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

Governor-Elect Shapiro

Governor-Elect Josh Shapiro held a press conference Wednesday, November 16 along with Governor Wolf and Lieutenant Governor-Elect Austin Davis to discuss the gubernatorial transition process.  The governor-elect announced that Akbar Hossain, who previously served as his campaign’s policy director, will be executive director of the transition.  Amanda Warren, formerly director of finance for the campaign, will serve as executive director of the inauguration.  Additional transition announcements will be made in the coming weeks.  Further information about the transition will be available here.

General Election Update

State Representative Todd Stephens (R-151) conceded to his challenger, Melissa Cerrato (D), yesterday afternoon.  Representative Stephens’ concession gives Democrats the 102 seats needed to control the state House of Representatives; Republicans have 101 seats.  The initial path forward for Democratic control is unclear, however, because of three impending vacancies in the Democratic caucus that will require special elections in early 2023.

General Assembly Update

• The state House and Senate briefly convened for voting session this week – the final voting session of the year.  Both chambers will return to Harrisburg for the commencement of the new legislative session on January 3.
• The Senate Health & Human Services Committee held a hearing on Tuesday to examine the Behavioral Health Commission’s recommendations for the allocation of $100 million earmarked in the FY 2023 budget.  Testimony and a recording of the hearing may be viewed here.
• The Senate Republican and Democratic caucuses held leadership elections this week for the new legislative session.  Senator Kim Ward (R-39) was elected the state’s first female Senate President Pro Tempore.  Senator Joe Pittman (R-41) was elected majority leader and Senator Scott Martin (R-13) was chosen chairman of the Appropriations Committee.  Senator Jay Costa (D-43) was re-elected by his caucus to serve as minority leader.  A complete list of the Senate Republican leadership team can be found here and a list of the Senate Democratic leadership team can be found here.

Department of Human Services

• As of December 5, DHS is adding a new procedure code to the Medical Assistance fee schedule for COVID-19 tests provided to Medicaid beneficiaries and removing the previous code for those tests.  Learn more from this Pennsylvania Bulletin notice.
• DHS will increase Medical Assistance fees for certain ambulance transportation services beginning on January 1.  Learn more, including the new fees, from this Pennsylvania Bulletin notice.
• Pennsylvania’s Independent Regulatory Review Commission has received final form rulemaking from DHS that would effectively rescind a provision in existing regulations that prohibits providers from co-locating or leasing space to another provider within a provider’s office.  This change was originally proposed in July 2021 and the commission is expected to approve the change at its December 8 meeting.  Find notice of the action in this Pennsylvania Bulletin listing.
• Next month, DHS’s Office of Long-Term Living will submit a proposed amendment to Pennsylvania’s OBRA 1915(c) home and community-based waiver to the Centers for Medicare & Medicaid Services (CMS).  To view a side-by-side comparison of the current and revised language and to see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 OBRA Waiver Amendment” under “Additional Resources.”  For additional information about the proposed amendment and how to submit written comments, see this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
• Next month, DHS’s Office of Long-Term Living will submit to CMS a proposed amendment to Pennsylvania’s Community HealthChoices 1915(c) home and community-based waiver.  To view a side-by-side comparison of the current and revised language and see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 Community HealthChoices (CHC) Waiver Amendment” under “Additional Resources.”  Learn more about the proposed amendment from this Pennsylvania Bulletin notice.  The deadline for submitting comments has been extended to December 14.
• DHS is making available for public review and comment the Office of Long-Term Living’s proposed home and community-based services provider sites that qualified for heightened scrutiny under CMS requirements.  Learn more about the types of sites to which this requirement applies and DHS’s actions to bring them into compliance with federal standards from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

• According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania over the past week declined 18 percent while the number of deaths remains unchanged.  The state is now averaging more than 1400 new reported cases a day and about 19 daily deaths.
• According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs fell 16 percent from the last week after two weeks of rising totals.
• The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
• As of November 18, 27 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 34 are experiencing substantial rates of community transmission; and six counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has published “Financial Analysis 2021:  Rehabilitation • Psychiatric • Long-Term Acute Care • Specialty:  An Annual Report on the Financial Health of Pennsylvania Non-GAC Hospitals.”  The report’s highlights include:

• During FY 2021, the operating margin for rehabilitation hospitals was 9.19 percent, for psychiatric hospitals was negative 2.86 percent, for long-term acute-care hospitals was 8.98 percent, and for specialty hospitals was negative 11.76 percent.
• During FY 2021, the total margin for rehabilitation hospitals was 12.04 percent, for psychiatric hospitals was negative 3.02 percent, for long-term acute-care hospitals was 7.76 percent, and for specialty hospitals was 9.9 percent.
• As a group, the foregone dollar value of uncompensated care for non-general acute-care hospitals decreased 6.19 percent, or $1.1 million, from $18.7 million during FY 2020 to $17.7 million in FY 2021.  Uncompensated care as a percentage of net patient revenue in FY 2021 among non-general acute-care hospitals ranged from 0.22 percent for long-term acute-care hospitals to 1.44 percent for psychiatric hospitals.

Learn more about the PHC4 report from this news release and the report itself.  In addition, go here to download data from the report in Excel format.

Stakeholder Events

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

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

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually.  For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

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

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

DHS – Medical Assistance Advisory Committee – December 8

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