The following is an update of selected state health policy developments in Pennsylvania for the week of June 20-24, 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 in Harrisburg.  Originally scheduled to be in session all week, the House and Senate cancelled session Thursday and Friday while legislative leaders and the governor continue to negotiate an FY 2023 spending plan.  Both chambers will back in session next week to attempt to finalize the budget by the state’s June 30 constitutionally-mandated deadline.
• The Senate unanimously concurred with House amendments to Senate Bill 709 and sent it to Governor Wolf for his signature.  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 Senate unanimously passed Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.  The bill now goes to the House for consideration.
• The Senate adopted Senate Resolution 288, which authorizes the Joint State Government Commission to research the impact of the pandemic on the staffing needs of long-term-care facilities.
• The House unanimously passed House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.  The bill was received in the Senate and referred to the Judiciary Committee for consideration.
• The House unanimously passed House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by FDA.  The bill was received in the Senate and referred to the Judiciary Committee.
• The House passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill was received in the Senate and referred to the Judiciary Committee.
• The House Human Services Committee favorably reported House Bill 107, which would require Medicaid managed care organizations to enter into an agreement with the Department of Human Services to enable the department to recoup any Medicaid funds that were spent on “provider-preventable conditions,” and House Bill 109, which increases the penalties for making a false claim against the state’s Medicaid program.
• The House Judiciary Committee favorably reported House Bill 2660, which is a proposed constitutional amendment that would establish the General Assembly’s sole authority to establish in statute the rules regarding venue in civil lawsuits.
• The Senate Health & Human Services Committee favorably reported House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  The committee also unanimously reported 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.
• The Senate Consumer Protection & Professional Licensure Committee reported Senate Bill 485, which seeks to improve access to physical therapy services, and Senate Bill 511, which authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
• The Senate amended Senate Bill 225 on second consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.
• Representative Wendy Thomas and Human Services Committee Chairman Frank Farry held a press conference to highlight House Bill 2686, which seeks to improve access to mental health care in Pennsylvania through the Behavioral Collaborative Care Model.  The legislation would provide grant funding to support the model’s implementation in physician practices.

Free COVID-19 Vaccines

Following the extension of authorization to administer COVID-19 vaccines to children six months of age and older, the federal Centers for Medicare & Medicaid Services (CMS) has announced that children ages six months to five years with Medicaid and CHIP coverage are eligible for COVID-19 vaccinations without cost-sharing.  Learn more about these free vaccines, and others who are eligible for free vaccines, from this CMS news release.

Department of Human Services

• The Department of Human Services (DHS) has announced that the plan selection period for physical health HealthChoices will run from June 22 through August 16.  This selection period comes ahead of implementation of new physical health managed care agreements that will take effect on September 1.  The new agreements will result in some consumers having to choose a new physical health plan, and all consumers can review options and select a new health plan if they would like to make a change.  Notices are being mailed to all Medicaid recipients enrolled in a physical health managed care plan.  The letter explains whether or not a person’s current plan will continue to be available after September 1, all options for plans in their region, important dates, and how to choose or change their plan.  Approximately 500,000 current HealthChoices participants will have to select a new physical health plan by August 16 or be automatically assigned due to the agreement changes.  Learn more about the plan selection period and find links to additional resources from this DHS news release.
• DHS has extended its calendar of remittance advice notifications, check mailings, and electronic funds transfers into early August.  Find the updated calendar here.
• DHS has updated its list of drug companies that participate in the federal Medicaid drug rebate program.  For a drug product to be compensable through the Medical Assistance program the company that markets the product must participate in the Federal Medicaid Drug Rebate Program.
• DHS’s Medical Assistance Advisory Committee met on Thursday, June 23.  Learn about the committee’s deliberations from presentations offered by:
  • The Office of Medical Assistance Programs
  • The Office of Long-Term Living
  • The Office of Developmental Programs
  • The Office of Mental Health and Substance Abuse Services
• DHS’s Medical Assistance Advisory Committee’s consumer subcommittee met on Wednesday, June 22.  Learn about the committee’s deliberations from presentations offered during the meeting by DHS’s Office of Medical Assistance Programs and its Office of Long-Term Living.
• DHS has published a notice announcing the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2023.  Find that notice here.
• DHS has announced its intent to amend Pennsylvania’s Title XIX State Plan to update the Medical Assistance payment methodology and standards for payment of Medical Assistance-covered nursing facility services in FY 2023 to authorize the continued use of a budget adjustment factor in setting payment rates for nursing facility services.  Learn more about this proposal in this Pennsylvania Bulletin notice.
• DHS has published its proposed annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Find that notice here.

Department of Health

The Department of Health has issued a health alert updating its recommendations for identifying cases of monkeypox, testing for the disease, and counseling patients.  Find the updated guidance here.

The Department of Health has issued a health alert informing providers and public health officials that the first mosquito pools of the season to test positive for West Nile virus in Pennsylvania have been found in Montgomery, Philadelphia, Bucks, and Cumberland counties and that the risk of West Nile infection is likely to remain elevated over the next several months.  The alert reviews symptoms of West Nile virus and when and how to test for the virus.  Find the alert here.

Pennsylvania Rural Health Model

The Pennsylvania Rural Health Model is a federal program that seeks to test whether care delivery transformation in conjunction with hospital global budgets increase rural Pennsylvanians’ access to high-quality care and improve their health while also reducing the growth of hospital expenditures across payers, including Medicare, and improving the financial viability of rural Pennsylvania hospitals to improve health outcomes of and maintain continued access to care for Pennsylvania’s rural residents.  Eighteen Pennsylvania hospitals participate in this program.  CMS’s Center for Medicare and Medicaid Innovation has just published an evaluation of the program’s second year of operations.  Find that evaluation report here and go here for other information about the program, including a list of the participating hospitals.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the expansion of ATLAS, the Addiction Treatment Locator, Assessment, and Standards platform, to Pennsylvania.  ATLAS evaluates addiction treatment facilities’ use of evidence-based best practices and offers a dashboard that enables those seeking assistance to search for and compare facilities using various criteria.  Learn more about ATLAS’s expansion to Pennsylvania in this Department of Drug and Alcohol Programs new release and on the ATLAS web site.  The news release notes that in the fall of this year there will be an open enrollment period for facilities that missed the first deadline for inclusion in ATLAS.

COVID-19:  By the Numbers

• For the fourth consecutive week COVID-19 case counts in Pennsylvania fell, declining from a seven-day average of 2897 on June 15 to 1761 on June 22, a 39 percent decline.
• The seven-day average of COVID-19-related deaths fell by more than half, from 24 to 11, over the same period of time.
• The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units remained relatively unchanged over the past week.
• Fifty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 56 counties last week.  Two counties experienced a moderate rate of community transmission and the remaining ten experienced a substantial rate.

Stakeholder Events

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.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.