Pennsylvania Department of Human Services Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for November 14

The following is an update of selected state health policy developments in Pennsylvania from November 10 – November 14 (Some of the language used below is taken directly from state documents).

Budget Update

After a stalemate lasting 135 days, the General Assembly has passed a comprehensive Fiscal Year (FY) 2025-2026 budget. The state House of Representatives passed Senate Bill 160 – the General Appropriations Act – by a vote of 156-47. Senate passed it by a vote of 40-9.

In total, the FY 2025-2026 budget spends $50.1 billion, which represents a $2.3 billion or 4.7 percent increase over the prior fiscal year. It is nearly $1.4 billion less than the budget proposed by Governor Shapiro in February. The budget is balanced primarily by utilizing prior-year funding lapses and special fund balances in state agencies totaling $3 billion. Using these funds in the 2025-26 budget prevented draining the state’s emergency reserves in the Rainy Day Fund, while leaving more than $200 million in the fund’s balance.

The budget includes a new Working Families Tax credit program. However, it does not include many of the spending initiatives highlighted in the governor’s proposal, such as additional mass transit funding, taxation for skill games, minimum wage increases, or legalization and taxation of recreational adult use cannabis. Also part of the deal includes the Commonwealth ending its participation in the Regional Greenhouse Gas Initiative.

In addition to the General Appropriations Bill, the General Assembly also passed code bills related to the budget and its enactment. House Bill 416 is an amended Fiscal Code which includes various instructions to help effectuate passage of the budget bill. House Bill 749 is an update to the Human Services Code which includes several policy provisions below:

Regulatory alignment with federal rules on MA reimbursement for behavioral health in telehealth settings – the “Four Walls” Requirement,
Requires DHS to report to the General Assembly on SNAP recipient data and lottery winnings, resources, and vehicles owned by public assistance recipients
Crosschecking MA and SNAP beneficiaries with data from DOH’s Vital Records system and wage records from the Department of Labor & Industry
Requires DHS to study the feasibility of a brokerage model for nonemergency Medical Transportation Services
Allows indefinite suspension of MA benefits for incarcerated individuals while incarcerated, among other provisions.

General Assembly

On Monday, November 17^th, the House Human Services Committee will hold an informational hearing on the federal SNAP changes in HR 1 and their impacts on Pennsylvania. The livestream link will be made available here.

The House Health Committee will meet on Tuesday Nov. 18^th to consider HB 1652 and HB 1715. Both bills would amend the Newborn Child Testing Act to update newborn screening requirements to include Gaucher Disease (HB 1652) and Duchenne Muscular Dystrophy (HB 1715), respectively.

Department of Health

The Department issued a Health Alert Network notice urging providers’ awareness for Acute Flaccid Myelitis through late Fall.

DOH updated the residency criteria for the Chronic Renal Disease Program effective November 15, 2025.

Department of Human Services

DHS is launching Human Services Helpers, a Substack that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department has announced it has restarted issuing full November Supplemental Nutrition Assistance Program (SNAP) benefit payments.

DHS shared a suicide prevention resource guide in recognition of National Suicide Prevention Month.

The Department released a Medical Assistance Bulletin with revisions to the MA Fee Schedule and prior authorization requirements.

The Department issued an updated Preferred Drug List which will be effective Jan. 1, 2026.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

The Department released an updated Managed Care Directory.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

The DHS Medical Assistance Advisory Committee plans to meet December 4^th at 10am. You can register for the meeting here.

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-11-14T21:03:25+00:00November 14th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for November 7

The following is an update of selected state health policy developments in Pennsylvania from November 3 – November 7 (Some of the language used below is taken directly from state documents).

General Assembly and Budget Update

After Pennsylvania’s judicial and local election this past Tuesday, four members of the PA House won local elected offices which will require special elections early next year following their respective swearing-in to those offices. As Rep. Lou Schmitt, winner of a county judicial race indicated, “People were focused on the election… Now that the election is out of the way, people can go back to policy.” The House and Senate will have the opportunity to do so when both chambers are set to return on November 17^th.

On Monday, November 10^th at 10am, the Senate Democratic Policy Committee will hold a public hearing on supporting home care workers and consumers. The hearing can be streamed live here.

Department of Health

The Department’s Special Pharmaceutical Benefits Program released their approved covered drug list in their October Advisory Council meeting which will take effect on December 1^st. The Department also updated its list of Medicare Part C and D plans with premium payment agreements with SPBP for 2026.

Department of Human Services

DHS has issued helpful guidance and information to assist individuals in understanding the federal SNAP work requirements instituted earlier this fall.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

State Board of Medicine

The State Board of Medicine shared Education and Volunteer Services proposed regulations to add new mandatory education requirements and clarify the process for a volunteer license.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

DOH’s Infant Hearing Screening Advisory Committee will meet on Thursday Nov. 13^th from 10am – Noon.

The DHS Medical Assistance Advisory Committee plans to meet December 4^th at 10am. You can register for the meeting here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-11-07T20:33:35+00:00November 7th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 31

The following is an update of selected state health policy developments in Pennsylvania from October 27- October 31 (Some of the language used below is taken directly from state documents).

Budget Update

In a hopeful sign, top legislative leaders have met daily with the Governor and key staff throughout the week. The House and Senate are both set to return on November 17th. As negotiations continue, school districts and counties are adjusting services and payments to navigate the impasse.

General Assembly

During this week’s session, the House unanimously passed Rep. Ben Sanchez’s HB 446, allowing patients to take home unused medications following a hospital stay. The House also passed HB 1828, vaccine coverage and access legislation offered by Rep. Arvind Venkat, by a margin of 104-99. Both bills now move to the Senate for consideration.

The House Professional Licensure committee advanced Sen. Rosemary Brown’s SB 507. This legislation would update and modernize midwifery services in Pennsylvania.

The Senate Health & Human Services Committee voted to advance SB 270 and SB 614. Senator Amanda Cappelletti’s SB 270 would restrict online sales of human donor milk. SB 614, Chairwoman Michele Brooks’ legislation on FQHC Preceptors, was amended to limit the program to only rural areas.

The Senate Institutional Sustainability and Innovation Committee met to consider HB 157, SB 804, and SB 998. Rep. Kathy Rapp’s HB 157 would create a Rural Health Care Grant Program within the Department of Health. Senate Bill 804 from Sen. Boscola would prohibit toxic additives in IV Bags and medical equipment. Senate Bill 998, introduced by Rep. Rosemary Brown, would create a Nursing Education Capacity Expansion Grant Program within the Department of Community & Economic Development.

The House Health Committee held an informational meeting on the Department of Health’s Newborn Screening program on October 28^th where Rep. Sailsbury’s House Bill 1652 was discussed. This legislation would add Gaucher Disease to the Newborn Screening program.

The Senate State Government Committee held a hearing to discuss SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

The House Human Services Committee amended and advanced House Bill 1974 by Rep. Venkat. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee voted out HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

Rep. Danielle Friel Otten released a co-sponsor memo for legislation to require coverage of obesity treatments.

Rep. Wendy Fink introduced HB 1997 which allows autologous or directed blood donations for certain medical procedures.

Department of Human Services

The Department issued several changes to the MA Fee Schedule, adding procedure codes, prior authorization requirements, and changing units and limitations on procedure codes.

State Board of Nursing

The State Board of Nursing issued final form regulations effective upon today’s publishing in the PA Bulletin, but with provisions relating to organ & tissue donation taking effect May 1, 2026.

Independent Regulatory Review Commission

IRRC will consider DHS’ proposed Covered Outpatient Drugs Regulation at their November 20^th public meeting.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

DOH’s Infant Hearing Screening Advisory Committee will meet on Thursday Nov. 13^th from 10am – Noon.

DOH’s Spinal Cord Research Advisory Committee will meet on Friday Nov. 7^th from 8:30am – 9:30am.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-31T18:57:20+00:00October 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 24

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

Budget Update

Earlier this week, the Senate passed Senate Bill 160 (PN 1258) by party line vote in yet another volleying of a General Appropriations Act bill to the House. The Senate’s amendments to the bill reduced the overall spend number to $47.9 billion, down from the House’s last proposal of $50.25 billion.

The bill reflects a prior version (PN 529) of the budget bill but with increased appropriations for debt service payments and school employees’ pensions, while also reducing operating expense line items for the General Assembly. The Governor labeled the Senate’s most recent effort as “unserious.”

As the impasse continues, meaningful impacts to Pennsylvanians and providers are becoming more frequent. Absent budget enactment, Head Start providers are signaling closures, Westmoreland County plans to furlough workers soon, and Lancaster County intends to pause social services payments.

The House and Senate are both set to return on October 27^th.

General Assembly

Last week, the Senate was in session and passed by a margin of 49-1, Sen. Rosemary Brown’s SB 507, legislation to update and modernize midwifery services in Pennsylvania. The bill will be considered by the House Professional Licensure Committee on October 28^th.

The Senate Labor & Industry Committee voted in support of SB 69 offered by Sen. Langerholc by a party line vote. This bill would create a “Recovery-to-Work” pilot program.

Next week, on October 28^th, the House Health Committee will hold an informational meeting on the Department of Health’s Newborn Screening program.

On October 29^th, the House Human Services Committee will meet to consider Rep. Benham’s HB 1939, and House Bill 1974 by Rep. Venkat. HB 1939 would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee will meet on October 29^th to vote on HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

On October 27^th, the Senate State Government Committee will consider SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

Marla Brown introduced HB 1962 which would cease state funding for any provider offering abortion services in PA.
HB 1965, introduced by Rep. Ryan Bizzarro, would allow EMS providers to perform community paramedicine services.
Paul Takac introduced HB 1980 which would require doctors to do an hour of medical nutrition continuing education every two years.
Mastriano introduced SB 1018 which would eliminate any mRNA vaccine mandates in Pennsylvania.
SB 1041 by Sen. Rosemary Brown would create the Complex Care Assistant Program, creating a certification program for family caregivers offering complex medical care to loved ones.
Senator Tartaglione introduced SB 1054 which would require the availability of opioid antagonists in Pennsylvania public schools.
Senator Collett has introduced SB 1055, companion legislation to HB 1881, which would expand pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines.

Department of Human Services

The Department of Human Services released September’s Physical Health Managed Care enrollment report.

Department of Health

In response to revised CMS guidance on conducting facility surveys during the federal shutdown, which will allow states to request approval from CMS to conduct revisit surveys, DOH notified providers that it will be reviewing outstanding surveys, their timelines, and the deficient practice(s) to request permission from CMS to perform revisit surveys that are necessary to prevent termination or the denial of payment for new admissions.

DOH updated the Resident Data Reporting Manual for long-term care facilities to reflect changes to use the Patient Driven Payment Model (PDPM) for the Pennsylvania case mix payment system.

Stakeholder Meetings

On Nov. 7 from 10am to 3pm, the Brain Injury Advisory Board will hold their quarterly meeting to discuss the Department of Health’s Head Injury Program.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-24T19:20:42+00:00October 24th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 17

The following is an update of selected state health policy developments in Pennsylvania from October 14- October 17 (Some of the language used below is taken directly from state documents).

Budget Update

The budget process has remained at a stalemate this week with no changes following House action last week. The Senate is scheduled to return this upcoming week. The House is set to return on October 27^th.

General Assembly

Rep. Melissa Shusterman introduced HB 2005, which would remove the counseling and waiting period requirements for abortions in Pennsylvania. This legislation along with several other abortion-related bills will be considered by the House Judiciary Committee on October 22^nd.

The Senate Labor & Industry Committee will convene on October 22^nd to consider Sen. Wayne Langerholc’s SB 69, which would create a “Recovery-To-Work” pilot program.

Rep. Jessica Benham introduced HB 1939, which would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index.

Senator Michele Brooks introduced SB 1043 and SB 1051, both designed to strengthen Pennsylvania’s eligibility for new federal Rural Health Transformation Fund dollars. The funding application offers states additional points in their total application score if they have adopted certain policy priorities of the Trump Administration or introduced legislation to do so. SB 1043 would require nutrition continuing medical education (CME) for clinicians to ensure providers are better equipped to address diet-related chronic disease. SB 1051 would require PA to join the Physician Assistant Licensure Compact to expand our rural workforce by making it easier for PAs from other states to practice in Pennsylvania.

Sen. Brooks also introduced SR174, which would urge Congress to establish a national database or system to share wage, employment, unemployment compensation and other relevant eligibility data with the states to improve compliance with the recent eligibility verification changes in the federal HR1.

Senator Tina Tartaglione introduced SB 1054, which would require all high schools in Pennsylvania to maintain opioid antagonists, such as naloxone or Narcan, onsite.

Department of Human Services

The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) issued a request for proposals from non-profit organizations interested in expanding the Fairweather Lodge (FWL) model in the commonwealth. The FWL model is a structured, community-based program that supports individuals with serious mental illness reintegrate themselves into the community after facing homelessness or transitioning from state hospitals, correctional facilities, or long-term care settings. FWL providers offer emotional support, a place to live, and employment. OMHSAS is interested in establishing two to five new lodges that would serve up to 18 individuals. Find details and application materials here.

DHS issued Remittance Advice guidance for providers that do not receive a check or Remittance Advice (RA) within established time frames for each RA cycle.

DHS proposed rulemaking on minimum standards for the issuance of licenses to provide emergency behavioral health crisis intervention services in alignment with national best practices for crisis services. This proposed rulemaking also establishes new requirements related to service modalities including facility requirements, quality monitoring, staffing qualifications, services provided and training.

Department of Health

DOH issued a request for proposals from eligible community-based health care clinics (CBHCs) to fund the development of new CBHCs or the expansion of existing clinics to enhance maternity and postpartum care, hospital partnerships, or alternative care delivery systems. The deadline for applications is November 17. Find the RFP with more details and budgeting materials here.

Pennsylvania Insurance Department

PID announced the releasing of the final Affordable Care Act (ACA) health insurance rates for 2026, which reflect significant price increases for Pennsylvanians if Congress fails to extend enhanced premium tax credits (EPTCs).

Department of Aging

The Department of Aging (PDA) announced a new tool for screening in-home care workers to increase hiring transparency and protect older adults.

PDA reminded older Pennsylvanians that Medicare Open Enrollment begins October 15, with free insurance counseling available through Local Aging Agencies.

Stakeholder Meetings

DHS is hosting its next Medical Assistance Consumer Subcommittee meeting on October 22, 2025, at 1:00 pm. Interested attendees can register here. The full MAAC will meet at 10 a.m. on October 23^rdin the Keystone Building, Harrisburg.

DHS and the Treasury Department are partnering on a webinar on a PA Achieving a Better Life Experience (ABLE) Savings Program for OLTL Service Coordinators, Direct Service Providers, MCO Staff, and anyone working in employment support services. The webinar is scheduled for October 29^th from Noon to 1pm. Individuals can register here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-17T19:25:43+00:00October 17th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 10

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

Budget Update

Tensions rose in the continued budget impasse this week. As the stalemate reached 100 days, House Democrats amended and sent SB 160, a $50.25 billion budget bill, over to the Senate. All four caucuses and the Governor held press conferences staking out their respective positions and the path forward remains uncertain. The Senate placed itself on a 24-hour call-of-the-chair but is formally scheduled to return on October 20^th. The House is set to return on October 27^th.

General Assembly

Rep. Arvind Venkat introduced HB 1925, which would regulate the usage of AI in healthcare.

The House amended a technical amendment into HB 446 which would allow individuals to take dispensed, unused medications home with them following a hospital stay.

HB 1828, which requires private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by recognized authorities, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

HB 1881, which expands pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines, was reported from the House Insurance Committee as amended on a party-line vote, with Republicans voting in the negative.

The House Aging & Older Adult Services Committee unanimously passed HB 1894 which would enhance counseling of individuals on the LIFE program during the MA long term care enrollment process.

SB 507 was advanced by the Senate on second consideration and by the Senate Appropriations Committee and is positioned for third and final consideration. This bill would create a licensure pathway for certified midwives in Pennsylvania, allow midwives to prescribe treatment for opioid use disorder, and modernizes the current collaborative agreement structure.

Department of Drug & Alcohol Programs

DDAP, in partnership with CODE PA, announced improvements to the ordering process for PA’s Overdose Prevention Program through a streamlined application process.

Department of Human Services

In this week’s PA Bulletin, DHS announced the addition of targeted case management (TCM) services for eligible juveniles effective October 12, 2025. The Department will use existing payment methodologies for the physical health and behavioral health pre-release and post-release TCM services rendered to eligible juveniles being released from a carceral setting, with CMS approval. The Department will issue an MA Bulletin to advise enrolled providers of the addition of TCM for eligible juveniles to the MA Program Fee Schedule and instructions for billing these services.

Following Executive Order 2025-02 ,  DHS affirmed that Pennsylvania’s Medicaid program will continue to support access to vaccinations at no out-of-pocket cost for Pennsylvanians whose health care is covered by Medicaid and CHIP.

The Department issued a MA Bulletin Notice adopting the American Academy of Pediatric Dentistry’s Dental Periodicity Schedule.

The Department released the MCO Enrollment Report for August 2025.

Department of Health

The Department of Health Division of Acute and Ambulatory Care (DAAC) revised its policy on when facilities must notify DAAC in advance of certain events and removed the requirement to provide 30 days’ notice before adding new equipment. See the revised guidance here and email DAAC at RA-DAAC@pa.gov with any questions.

DOH has updated the forms that hospitals and ambulatory surgical facilities should use for exception requests. Follow the links on this document for the most current forms.

DOH issued a notice to facilities explaining that the department will be adhering to the CMS guidance for survey activities during the federal government shutdown. DOH will continue to conduct state and Medicaid only licensure, occupancy, and complaint surveys. Federal survey activities will be limited to the excepted surveys identified by CMS, including hospice surveys and other facility surveys involving allegations of immediate jeopardy or actual harm and survey-related activities associated with federal terminations from CMS. The department is awaiting CMS guidance on managing any follow-up activities related to surveys completed prior to September 30.

Stakeholder Meetings

PA Safety Net Admin2025-10-14T16:33:27+00:00October 10th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 3

The following is an update of selected state health policy developments in Pennsylvania from September 29- October 3 (Some of the language used below is taken directly from state documents).

Budget Update

As the state budget impasse continues on, with added pressure of a federal shutdown, this week the House positioned a budget bill, SB 160, into the House Appropriations Committee for future potential action. Additionally, the House amended HB 1331, Capital Debt Itemization legislation, with additional capital projects for future consideration.

General Assembly

Both the House and Senate will return for voting session beginning on Monday, October 6^th, the first time both chambers will be in voting session together since June. For the week ahead, the following hearings and voting meetings are scheduled:

On Monday, the House Aging & Older Adult Services Committee will hold a voting meeting on Chairwoman Maureen Madden and Chairman Steve Mentzer’s HB 1894, legislation which would enhance educational efforts for the LIFE program during the Medicaid long-term care enrollment process. The committee will also consider HB 1528, Grandfamilies Assistance legislation to benefit grandparents raising grandchildren.

On Tuesday, the House Insurance Committee will meet to consider HB 1828 which would set into law the Governor’s recent actions requiring private insurance coverage of vaccines without cost-sharing that are FDA-approved and recommended by the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACOP), or the American Academy of Family Physicians (AAFP) according to their immunization schedules. The committee will also consider HB 1123, updating the recommended age for insurance coverage of colorectal cancer screenings from 50 to 45.

On Wednesday, the House Professional Licensure Committee will consider adding a pharmacy technician and a second acute care institutional pharmacist to the State Board of Pharmacy through HB 980. Also, the committee will also consider HB 1881 which would guarantee that Pennsylvania pharmacists’ vaccination practice authority can be guided by recommendations from Pennsylvania’s health authorities that may be informed by our state’s professional medical societies.

Below are some health care-related legislation introduced or co-sponsorship memos circulated this week:

Rep. Marla Brown circulated a co-sponsor memo for legislation to remove staffing ratios for nursing homes in Pennsylvania.

Sen. Judy Ward released a co-sponsor memo on legislation to address lags in MA enrollment in long-term care.

Sen. Cris Dush filed SB 125 proposing a Constitutional Amendment giving the General Assembly the authority to establish laws on venues for civil litigation in the Commonwealth as a way to address venue shopping in malpractice cases.

Department of Human Services

The Department of Human Services (DHS) has shared an update for Community Service Support Provider fee-for-service rates for the start of the new federal fiscal year.

Department of Health

The Department of Health (DOH) issued a health alert with recommendations for health care providers to take in preparation for the 2025-2026 Respiratory Season, including details on reporting requirements. The Department also updated its Respiratory Virus Outbreak Toolkit, which gives recommendations to long-term care facilities on how to prepare for and respond to outbreaks of influenza, RSV, COVID-19, adenovirus, and more.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) approved final regulations from the State Board of Nursing making additions to the continuing education requirements for certified registered nurse practitioners (CRNP) and registered nurses (RN) in the areas of opioid prescriptions and organ donation.

Around the State

On Thursday, Governor Shapiro signed an Executive Order at the Children’s Hospital at Philadelphia directing the Department of Health to develop a plan to preserve access for children in the Vaccines for Children program without cost sharing if future Advisory Committee on Immunization Practices (ACIP) changes impact access, aligning vaccine guidance with American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Pediatrics (AAP), creating a website for vaccine information and guidance, ensuring insurance coverage without prior authorizations or cost sharing, among other points.

Stakeholder Meetings

DHS will hold their scheduled MAAC meeting on October 23, 2025, at 10am. Prior Authorization Guideline briefing documents are linked here (downloaded as zip file) for review and public comments are due as indicated on each document.

DOH announced upcoming meetings of several of its advisory committees:

Organ Donation Advisory Committee – November 6

Renal Disease Advisory Committee – October 24

Special Pharmaceutical Benefits Program Advisory Council – October 23

PA Safety Net Admin2025-10-03T21:07:51+00:00October 3rd, 2025|Governments, Medical Assistance Advisory Committee, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for September 26

The following is an update of selected state health policy developments in Pennsylvania from September 22- 26 (Some of the language used below is taken directly from state documents).

Budget Update

The state budget impasse continues to drag on. This week, the Senate was not in session but the House met for non-voting session. The Senate has scheduled a non-voting session day on October 3^rd and voting session on October 6^th through 8^th. As highlighted in this Penn Capital Star article, with transit funding handled through other means, counties and schools will become the pressure point as negotiations continue.

Treasurer Stacy Garrity announced the creation of a $500 million loan fund for counties and Head Start providers as a bridge for funding through the budget stalemate.

General Assembly

The House will return for voting session beginning on Monday, September 29^th. For the House session week ahead, the following hearings and voting meetings are scheduled:

Monday, Sept. 29, 9:30am – The House Aging & Older Adult Services Committee will hold an informational meeting on the PA CareKit Program. The Department of Aging will offer testimony.
Monday, Sept. 29, 10:45am – House Human Services Committee will meet to consider HR 290, a resolution recognizing the month of September 2025 as “National Recovery Month” in Pennsylvania.
Tuesday, Sept. 30, 10am – The House Consumer Protection, Technology, and Utilities Committee will hold a voting meeting to consider HB 1530 which would create privacy and transparency requirements genetic data collected through direct-to-consumer genetic testing.
Tuesday, Sept. 30, off-the-floor – The House Health Committee will hold a voting meeting on the following legislation:
HB 880 – Updating and closing loopholes within Pennsylvania’s Clean Indoor Air Act.
HR 271 – A Resolution directing the Joint State Government Commission to establish an advisory committee and conduct a comprehensive study regarding the indoor air quality for seniors and children in this Commonwealth.

Below is some health care-related legislation introduced or co-sponsorship memos circulated this week:

Arvind Venkat introduced HB 1881 which would guarantee that Pennsylvania pharmacists’ vaccination practice authority can be guided by recommendations from Pennsylvania’s health authorities that may be informed by our state’s professional medical societies.
Rich Irvin filed a co-sponsor memo which proposed transferring the pharmacy delivery model in Medical Assistance (MA) from Managed Care back to a Fee-For-Service model as a means to impact reimbursements for pharmacies.
Cris Dush filed a co-sponsor memo proposing a Constitutional Amendment giving the General Assembly the authority to establish laws on venues for civil litigation in the Commonwealth as a way to address venue shopping in malpractice cases.
Lynda Schlegel Culver filed a co-sponsor memo to provide MA coverage for rapid whole genome sequencing (rWGS) for critically ill infants up to one year of age who are admitted to an inpatient intensive care unit with a complex illness.
Senators Michele Brooks and Lisa Boscola filed a co-sponsor memo for a resolution urging Congress to provide Pennsylvania with any and all assistance to help comply with the recent federal changes following the One, Big, Beautiful Bill Act.

Department of Human Services

The Department of Human Services (DHS) issued guidance to providers related to “Date of Death Recovery” following a recent audit noting recipient date of death discrepancies where recipients were deceased prior to the dates of service being billed.

DHS’ Office of Developmental Programs issued guidance for flu, RSV, and COVID vaccinations.

Department of Health

The Department of Health (DOH) issued general immunization guidance to clinicians in response to last week’s federal ACIP meeting. The list clarifies organizations for doctors and families to consult on vaccine recommendations.

DOH issued a health alert to providers with guidance on when and how to exclude health care personnel from direct patient care when they are experiencing respiratory illness symptoms.

DOH reminded long-term care facility providers that the annual long-term care questionnaire is due by October 24. Facilities were contacted directly with instructions to complete the web-based questionnaire. Any questions should be directed to Aicha Hassane Noma at ahassaneno@pa.gov or email RA-dohbhssurveys@pa.gov.

Insurance Department

The Pennsylvania Insurance Department has confirmed the private insurance companies operating in the Commonwealth will continue to cover all of the vaccines covered under ACIP’s 2024 recommendations.

Around the State

A group of statewide researchers have compiled a website which aims to track opioid settlement fund spending data in Pennsylvania, which is driven out primarily through counties.

Stakeholder Meetings

Medical Assistance Advisory Committee

The following materials presented at the September 25^th meeting of the MAAC have been posted on the MAAC website:

PA Safety Net Admin2025-09-26T19:05:37+00:00September 26th, 2025|Governments, Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues, Uncategorized|Comments Off

PA Health Policy Update for September 19

The following is an update of selected state health policy developments in Pennsylvania from September 15- 19 (Some of the language used below is taken directly from state documents).

Budget Update

The state budget impasse continues, and the House and Senate did not meet in session in Harrisburg this week. Various potential budget bills are positioned to be passed within a few days of a deal being reached. This article from Spotlight PA offers insight on the issues that are still preventing a deal, even as the issue of transit funding was taken out of the mix when the governor released funding to SEPTA and other regional authorities last week. The caucuses continue to disagree on issues including the overall spending amount, welfare program reforms, school choice, and education funding.

The Senate stands in recess to the call of the President Pro Tempore and the House will return for non-voting scheduled session on Monday, September 22.

General Assembly

Although legislators are not present at the Capitol, they have circulated a number of health care-related co-sponsorship memos this week:

Senator Michele Brooks (R), chairwoman of the House Human Services committee, issued a co-sponsorship memo about her intent to introduce a series of bills designed to strengthen Pennsylvania’s eligibility for new federal funding streams under the Rural Health Transformation Fund that was designed in the One, Big Beautiful Bill Act (OBBBA). The funding application offers states additional points in their total application score if they have adopted certain policy priorities of the Trump Administration or introduced legislation to do so.
House Aging & Older Adult Services Committee Chairs Maureen Madden (D) and Steve Mentzer (R) have circulated a co-sponsorship memo to introduce legislation intended to help ensure Pennsylvanians are fully informed of the Living Independence for the Elderly (LIFE) as an available long-term care option.
Senator Tim Kearney (D) circulated a memo announcing his plan to introduce a bill to create an all-payer claims database in Pennsylvania. This was an initiative in the governor’s budget proposal, which sought to allocate $4 million for the Pennsylvania Health Care Cost Containment Council (PHC4) to develop that tool.

Pennsylvania Commission on Crime and Delinquency

The Pennsylvania Commission on Crime and Delinquency (PCCD) is accepting applications for funding under the Local Hospital-based Violence Intervention Program (HVIP) Supports grant program. HVIPs are multidisciplinary programs that connect violently injured patients with trauma-informed care and long-term community supports that start at the emergency department or at the hospital bedside. Local governments should apply for this funding in collaboration with a designated provider, nonprofit organization, or institution of higher education. View the full notice of funding here. Applications are due October 30.

Department of Human Services

The Department of Human Services (DHS) issued a Provider Quick Tip to notify providers that the commonwealth’s Sterilization Consent Form (MA 31) will be issued soon with updates to reflect changes to the federal Consent for Sterilization Form (HHS-687). Stay tuned to this health policy update for an announcement of the updated form when it is released.

DHS has updated its calendar of Remittance Advice mailing dates to include October dates.

Department of Health

The Department of Health (DOH) added new training material to the Project Firstline training portal, which offers free on-demand training on infection prevention and control for all frontline workers in Pennsylvania. The new training is tailored for environmental services staff and discusses the importance of hand hygiene and the critical moments when hand hygiene matters most for these staff members. See this and more trainings and posters on the Project Firstline webpage and request free training materials through this form.

DOH issued the new income eligibility guidelines that will be used in the Special Pharmaceutical Benefits Program (SPBP) effective on October 1, 2025 for new enrollees and on the next date of renewal for any current program participants. The SPBP provides FDA-approved medications to low-income individuals living with HIV who are uninsured or have limited health care coverage. The department explained that due to the recent unprecedented increase in both program enrollment and the overall cost of medications, it is necessary for SPBP to lower the income limits as a measure to sustain the long-term viability of SPBP. Individuals that lose SPBP eligibility are encouraged to explore options on Pennie.

Around the State

Pennsylvania has joined a consortium of northeast states to make collaborative decisions about vaccination guidance and emergency response, in the wake of changes to the Centers for Disease Control and Prevention (CDC) vaccine approval process. See details in this article by the Pennsylvania Capital Star.
Several PA publications, including WHYY, raised the alarm this week about how 2026 costs could increase for Pennsylvanians who get their insurance coverage in the ACA marketplace unless Congress acts to expand enhanced federal tax credits. The PA Insurance Department reported that statewide average premium costs could increase by about 19 percent. The Kaiser Family Foundation has created a cost estimator tool for individuals to get personalized estimates of their costs with and without the tax credits.

Stakeholder Meetings

Medical Assistance Advisory Committee (MAAC) – Sept. 25

The DHS Medical Assistance Advisory Committee will meet virtually on September 25, 2025, at 10:00am. To register, click here.

PA Safety Net Admin2025-09-22T14:10:02+00:00September 19th, 2025|Meetings and notices, Pennsylvania proposed FY 2026 budget|Comments Off

PA Health Policy Update for September 12

The following is an update of selected state health policy developments in Pennsylvania from September 8- 12 (Some of the language used below is taken directly from state documents).

Budget Update

The state budget impasse continues, more than ten weeks past the constitutional deadline. Senate Majority Leader Pittman told reporters this week that he is “encouraged by the meaningful work at the negotiating table” but there is no agreement on a final budget at this time. Various potential budget-related bills continue to be positioned in order for a completed budget to be passed within a few days of a budget deal being reached. The Senate stands in recess to the call of the President Pro Tempore and the House stands adjourned until Monday, September 22, 2025 unless sooner recalled by the Speaker.

General Assembly

The Senate met for voting session this week. The following is a summary of health care related legislative activity:

The Senate passed SB 381 that would prohibit the use of commonwealth funding for certain animal testing activities in research facilities. The bill will be sent to the House for consideration.

The Senate Consumer Protection and Professional Licensure committee favorably reported SB 507 with amendments. The bill provides for licensure of certified midwives, allows them to prescribe treatment for opioid use disorder, and seeks to modernize the collaborative agreement structure for midwives.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) issued comments on the State Board of Nursing’s proposed regulations for the certified registered nurse anesthetists. See IRRC’s comments in this Pennsylvania Bulletin notice. The nursing board is required to address IRRC’s comments and questions when issuing its final form regulations.

Department of Human Services

The Department of Human Services (DHS) updated its list of Remittance Advices with information on a new ADA claim form that should be used for dental claims with dates of service after November 1, 2025. See the alert here.

DHS issued its 2024 Annual Report from the Bureau of Human Services Licensing, which licenses personal care homes and assisted living residences. The report shows data on the number of facilities, patient census and demographics, and facility incidents and complaints. Click here for the full report.

The Office of Long-Term Living is accepting statements of interest from new and existing Living Independence for the Elderly (LIFE) program operators to serve 12 counties that do not yet have LIFE program services available for seniors age 55 and older. Click here to view the announcement in the Pennsylvania Bulletin with instructions on how to request information about the application and evaluation process.

DHS issued an Medical Assistance Bulletin with updates to the Dental Fee Schedule. These updates include revised frequency and unit limitations for several codes as well as a change in age limits for two codes. These changes are considered effective as of August 1, 2025.

Around the State

An article from the Penn Capital Star explores the ways in which health care providers in Pennsylvania are already responsibly using artificial intelligence (AI) amid discussions from lawmakers to introduce legislation to regulate AI use in health care.
ABC27 describes the geographic split that may be compounding the political split between legislative leaders as the budget impasse wears on. With caucus leaders from opposite sides of the commonwealth and regional transit funding issues at the core of negotiations, “There’s no question geography of the membership and leadership members has played a role,” said Senate Minority Leader Jay Costa (D-Allegheny).
Though it is not an unusual financing move for many school districts, the Philadelphia district this week voted to borrow up to $1.55 billion (WHYY) to support services during the state budget impasse. Because of the lack of state and federal funds, this year’s borrowed amount is $1 billion more compared to previous years, costing millions more in interest payments for the district.

Stakeholder Meetings

Medical Assistance Advisory Committee (MAAC) – Sept. 25

The DHS Medical Assistance Advisory Committee will meet virtually on September 25, 2025, at 10:00am. To register, click here.

Department of Drug and Alcohol Programs Emerging Drug Trends Symposium – Nov. 18

DDAP will host its 2025 Emerging Drug Trends Symposium on November 18 from 7:00am to 4:00pm at the Penn Harris Hotel & Conference Center in Camp Hill, PA. Attendees will discuss the latest drug use and overdose trends in PA, shifting overdose patterns and drug supply, and evidence-based best practices. Click here to register for this free event.

PA Safety Net Admin2025-09-12T21:51:32+00:00September 12th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off

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