SNAPShots

SNAPShots

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.

2025-09-12T21:51:32+00:00September 12th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for September 12

PA Health Policy Update for September 5

The following is an update of selected state health policy developments in Pennsylvania from September 1 – 5 (Some of the language used below is taken directly from state and federal documents). 

Fiscal Year 2025-26 Budget Update 

There was no legislative activity surrounding the state budget this week. Governor Shapiro sent a compromise budget proposal to Senate Republican leadership last week, but they have yet to take any action. The Senate is scheduled to return to session next week on September 8, but that date could be pushed back if an agreement is not ready.

The House stands adjourned until September 22.

Department of Health

The Department of Health (DOH) issued interpretative guidance to clarify staffing regulations for hospitals, allowing for flexible physician coverage models while maintaining patient safety and regulatory compliance. It focuses on on-site, on-call, and telemedicine-based physician coverage requirements. Review the full document here. 

Department of State

The State Board of Pharmacy met this week and voted to approve four new entities as “competent authorities” to issue guidelines for licensed pharmacists under 49 PA Code § 27.403 on the use of injectable immunizations. This action was taken in anticipation of changes from the Centers for Disease Control’s upcoming vaccine committee meeting and will permit pharmacists to continue providing COVID-19 vaccinations, which had been paused by some providers. Find a news release about the voting meeting here.

Department of Human Services 

The Department of Human Services (DHS) updated its list of Remittance Advices with an updated participating drug company list for the Medicaid Drug Rebate Program. Find the updated list here.

The Offices of Long-Term Living and Medical Assistance Programs issued a Medical Assistance bulletin alerting providers that it will begin issuing electronic visit verification (EVV) alerts to providers whose EVV manual entry percentages exceed 15 percent for the previous quarter. These alerts will be sent directly by DHS for fee-for-service claims and the department will transmit a list of noncompliant providers to the appropriate managed care organizations for awareness and follow up.

The Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) Letter jointly developed by CMS and the Substance Abuse and Mental Health Services Administration (SAMHSA). This SHO provides guidance to states on the best practices for implementing the continuum of crisis services. It describes specific Medicaid and CHIP authorities and flexibilities to support the full continuum of crisis response services and suggests strategies for measuring and monitoring crisis response services. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 released a new interactive map displaying access to care in different counties, called MAPPED 2. This resource includes hospitals, ambulatory surgery centers, and nursing homes. It was designed to help patients, legislators, and health care providers learn more about the health care landscape of Pennsylvania. 

Around the State  

  • A Philadelphia judge has directed SEPTA to immediately reverse all service cuts imposed last month. WHYY reports on the decision in this article.
  • The Penn Capital Star reported on the state pharmacy board’s decision this week to permit additional professional organizations to issue guidance for immunizations.
  • An article from the Altoona Mirror details the financial strain and difficult decisions that are facing county providers and non-profits now that the state budget is two months late. 

Stakeholder Meetings

DHS Statewide Positive Approaches & Practices Conference – September 17

This quarterly meeting is jointly hosted by The Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs (ODP). It aims to provide the most recent research and resources for people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities to live an everyday life. The meeting is held virtually from 10am to 3pm. For details and registration, click here.

Dual Diagnosis Professional Conference Series – September 18

Jointly hosted by OMHSAS and ODP, this presentation will review the clinical clues for identifying the effects of fetal alcohol spectrum disorder, suggestions for screening, current research, and statistics. The meeting is held virtually from 9am to 12:30pm. Click here to register.

2025-09-05T19:11:23+00:00September 5th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for September 5

PA Health Policy Update for August 29

The following is an update of selected state health policy developments in Pennsylvania from August 25 – 29.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update

There was no legislative activity surrounding the state budget this week, with both houses in recess, but officials continue their informal negotiations. The budget impasse is expected to extend into mid-September.

Governor Shapiro pitched an amended budget to legislative leaders, which would increase spending by 5% rather than the 8% increase proposed in February. Democrats, including House Majority Leader Matt Bradford, showed a new willingness to help support transit operating budgets through a special trust fund – as pitched by the Senate Republicans earlier in August – if there could be a plan to replenish that fund with new revenue sources. For more perspectives and statements from other legislators on the budget, see this Spotlight PA article.

The House stands adjourned until September 22 and the Senate until September 8. 

Department of Human Services 

The Department of Human Services (DHS) shared several resources from the federal government on how individuals can take action to move their Social Security benefit payments to electronic payments before the September 30, 2025 deadline after which paper checks will no longer be issued to beneficiaries. This action is particularly important for administrators of personal care and assisted living facilities who may be receiving checks on behalf of their residents. DHS will host a webinar for providers on September 10 at 1pm.

DHS updated its Medicaid managed care organization directory for September 2025. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) will kick off Recovery Month next week, with events continuing throughout September. For event details taking place throughout the state click here.

Pennsylvania Health Insurance Exchange Authority

Pennie, Pennsylvania’s official health insurance marketplace, in coordination with Health Market Connect LLC (HMC), the newly appointed contractor of Pennie’s Assister Network, are launching a new network of regional organizations dedicated to providing localized support throughout the Commonwealth. 

Around the State  

  • An op-ed from a retired county mental health commission member published in PennLive details the risk that the budget impasse poses to Pennsylvania’s behavioral health safety net.
  • WHYY reported on the state of traffic and commute disruptions in light of the current SEPTA service reductions and predicts how the situation will change as more cuts come into place next week.
  • The Pittsburgh area NPR partner, WSEA, hosted a story about how their regional transit authority’s cuts to the paratransit and ride share program will impact individuals living with disabilities. 

Stakeholder Meetings

Patient Safety Authority – Sept 16

The Patient Safety Authority established by the MCARE Act will hold a virtual board meeting on September 16 at 1pm. For registration and meeting instructions, see this PA Bulletin notice.

Pennsylvania Association of Addiction Professionals (PAAP) Annual Conference – Sept 18

The PAAP annual conference will take place in Trevose, PA on September 18 from 8:00 am to 4:30 pm. The addiction-specific educational experience will feature immersive training sessions, an exhibit hall, and networking opportunities. For more information and to register, click here.

2025-09-02T13:49:51+00:00August 29th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for August 29

PA Health Policy Update for August 22

The following is an update of selected state health policy developments in Pennsylvania from August 18 – 22.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update 

There was no legislative activity surrounding the state budget this week, with both houses in recess, but officials continue their informal negotiations. The budget impasse is expected to extend into mid-September.

The House stands adjourned until September 22 and the Senate until September 8. 

Department of Human Services 

The Department of Human Services (DHS) added a new PROMISe Banner page with information on a New Batch EDI Translator effective September 2025. For additional information see the EDI as a Service FAQ here. 

Department of Health 

The Department of Health alerted providers and public health officials about a late-summer surge in COVID-19 cases that is expected to peak in September. Find information on how to handle this sharp increase in cases in this health alert.

The Department of Health alerted Pennsylvanians that an individual from another state who was contagious with measles visited multiple locations across the state, creating a potential for exposure to others in this health alert 

Pennsylvania Healthcare Cost Containment Council (PHC4) 

PHC4 publicly released new County-Level Condition-Specific and County-Level Utilization reports today, giving insight into ambulatory/outpatient usage and hospitalization rates of high interest conditions, using the most recent data available.  

Around the State  

  • The Altoona Mirror reported on the efforts of PA legislators to introduce the state’s own Medicaid work requirements in response to the federal requirements passed as part of the One Big Beautiful Bill Act. 
  • Counties and providers of human services explain how they are bracing for the protracted state budget standoff in this article from the Pennsylvania Capital Star. 
  • City + State profiled State Treasurer Stacy Garrity in this article after she announced her candidacy for governor in 2026. 
  • Attorney General Dave Sunday announced that an agreement has been finalized that ensures free access to personal medical records for thousands of patients — including Medicaid patients — formerly treated at Crozer Health hospitals. 

Stakeholder Meetings

HIV Community Prevention Planning Committee – September 10 

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting (in-person and virtually) on Wednesday, September 10, 2025, from 9 a.m. to 12 p.m. For registration information click here.

PHC4 Committee Meetings – August – September

The PA Health Care Cost Containment Council (PHC4) announced the following meetings

  • Education Committee meeting (August 28, 2025, at 10 a.m.)
  • Council meeting (September 4, 2025, at 10 a.m.)
  • Payment Data Advisory Group meeting (September 11, 2025, at 10 a.m.)

Individuals who wish to participate may contact rgreenawalt@phc4.org at least 24 hours in advance. 

MAAC – July Meeting Materials 

The Department of Human Services (DHS) published the meeting materials from the July meeting of the Medical Assistance Advisory Committee (MAAC):

2025-08-23T01:22:42+00:00August 22nd, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for August 22

PA Health Policy Update for August 15

The following is an update of selected state health policy developments in Pennsylvania from August 4 – August 15.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update 

While there has been considerable activity surrounding the state budget impasse, the passage of budget and mass transit legislation remains largely about political positioning rather than tangible progress toward a final budget for this fiscal year. It appears likely the budget impasse will extend into September.

The House stands adjourned until September 22 and the Senate until September 8. 

Department of Human Services 

The Department of Human Services (DHS) is taking steps to inform the commonwealth’s Rural Health Transformation Plan that will be required for submission to the federal government to receive an award of rural health funds that were included in the One Big Beautiful Bill Act. DHS is seeking feedback in the following areas as well as any ideas that help improve access in rural communities:

  • maternal health
  • mental and behavioral health
  • aging and access
  • transportation and EMS
  • rural healthcare workforce

Respondents should use this online form to submit feedback by August 29.

DHS has updated a guidance document for providers participating in the DHS Breast & Cervical Cancer Prevention & Treatment Program.

DHS’s calendar of Remittance Advice Dates has been updated to include September 2025. 

Department of Health

The Department of Health (DOH) is looking for feedback on the development and implementation of a virtual and/or hybrid skills assessment examination process for nurse aides entering the long-term care sector in Pennsylvania. DOH is interested in learning about existing models, technologies, operational logistics, training and credentialing frameworks, and regulatory considerations that support successful and scalable virtual nurse aide skills examination solutions. For more information and instructions for how to submit a response to this RFI here. 

Around the State 

  • Broad + Liberty discusses the impact of private equity and health care bankruptcies on patient access to care in this article related to the closure of Crozer-Chester hospitals in southeast Pennsylvania.
  • Spotlight PA in this article highlighted how the legislative action from this past week has only deepened the budget impasse in Harrisburg. 

Stakeholder Meetings

OMHSAS – Certified Recovery Specialist Feedback Sessions (Sept-Oct) 

The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) is hosting six stakeholder sessions to gather feedback on Certified Recovery Specialists (CRS) services within the Medicaid program. The intended audience includes county mental health providers, CRS, and CRS supervisors. Click here for registration information.

2025-08-15T20:00:26+00:00August 15th, 2025|Meetings and notices, Pennsylvania Rural Health, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for August 15

PA Health Policy Update for August 1

The following is an update of selected state health policy developments in Pennsylvania from July 28 – August 1.  (Some of the language used below is taken directly from state documents).

The SNAP State Health Policy Update is taking a summer break and will return on August 15 with more health policy news. 

Fiscal Year 2025-26 Budget Update 

Governor Shapiro and legislative leaders continue to negotiate a final Fiscal Year (FY) 2025-26 budget agreement. The state House of Representatives and Senate are currently in recess pending a final budget agreement.  

The Senate Republican Policy Committee is holding an informational meeting on August 5 regarding mental health services at the Geisinger Behavioral Health Center in Danville, PA. 

Department of Human Services  

DHS has issued Provider Quick Tip #278 indicating DHS has experienced a delay in implementing the updates noted in Medical Assistance (MA) Bulletin 99-25-03 titled, “Updates to Screening Guidelines for Prior Authorization”.  This MA Bulletin advised providers that the Department would transition from InterQual guidelines to Milliman Clinical Guidelines (MCG) as the screening guidelines for prior authorization requests to determine medical necessity for services, items, procedures, or level of care provided to MA beneficiaries in the Fee-for Service (FFS) delivery system, effective July 18, 2025.

The Department of Human Services has published in this week’s Pennsylvania Bulletin final-form rulemaking to amend a data element in the department’s case-mix payment system for nonpublic and county nursing facilities to utilize the Patient Driven Payment Model (PDPM) in place of the Resource Utilization Groups, Version III (RUG-III) classification system in setting Medical Assistance (MA) payment rates for nursing facilities. 

Department of Health 

The Department of Health (DOH) recently shared a message from the Pennsylvania State Police (PSP) asking health care operators for assistance investigating an individual who is accused of using several aliases to pose as a licensed practical nurse, registered nurse, and RN supervisor at multiple facilities in the commonwealth. Providers are asked to review their employment records and report new information to PSP directly. Find more information in this PSP notice. 

The Department of Health (DOH) is coordinating the statewide distribution of free potassium iodide (KI) tablets on August 14 for all Pennsylvanians who live, work, or study within 10 miles of the four active nuclear power plants in the Commonwealth.  The press release can be found here.

Department of Aging 

The Shapiro administration announced the members of an advisory committee to support the newly created Alzheimer’s Dementia and Related Disorders Office in the Department of Aging.

Around the State  

  • Secretary of the Budget Office, Uri Monson, penned letters to local educational leaders and county public welfare providers explaining which funds will not be able to be distributed during the budget impasse. Find more information and copies of the letters in this Spotlight PA article.
  • Less than half of Pennsylvania hospitals are complying with federal price transparency requirements, according to a new study discussed in this article from Erie News Now. 
  • The Philadelphia Inquirer reported on the nutritional value of food in hospitals and how some providers are working to improve it in this article. 
  • Spotlight PA launched the first in a series of articles called The Cost of Failing, which will analyze and chronicle mental health spending and services in all 67 counties over the last few state administrations to show how many fewer people receive mental health services in the commonwealth today than just a few years ago.
  • City & State reports on how rural hospitals across Pennsylvania are bracing for steep financial stress following the passage of the “One Big Beautiful Bill” and how these hospitals, which rely heavily on Medicaid revenue, face escalating risks of closures and service reductions as proposed cuts drive up uncompensated care and threaten stability in already vulnerable rural communities. 

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – August 6

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on August 6 at 10:00 a.m. The meeting will be held virtually. Register to participate here. 

DOH – Organ Donation Advisory Committee – August 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

2025-08-01T20:53:57+00:00August 1st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for August 1

PA Health Policy Update for July 25

The following is an update of selected state health policy developments in Pennsylvania from July 21 – July 25.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update 

Governor Shapiro and legislative leaders continue to negotiate a final Fiscal Year (FY) 2025-26 budget agreement. The state House of Representatives and Senate are currently in recess pending a final budget agreement.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has informed states, including Pennsylvania, that it “does not anticipate approving new state proposals of section 1115 demonstration expenditure authority that allow for expanded continuous eligibility or extending existing section 1115 demonstration authority for expanded continuous eligibility, beyond what is required or available under the Medicaid or CHIP statutes.” This will likely prevent Pennsylvania from implementing continuous eligibility for children on Medicaid until the age of six and 12 months of Medicaid coverage to individuals leaving state correctional facilities. 

Department of Human Services 

The Department of Human Services (DHS) has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of June 2025.

DHS has announced that the Human Services Provider Directory has moved to a new web address. The new address is https://www.humanservices.dhs.pa.gov/human_service_provider_directory/. 

Department of Health 

The Department of Health (DOH) has announced the launch of seven new training opportunities to assist health care providers reduce overdose risk and improve patient outcomes. Training is available online and in-person at no cost and includes continuing education credits for health care providers. Find additional information in this press release. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of its Cardiac Procedures Report, which includes results for six cardiac procedures performed in Pennsylvania acute care hospitals from January 1, 2022 through December 31, 2023. This report displays hospital-specific ratings for in-hospital mortality, readmissions, extended postoperative length of stay, volume of cases, and average hospital charges. 

Board of Dentistry 

The State Board of Dentistry has published final form rulemaking to implement licensure by endorsement for dentists. The rulemaking is effective upon its publication in the Pennsylvania Bulletin. Find the final rulemaking here.

Board of Examiners in Speech-Language Pathology and Audiology

The State Board of Examiners in Speech-Language Pathology and Audiology has published final form rulemaking to implement licensure by endorsement. The rulemaking is effective upon its publication in the Pennsylvania Bulletin. Find the final rulemaking here. 

Around the State

 

  • Spotlight PA has published a piece on the closure of pharmacies across Pennsylvania and the broken payment system that’s being blamed for their closure. 
  • Pennsylvania’s ongoing budget impasse and the impact it will potentially have on schools, county governments, and mass transit was the focus of an article published by The Philadelphia Inquirer. 
  • PennLive has written an article about the potential for additional rural hospital closures due to the federal changes in H.R. 1 that will impact Medicaid funding for hospitals.  

Stakeholder Meetings

DHS – Long-Term Services & Supports Subcommittee – August 6

The Long-Term Services and Supports (LTSS) Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold its next public meeting on August 6 at 10:00 a.m. The meeting will be held virtually. Register to participate here. 

DOH – Organ Donation Advisory Committee – August 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

2025-07-25T19:33:08+00:00July 25th, 2025|Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for July 25

PA Health Policy Update for July 18

The following is an update of selected state health policy developments in Pennsylvania from July 14 – July 18.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update

Governor Shapiro and legislative leaders continue to negotiate a final Fiscal Year (FY) 2025-26 budget agreement. The state House of Representatives and Senate briefly convened in Harrisburg this week to position House Bill 1330, which provides for appropriations from the General Fund, to enable the budget to be swiftly enacted when an agreement is reached. Both chambers are currently recessed pending a final agreement.  

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The House of Representatives unanimously passed House Bill 564, which requires the Department of Human Services (DHS) to implement a campaign to increase public understanding and engagement with the 988 suicide and crisis lifeline. The bill will now be sent to the Senate for consideration.
  • The Senate passed Senate Bill 604, which authorizes the state to join the National Counseling Compact. The bill was subsequently sent to the House of Representatives and referred to the Professional Licensure Committee.
  • The Senate Health & Human Services Committee met on Thursday, July 17 and favorably reported House Bill 1429, which requires a study on the feasibility of implementing chip-enabled electronic benefit cards (EBT) for the Supplemental Nutrition Assistance Program (SNAP), and House Bill 1527, which extends the Rare Disease Advisory Council’s sunset date to 2028.
  • The Center for Rural Pennsylvania held an informational hearing on Wednesday, July 16 regarding health care provider policies that have been implemented in other jurisdictions to address the shortage of health care workers in rural areas. A recording of the hearing is viewable here.

Department of Human Services

The Department of Human Services (DHS) has issued a Remittance Advice  (RA) related to its previous announcement that it will begin to mass adjust claims submitted for discharge dates October 1, 2024 through June 6, 2025 due to a delay in implementing Version 42 of the APR DRG classification system for Medical Assistance (MA) enrolled acute care general hospitals.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of August. Find the updated calendar here. 

Department of Health 

The Department of Health (DOH) has issued final notice to temporarily schedule any material, compound, mixture or preparation which contains any quantity of the following Nitazene substances, their salts, isomers and salts of isomers: Butonitazene, Etodesnitazene, Flunitazene, Isotonitazene, Metodesnitazene, Metonitazene and Protonitazene. This final order to temporarily schedule will temporarily categorize this class of compounds as Schedule I controlled substances. Find more information in this press release. 

Department of Drug & Alcohol Programs  

The Department of Drug & Alcohol Programs (DDAP) along with the Department of Human Services has announced that licensing staff from both agencies will begin conducting coordinated annual inspections of substance use disorder (SUD) and mental health treatment facilities that are licensed by both agencies for outpatient, partial hospitalization and residential services. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.  

Around the State  

  • The Pennsylvania Capital-Star has written an article about the potential impact of the recently enacted federal reconciliation package on Medicaid coverage in the Pittsburgh area.
  • Spotlight PA has published a piece about the board that oversees how Pennsylvania counties spend opioid settlement money and how it operates outside of the state’s transparency laws.
  • WESA has published an article about Pennsylvania’s FY 2025-26 budget, which is more than two weeks late, and the state of negotiations.   

Stakeholder Meetings

DHS – Consumer Sub-MAAC – July 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – July 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Organ Donation Advisory Committee – August 7

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 7 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

2025-07-18T20:47:25+00:00July 18th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for July 18

PA Health Policy Update for July 11

The following is an update of selected state health policy developments in Pennsylvania from July 7 – July 11.  (Some of the language used below is taken directly from state documents). 

Fiscal Year 2025-26 Budget Update 

Governor Shapiro and legislative leaders continue to meet and negotiate in an attempt to reach a final agreement on the commonwealth’s Fiscal Year (FY) 2025-2026 spending plan, which is 11 days overdue. As discussions continue, the Senate is recessed until the call of the chair and the House is currently scheduled to return to session on Monday, July 14. 

Governor Shapiro 

Governor Shapiro signed the following bills into law this week.

  • House Bill 309, now known as Act 29 of 2025, amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license.
  • Senate Bill 95, now known as Act 34 of 2025, permits EMS providers to leave naloxone with a caregiver of a patient who overdosed. The bill also places certain disclosure requirements on pharmacies related to the retail and generic versions of prescribed medications and allows for the provisional licensing of pharmacists. 

The Shapiro administration has announced that Pennsylvania is a full participant in three multistate licensure compacts that will streamline the licensure process for physicians, nurses, and physical therapists. 

General Assembly

The state House of Representatives convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The House of Representatives passed House Bill 1697 by a vote of 136-67. House Bill 1697 establishes a state level false claims act. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 80, which authorizes the commonwealth to join the Audiology & Speech-Language Pathology Interstate Compact. The bill will now be sent to the Senate for consideration.

The House of Representatives is currently scheduled to return to session on Monday, July 14. The Senate is recessed until the call of the chair.

Department of Human Services 

The Department of Human Services (DHS) has announced that it experienced a delay in implementing Version 42 of the APR DRG classification system for Medical Assistance (MA) enrolled acute care general hospitals. As a result of the delay, DHS will begin to mass adjust claims submitted for discharge dates October 1, 2024 through June 6, 2025. Find additional information in Provider Quick Tip #275.

DHS has announced it will hold another listening session in its “Food is Medicine Stakeholder Engagement Series,” which is part of the Bridges to Success: Keystones of Health demonstration waiver. The next session, which will focus on pregnancy food boxes, will take place on June 21 at 1:00 p.m. Find additional information and registration details here. 

Department of Community & Economic Development

The Department of Community & Economic Development (DCED) has announced it will publish its draft action plan for the 2024 Allocation of Recovery Housing Program for public review and comment beginning July 12. The federal Department of Housing and Urban Development awarded Pennsylvania $1.2 million of Recovery Housing Program funds, which will be administered by DCED. The purpose of the program is to help grantees to provide stable, temporary housing to individuals in recovery from a substance disorder. Find additional information in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission (IRRC) 

The Independent Regulatory Review Commission (IRRC) has published notice in the Pennsylvania Bulletin of recent actions taken by the commission, including the approval of the following pertinent regulations.

Around the State  

Spotlight PA has published an article about the potentially negative impacts the federal reconciliation package passed by Congress and signed into law by President Trump will have on access to rural health care.

The Philadelphia Inquirer has written a piece about the Pennie, Pennsylvania’s state-based insurance marketplace, and the impact on enrollment if Congress doesn’t extend the enhanced tax credit subsidies. 

Stakeholder Meetings

DOH – HIV Planning Group – July 16-17

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, July 16 from 9:00 a.m. to 4:00 p.m. and on Thursday, July 17 from 9:00 a.m. to 2:30 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – WIC State Advisory Board – July 22

The WIC State Advisory Board has announced its next regular meeting of the board will be held on July 22 from 1:00 p.m. to 2:00 p.m. The purpose of this meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – August 7

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, August 7 from 12:00 p.m. until 3:00 p.m. at 6340 Flank Drive, Harrisburg, PA 17112. The meeting will be conducted in person only. Find information on how to RSVP in this Pennsylvania Bulletin notice.

2025-07-11T20:14:15+00:00July 11th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for July 11

PA Health Policy Update for June 27

The following is an update of selected state health policy developments in Pennsylvania from June 23 – 27.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate unanimously voted to concur with the House’s amendments to Senate Bill 411, which provides the ability for the Pennsylvania Department of Health to create and utilize a stroke registry. The bill will now be sent to Governor Shapiro’s desk for his signature.
  • The Senate unanimously passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The amended bill will now be sent back to the House for concurrence.
  • The Senate unanimously passed House Bill 309, which amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license. The amended bill will now be sent back to the House for concurrence.
  • The Senate passed Senate Bill 715, which extends the Rare Disease Advisory Council’s sunset date to 2028. The bill was subsequently sent to the House and referred to the Health Committee.
  • The Senate passed Senate Bill 88, which provides coverage for supplemental screenings and diagnostic examinations without cost-sharing if a patient is at average risk or higher for breast cancer. The bill was subsequently sent to the House and favorably reported out of the Insurance Committee.
  • The House of Representatives passed House Bill 1100, which creates a grant program to provide eligible public-school entities with funding to acquire and distribute menstrual hygiene products. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1445, which prohibits an insurer from denying what would otherwise be a service covered by the policy simply because the health care service was received in a school setting. The bill was subsequently sent to the Senate and referred to the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1590, which supports Pennsylvania’s implementation of a new federal Medicaid flexibility that waives the longstanding “four walls” requirement for outpatient behavioral health clinics. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 583, which requires the Department of Human Services to establish a benefit package for dental services for Medicaid. The bill was subsequently sent to the Senate and referred to the Health & Human Services Committee.
  • The House of Representatives passed House Bill 1442, which places requirements on coroners to report Sudden Unexpected Death in Epilepsy (SUDEP). The bill was subsequently sent to the Senate and referred to the Local Government Committee.

The House and Senate will reconvene on Monday, June 30 for voting session.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that it will begin using Milliman Clinical Guidelines (MCG) as the screening guidelines to determine medical necessity for services, items, procedures, or level of care provided to Medical Assistance (MA) beneficiaries, effective July 18, 2025. 
  • DHS has also issued a Medical Assistance Bulletin to advise providers of changes to the MA program fee schedule. The department is adding and end-dating codes as a result of the 2025 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The changes are effective for dates of service on and after June 16, 2025. 
  • DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in Fiscal Year (FY) 2025-2026. Find additional information in this Pennsylvania Bulletin notice. 
  • The Office of Long-Term Living (OLTL) has shared an alert from the Centers for Medicare & Medicaid Services (CMS) about a fraud scheme that uses phishing fax requests, which falsely claim to be from CMS staff, to obtain medical records and documentation for auditing purposes.

Department of Health

The Department of Health (DOH), in partnership with the Pennsylvania Insurance Department and the Department of Human Services has launched a public survey looking for feedback on and suggestions for improving women’s health care across the commonwealth. The 10-minute survey is open through July 7 and focuses on women’s preventive health care, like health screenings, birth control, pregnancy care, and mental health services. 

Independent Fiscal Office

The Independent Fiscal Office (IFO) has published a revised document updating its prior impact of the Medicaid provisions included in the federal reconciliation bill package being negotiated by the U.S. Congress. 

Department of State 

The Department of State has announced that Pennsylvania will become a full participant in three health care compacts – physician, nursing, and physical therapy – beginning July 7. Click the respective compact link for more information regarding its implementation. 

Department of Aging

The Department of Aging has announced that it is conducting an evaluation of the PA Link to inform the design of a strategic plan to refresh and improve the program to better serve older adults, people with disabilities, and caregivers. Find additional information in this Pennsylvania Bulletin notice. 

State Board of Nursing 

The State Board of Nursing has released proposed regulations implementing Act 60 of 2021, which establishes title protection for certified registered nurse anesthetists (CRNA). Find the proposed rulemaking in this Pennsylvania Bulletin notice.

State Board of Pharmacy 

The State Board of Pharmacy has issued final-form rulemaking to effectuate Act 140 of 2020, which establishes criteria for pharmacy technician training programs as well as the standards of practice and registration fees for both pharmacy technicians and pharmacy technician trainees. Find the final rulemaking in this Pennsylvania Bulletin notice. 

Around the State  

The Philadelphia Inquirer has published an article about the Pennsylvania Medicaid program’s cost growth and its role in current state budget talks.

Stakeholder Meetings

PHC4 – Council Meeting – July 3

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced it will hold a council meet on July 3 at 10:00 a.m. PHC4 will also hold an Education Committee meeting on June 25. Find additional information in this Pennsylvania Bulletin notice. 

DOH – HIV Planning Committee – July 16-17

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee has announced it will hold a virtual public meeting on Wednesday, July 16 and Thursday, July 17. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 18.  The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find information on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – July 31

The Special Pharmaceutical Benefits Program Advisory Council will hold a public meeting on Thursday, July 31. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility and program management. Find details on how to participate in this Pennsylvania Bulletin notice.

2025-06-27T21:30:45+00:00June 27th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 27
Go to Top