Board – November 5

The Traumatic Brain Injury Advisory Board will hold a virtual meeting on Friday, November 5 at 10:00 a.m.  See this Pennsylvania Bulletin notice for information about how to join the meeting.

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m.  To participate virtually or by phone, go here for further information.

 

2021-10-22T21:03:04+00:00October 22nd, 2021|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 October 18-22
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PA Health Policy Update for the Week of September 20-24

The following is an update of selected state health policy developments in Pennsylvania for the week of September 20-24, 2021.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • House Republican leadership held a press conference on Monday to discuss their legislative agenda for the fall.  In addition to addressing the Wolf administration’s mask mandate for K-12 schools, they plan to work on legislation to address the opioid and addiction crises and COVID-19 regulatory waivers and flexibilities.  View the news conference here.
  • The House of Representatives sent House Bill 1861 to the Senate, where it was referred to the Health & Human Services Committee.  This bill will likely serve as the legislative vehicle for an extension of the health-related COVID-19 regulatory waivers and flexibilities set to expire on September 30, 2021.
  • The House of Representatives unanimously approved House Bill 1774, which amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP).  Specifically, the bill extends the sunset date to December 31, 2028 and grants the Department of Labor & Industry access to the prescription monitoring program.
  • Senate Bill 397 and Senate Bill 398 were reported as amended by the House Professional Licensure Committee on Monday.  These two bills would modernize Pennsylvania law on physician assistants and their oversight.
  • The House and Senate will be in session again next week on Monday (9/27), Tuesday (9/28), and Wednesday (9/29).  The following health care-related committee meetings have been scheduled:
    • The House State Government Committee will convene on Monday (9/27) to consider, among other bills, House Bill 1893, which amends the Disease Control and Prevention Act of 1955 to make disease information under this act subject to the Right-to-Know Law.  The committee also will consider Senate Bill 533, which prohibits certain regulatory and administrative actions during a disaster emergency.
    • The Senate Health & Human Services Committee will convene on Monday, September 27 at 12:00 p.m. to consider House Bill 1861 (COVID-19 regulatory waiver and flexibility extension); House Bill 1774 (Achieving Better Care by Monitoring All Prescriptions Program); Senate Bill 782 (payment for FDA-approved anti-obesity drugs); Senate Bill 815 (pelvic exam consent requirement); and Senate Bill 818 (allowable ambulatory surgical center procedures).

Department of Human Services

Department of Health

  • The Department of Health has updated its interim infection prevention and control recommendations for health care settings to add new options for fully vaccinated individuals working in facilities in counties with low to moderate rates of community transmission of COVID-19.
  • The Department of Health, Department of Drug and Alcohol Programs, and the Pennsylvania Commission on Crime and Delinquency have written to Pennsylvania hospital officials advising them on how they can secure a supply of Narcan to support hospital- and community-based naloxone distribution efforts to help in the fight against overdose-related deaths.  See their letter here.
  • Acting Secretary of Health Alison Beam has signed an order to ensure that vaccine providers are prepared to start COVID-19 booster shots as soon as the CDC issues federal guidance to do so.  The order requires vaccine providers, as possible, to provide online scheduling for vaccination appointments; provide a telephone number to assist with scheduling appointments; offer walk-in appointments; and work with local Area Agencies on Aging and Medicaid managed care plans to help schedule appointments for eligible adults and people who cannot leave their homes to get vaccinated.  Learn more from the Department of Health’s announcement about the order and the order itself.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases remained very high this week.  Today the number of Pennsylvanians who have contracted COVID-19 surpassed 1.4 million.
  • The number of COVID-19 cases among school-aged children (between 5-18 years old) is 12.2 times greater this year than in 2020.  Between September 15 and September 21, 2020 there were a total of 650 COVID-19 cases in school-aged kids compared to 7,928 cases in the same age group during the same week in 2021.
  • According to Pennsylvania’s COVID-19 dashboard, only 41 pediatric intensive care beds in the state – 11 percent of the total number of such beds state-wide – are currently unoccupied.
  • The number of new COVID-19-related deaths also remains high.  Yesterday the number of Pennsylvanians who have died from COVID-19 rose past 29,000.
  • For the third consecutive week, every county in Pennsylvania is experiencing a high level of COVID-19 transmission (scroll down to page 13).
  • The number of Pennsylvanians hospitalized because of COVID-19 rose 13 percent in the past week and has risen 44 percent since the first of the month; the number on ventilators has risen 14 percent in the past week and 38 percent since the first of the month; and the number in hospital intensive care units has risen 12 percent in the past week and 37 percent since the beginning of September.
  • 68.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – 6.1 million people – up from 67.5 percent last week.  10,000 Philadelphians and 74,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week; some of the 74,000 were added to the ranks of the vaccinated as the result of a Department of Health adjustment of its vaccination data.

Around the State

  • “Regulatory waivers established last year to help hospitals and health-care workers fight COVID-19 will expire this month, and those in the field are warning the lapse could exacerbate an ongoing staffing crisis as coronavirus cases rise again,” reports Spotlight PA, which takes a closer look at some of the waivers that have been in place in Pennsylvania, what they do, and what the stakes might be if they are not renewed.
  • Emergency department volume at Children’s Hospital of Pittsburgh and Excel Health Frick Hospital has risen so much that the hospitals have erected tents to help them handle growing numbers of patients, according to the Pittsburgh Tribune-Review.
  • Mobile clinics operated by the organization Latino Connection are making a special effort to provide COVID-19 vaccines to Hispanic communities around the state, the Allentown Morning Call reports.
  • Black Doctors COVID-19 Consortium, a group launched to ensure access to COVID-19 vaccines for Philadelphia’s African-American community, will extend its scope of endeavor and open a primary care clinic to help address health disparities and inequities.  The Philadelphia Inquirer explains the group’s evolution.
  • “A new study from Penn State shows Pennsylvania could avoid billions of dollars in health damages by joining a regional cap and trade program targeting power plant emissions… The team at Penn State used four types of damage estimates to find that the commonwealth could reduce health impacts caused by power plant pollution by between $18 and 40 billion dollars over the next nine years by joining the Regional Greenhouse Gas Initiative (RGGI).”  StateImpact Pennsylvania explains.
  • Spotlight PA has posted an update on its reporting on what it calls the “…growing dementia care crisis in one of the nation’s most rapidly aging states…”  Read it here.
  • “Mental health agencies in Bucks, Dauphin, Carbon, Monroe and Pike counties are using new grant funding to test out a program designed to help people who live with serious mental illness and are at risk of ending up in jail.”  Learn more from this WITF story.
  • An EMS organization serving parts of Lancaster County is encountering funding problems – a situation found in other parts of the state as well, according to the Pennsylvania Capital-Star.

 

2021-09-24T20:29:14+00:00September 24th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 20-24
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PA Health Policy Update for the Week of September 6

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

General Assembly

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

Department of Health

Department of Human Services

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

Pennsylvania Rural Health Model

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

COVID-19:  By the Numbers

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

Around the State

Independent Regulatory Review Commission

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

Stakeholder Events

  • The consumer subcommittee of the Medical Assistance Advisory Committee will meet on September 22 at 1:00 pm.  Go here to register to participate remotely.
  • The Medical Assistance Advisory Committee will meet on September 23, 2021 at 10:00 am.  Go here to register to participate remotely.
  • The Patient Safety Authority will hold a virtual public meeting on Thursday, September 23 at 1:00 p.m. and it is open to the general public.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.
2021-09-10T21:48:42+00:00September 10th, 2021|Coronavirus, COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for the Week of September 6
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PA Health Policy Update for the Week of July 26-30

The following is an update of selected state health policy developments in Pennsylvania for the week of July 26-30, 2021.  (Some of the language used below is taken directly from state documents.)

General Assembly

House majority leader Kerry Benninghoff announced this week that he sent letters to state agencies notifying them that they should be prepared to have the nearly 500 waived and suspended regulations that were in place under the COVID-19 emergency disaster declaration reinstated on September 30, 2021.  He also encouraged agencies to work closely with the relevant standing committees in the House to review which regulations should be permanently repealed or reformed.  The letter noted the need to work expeditiously given the limited number of legislative session days scheduled between now and September 30.  Benninghoff also highlighted in a letter to the Department of Health that “…nothing in current law prohibits tele-health services from being provided at pre-pandemic levels.”  See Benninghoff’s letter to the Office of Administration here and his letter to the Department of Health here.

Department of Health

The Department of Health has invited applications for the approval of up to two additional academic clinical research centers as part of its medical marijuana program.  Applications will be available beginning on August 3 on the Department of Health’s web site and applications are due September 2.  Learn more from the department’s notice published in the Pennsylvania Bulletin.

The Department of Health plans to pursue a series of changes in the manner in which long-term-care facilities are regulated.  It intends to do so in five separate parts and has published one of those parts, with explanations, in the Pennsylvania Bulletin.

Department of Human Services

  • DHS has issued a Medical Assistance Bulletin to inform providers that it is expanding the scope of Medicaid-enrolled providers that may bill the program for administration of COVID-19 vaccines and monoclonal antibody therapy.  The new policy applies to physicians, certified registered nurse practitioners, certified nurse midwives, outpatient hospital clinics, independent medical/surgical clinics, home health agencies, renal dialysis centers, psychiatric outpatient clinics, drug and alcohol outpatient clinics, partial psychiatric hospitals, ambulance providers and licensed pharmacies.  The policy is retroactive to April 1.  Find the bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will make an enhanced payment for the administration of COVID-19 vaccines to Medicaid beneficiaries who are homebound and has added a CPT code for the billing of this service.  The policy is retroactive to April 1.  Learn more in the bulletin notice.
  • DHS and the Department of Aging are seeking presenters for their 2021-2022 protective services virtual conference, to be held on October 6 and October 7.  This year’s conference is about getting back to basics and mastering the core competencies of protective services:  opening and conducting investigations.  Learn more about the conference and opportunities to make presentations during it from this conference notice.  The deadline for applying to make a presentation is August 6.
  • DHS has updated its Pennsylvania Medicaid Managed Care Directory with key contacts for both the physical health and behavioral health HealthChoices programs.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has published a policy bulletin to announce changes in its prevention, fiscal, operations and case management, and clinical services manuals.  Go here to find the revised manuals.

The state’s Independent Regulatory Review Commission has disapproved a proposed regulation submitted by the Department of Drug and Alcohol Programs seeking to “…establish regulations for recovery houses that receive public funds or referrals.  Recovery houses provide support to individuals receiving outpatient treatment for substance use disorder who may benefit from supportive housing, a substance-free environment and peer camaraderie.”  The commission has not yet issued an explanation for the rejection.  The department now has three options:  it may withdraw the regulation, resubmit the regulation with revisions within 40 days of receipt of the commission’s disapproval order, or submit the regulation without revision to the General Assembly.

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases rose considerably again over the past week.  Thursday marked the first time since May 28 that the state registered more than 1000 new cases in a single day.  Even these numbers, however, are less than half of what they were in mid-May.
  • The number of deaths, however, remains very low.
  • For the week from July 16 through July 22 the state’s overall COVID-19 test positivity rate was 2.6 percent, up from 1.7 percent last week and the third consecutive week with an increase after more than two months of declining rates.  As a frame of reference, however, that rate was 9.5 percent just three months ago.
  • Since the beginning of July the number of Pennsylvanians hospitalized with COVID-19 has risen 53 percent; the number in hospital ICUs has risen 71 percent; and the number on ventilators has risen 37 percent.
  • According to the state’s revised figures, 62.8 percent of Pennsylvanians 18 years of age and older are now fully vaccinated, up from 62.2 percent last week.  Only 56,000 Pennsylvanians completed a vaccine regimen in the past week and only 300,000 have done so since July 1.  In Philadelphia, only 17,000 people reached full vaccination status in the past week and 46,000 have done so since July 1.

Around the State

  • Spotlight PA has identified all of the emergency procurement spending the state has done since the start of the COVID-19 pandemic and highlighted those that were pandemic-related.  Find its report here.
  • A Department of Drug and Alcohol Programs web site that enabled visitors to obtain information about drug abuse treatment facilities’ violations of state guidelines identified during state inspections had inaccurate information and has been taken down.  Learn more from two Allentown Morning Call reports:  the article about the inaccurate information and a separate story about the state’s decision to take down the site while it reviews the inaccurate data.
  • Shortly after the federal Centers for Disease Control and Prevention recommended that school teachers, staff, and students wear face masks in areas with high rates of COVID-19 transmission, a spokesperson for Governor Wolf said that the governor did not intend to mandate such a policy although he would urge local school districts to follow the new federal guidance.  PennLive tells the story.
  • Shortly after the CDC recommended that even vaccinated people wear face masks indoors and under certain circumstances in areas of high transmission of COVID-19, Pittsburgh’s WTAE television published an interactive map showing community transmission rates throughout Pennsylvania.
  • PennLive was even more specific:  it listed the seven Pennsylvania counties where the COVID-19 transmission rates meet the criteria for vaccinated people to wear masks indoors.  They are Cameron and Crawford counties (high rates of community transmission) and Adams, Lawrence, Monroe, Northampton, and Wyoming counties (substantial rate of community transmission).
  • Scranton’s city council has voted to accept a three-year, $360,000 grant from the Moses Taylor Foundation to fund a health coordinator position for the city, according to the Scranton Times-Tribune.
  • “Drexel University College of Medicine at Tower Health is ready to welcome its inaugural class of first-year medical students next week,” the Reading Eagle reports.

Stakeholder Events

  • Traumatic Brain Injury Advisory Board

August 6 at 9:00 a.m.

The Traumatic Brain Injury Advisory Board will hold a virtual public meeting on Friday, August 6, 2021.  For information about the board’s mission, meeting materials, and how to participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

  • Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee

August 11-12 at 9:00 a.m.

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, August 11, 2021, and Thursday, August 12, 2021 from 9 a.m. to 4:30 p.m.  To see the agenda and find information about where the meeting will be held and how individuals can participate virtually, see the meeting announcement in the Pennsylvania Bulletin.

 

 

2021-08-16T15:10:18+00:00July 30th, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for the Week of July 26-30
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PA Health Policy Update for the Week of July 5-9

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-9, 2021.  (Some of the language used below is taken directly from state documents.)

State Revenue Collections

According to the Independent Fiscal Office’s Monthly Revenue Update, the state collected $3.77 billion in June, the last month of the fiscal year; that was $350.7 million, or 10.3 percent, more than projected.  This strong monthly performance was led by growth in corporate net income tax collections, which were 42.2 percent higher than anticipated.  Pennsylvania ended FY 2020-21 with the largest budget surplus in the state’s history:  $3.4 billion more than anticipated.

Department of Human Services

COVID-19:  By the Numbers

  • The daily number of new COVID-19 cases and deaths remained down and steady over the past week.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital ICUs because of it remained down and steady.
  • To date, nearly 1.2 million Pennsylvanians have contracted COVID-19, among them 29,000 health care workers and 88,000 residents and staff of nursing facilities and personal care homes.  27,700 Pennsylvanians have died from the virus.
  • For the week from June 25 through July 1 the state’s overall COVID-19 test positivity rate was 1.1 percent, down from 1.2 percent last week and 1.4 percent the week before.
  • 5.5 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard, but only 82,000 have completed the full vaccination regimen in the past week; another 9000 Philadelphians have done so as well.  According to the state, 60.5 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 63.0 percent of the entire population has now received at least the first dose of a vaccine.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has sent a reminder to stakeholders that under the federal Health Resources and Services Administration’s (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment Program, HRSA will provide up to $250,000 in loan repayment to substance abuse disorder health professionals in exchange for a six-year, full-time service commitment in rural and underserved areas.  Facilities interested in hiring or supporting current substance use disorder health professionals who receive loan repayment must apply to become an approved facility.  Learn more about the HRSA program here and apply to become an approved facility to employ current substance use disorder professionals here.  Applications are due July 22.

Around the State

  • The Department of Health is hiring a new contractor to run its COVID-19 contact tracing program after firing its old contractor after a major data breach.  Spotlight PA explains who, why, and how much.
  • Western Pennsylvania hospitals, nursing homes, assisted living facilities, personal care homes, and home care agencies are experiencing a major shortage of nurses.  The Pittsburgh Tribune-Review details the extent of the problem.
  • A new law passed late last month gives Pennsylvania parents the right to have their children repeat the grade they just finished because of the learning loss they believe their children experienced during remote schooling while the COVID-19 pandemic raged.  Parents must make a decision and file appropriate paperwork by July 15.  The Pittsburgh Post-Gazette offers the details.
  • The Butler County commissioners have unanimously voted to end their emergency declaration, KDKA Pittsburgh reports, “… because the vaccination site at the county mall is closed and they no longer require the state’s emergency funding.”
  • A new law in Pennsylvania “…will require treatment facilities to notify a patient’s emergency contacts if they leave a rehab center against medical advice,” the Pittsburgh Post-Gazette reports, adding that “Heather’s Law, as it’s called, will take effect in 60 days and is named after a woman who overdosed and died 12 hours after leaving a treatment facility in Pennsylvania.  Her family wasn’t aware she had left.”  Learn more here.
  • “After more than five months of discussions and one meeting with Tower Health’s board of directors, Lehigh Valley Health Network and StoneBridge Healthcare have decided not to make an offer to acquire the financially ailing Reading-based health system,” according to the Philadelphia Business Journal.  Tower Health’s hospitals include Reading Hospital, Brandywine Hospital, Chestnut Hill Hospital, Jennersville Hospital, Phoenixville Hospital, Pottstown Hospital, and St. Christopher’s Hospital for Children, a partnership of Tower Health and Drexel University.
  • “Geisinger Health Plan has expanded its Children’s Health Insurance Program (CHIP) coverage to eight more Pennsylvania counties including all five in the Philadelphia region.  GHP Kids coverage is now available for uninsured children and teens, up to age 19, in 48 of Pennsylvania’s 67 counties,” the Philadelphia Business Journal writes

Stakeholder Events

  • Health Research Advisory Committee Meeting

July 12 at 10:00 a.m.

The public meeting will be held virtually by means of Microsoft Teams at (267) 332-8737 with Conference ID: 689 378 043#.

  • Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting.  The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

  • 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#

 

2021-07-09T20:01:40+00:00July 9th, 2021|Coronavirus, COVID-19, DSH hospitals, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for the Week of July 5-9
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  • P: (717) 234-6970

  • 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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