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PA Health Policy Update for July 26

The following is an update of selected state health policy developments in Pennsylvania from July 15 – 26.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

  • Governor Shapiro has signed several bills into law, including the following health care bills.
    • House Bill 1664 (Act 58 of 2024), which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card.
    • House Bill 1633 (Act 74 of 2024), which establishes restrictions on non-compete covenants for certain health care practitioners.
    • House Bill 1853 (Act 75 of 2024), which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys.
    • House Bill 1993 (Act 77 of 2024), which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients.
    • House Bill 2200 (Act 79 of 2024), which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts.
  • Governor Shapiro joined Insurance Commissioner Michael Humphreys, members of the General Assembly, and local pharmacists in Lawrence County this week to tout the recent enactment of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs). Read more in this press release.
  • The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.  

General Assembly 

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through August 2024. Find the updated calendar here.
  • DHS has issued Provider Quick Tip #85 with eligibility and enrollment information for the Breast & Cervical Cancer Prevention & Treatment (BCCPT) program, which provides eligible individuals treatment for confirmed cases of breast and cervical cancer or precancerous conditions of the breast or cervix. 

Department of Health 

The Department of Health (DOH) has reminded providers who operate mobile clinics to complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services. 

Department of Drug & Alcohol Programs  

The Department of Drug & Alcohol Programs (DDAP) has issued a Licensing Alert to notify licensed treatment facilities and recovery houses of the new process for submitting licensing regulation exceptions and facility requests to DDAP. 

Around the State 

  • The Citizen’s Voice has published an article about Pennsylvania’s Cancer Drug Repository Program and barriers to its utilization.
  • The Patriot-News has written an article about President Joe Biden’s decision to withdraw from the U.S. presidential race and what it means for Governor Shapiro.
  • Governor Shapiro’s signing of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs), and its potential impact on local pharmacies and patients was featured in an article published by the Times Leader.
  • The Pittsburgh Business Times has published an article about the challenges confronting rural health care and efforts to find solutions.

PA Health Policy Update for June 28

The following is an update of selected state health policy developments in Pennsylvania from June 24 – 28.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future. 

General Assembly

The state House of Representatives and Senate were in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity.

  • The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 194-8. The bill will now be sent to the Senate for consideration.
  • The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.
  • The Senate unanimously passed on Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently received in the House and referred to the Health Committee.
  • The House unanimously passed House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.
  • The House Children & Youth Committee met on Tuesday, June 25 and favorably reported House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.
  • The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here. 

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m. 

Department of Human Services

  • The Department of Human Services (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 FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.
  • DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

Department of Health 

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release 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.  

Stakeholder Events   

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 from 10:00 a.m. to 12:00 p.m. 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 additional details here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 28

PA Health Policy Update for June 21

The following is an update of selected state health policy developments in Pennsylvania from June 17 – 21.  (Some of the language used below is taken directly from state documents). 

General Assembly

  • The state House of Representatives and Senate will reconvene for voting session next Monday, June 24. Both chambers are currently scheduled to remain in session until Monday, June 30, which is Pennsylvania’s constitutional deadline to enact a budget.
  • The House Children & Youth Committee is scheduled to meet on Tuesday, June 25 at 9:00 a.m. to consider House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The meeting will be held in Room B-31 of the Main Capitol. It will be livestreamed here.
  • The House Health Committee is scheduled to meet on Wednesday, June 26 at 9:30 a.m. to consider House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. The meeting will be held in Room G-50 of the Irvis Building. It will be livestreamed here. 

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July 2024. Find the updated calendar here.
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.
  • DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death.  Find the notice here. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced it will offer a virtual “Implementation, Improvement, Sustainability and Coaching of the ASAM Criteria – A How-To Science Based Approach” training in conjunction with Train for Change. The training will be offered in three series. It will teach the NIATx model for process improvement in conjunction with the ASAM Criteria Implementation Guide. Find the three series’ dates and additional information here. 

Around the State 

  • The Pennsylvania Capital-Star has reported about the state’s looming budget deadline and Senator Majority Leader Joe Pittman’s assertion that “[negotiations] could perhaps use… a kick in the pants to get moving.”
  • The New York Times has published an article about the role of pharmacy benefit managers (PBMs) and how they contribute to the cost of prescription drugs.
  • Spotlight PA has published an article about efforts to legalize recreational marijuana and the likelihood of legalization being a part of this year’s budget package.

Stakeholder Events   

DHS – Consumer Sub-MAAC – June 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 26 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – June 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on June 27 at 10:00 a.m. Find the agenda here and register to participate here.

2024-06-21T21:00:21+00:00June 21st, 2024|Governments, Medical Assistance Advisory Committee, Meetings and notices|Comments Off on PA Health Policy Update for June 21

PA Health Policy Update for June 14

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

Governor Shapiro

Governor Shapiro signed, among other bills, Senate Bill 721 into law this week. Senate Bill 721, now known as Act 22 of 2024, establishes the Women, Infants and Children (WIC) State Advisory Board. Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The House of Representatives passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to the Senate and reported favorably from the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1783, which requires the Department of Health to develop and publish educational material about opioid-related overdose and requires the Department of Drug & Alcohol Programs to establish a grant program from the development, expansion, or improvement of recovery support services. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2127, which allows clinicians to distribute information related to postpartum depression and counseling resources. It also requires the Department of Health to publish those resources on its website. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed  House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational hearing on Senate Bill 840 and House Bill 2400, which both create an Alzheimer’s Disease and related disorders division within the Department of Aging and establish an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the hearing is viewable here.
  • The House Children & Youth Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, June 11 and favorably reported House Bill 1140, which expands access to contraceptives, and House Bill 2268, which provides coverage for speech therapy for stuttering. A recording of the meeting is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, June 11 and favorably reported Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions, and Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. A recording of the meeting is viewable here.
  • The Senate Banking & Insurance Committee met on Tuesday, June 11 and favorably reported, among other bills, House Bill 1664, which prohibits insurers from restricting their method of payment to solely credit card, and House Bill 1754, which requires public and private insurers to cover biomarker testing. A recording of the meeting is viewable here.
  • The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 12 and favorably reported, among other bills, Senate Bill 1251, which aligns Pennsylvania’s nursing statute with federal rules regarding accreditation. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee and the Senate Aging & Youth Committee held a combined hearing on Wednesday, June 12 regarding the status of the state’s Aging Our Way plan. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, June 12 and favorably reported the following bills.
    • House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients,
    • House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance.
    • House Bill 2363, which expands the existing Cancer Drug Repository Program to allow both health care facilities and individuals to donate prescription drugs (other than cancer drugs) to the program.

A recording of the meeting is viewable here.

  • The House Human Services Committee met on Wednesday, June 12 and favorably reported House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, June 12 and favorably reported, among other bills, House Bill 2198, which caps the fees for obtaining electronic medical records. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee met for a voting meeting on Wednesday, June 12 and favorably reported, among other bills, House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. A recording of the meeting is viewable here.

The state House of Representatives and Senate will be in recess next week. Both chambers are scheduled to return to Harrisburg, Monday June 24.

Department of Human Services 

The Department of Human Services (DHS) has announced it is making available for public review and comment the Office of Long-Term Living’s proposed amendment for the OBRA waiver. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced it is making available for public comment and review the Office of Long-Term Living’s proposed renewal for the Community HealthChoices (CHC) waiver. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 753) regarding testing for influenza in persons with severe respiratory illness given the potential for severe human infections with influenza A(H5N1) viruses and the recent spread into dairy cattle. 

Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

2024-06-14T21:14:14+00:00June 14th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for June 14

PA Health Policy Update for May 31

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

General Assembly

The state House of Representatives and Senate will return to Harrisburg for voting session Monday, June 3 through Wednesday, June 5. Following is an overview of selected health care-related legislative activity currently scheduled.

  • The House Aging & Older Adult Services Committee will hold an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3 at 10:00 a.m. The meeting will take place in Room 140 of the Main Capitol. It will also be livestreamed here.
  • The House Insurance Committee will convene on Monday, June 3 at 10:30 a.m. to consider, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. The meeting will be held in the East Wing, Room 60. It will also be livestreamed here.
  • The House Children & Youth Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. The meeting will be held in East Wing, Room 60. It will also be livestreamed here.
  • The House Health Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider House Bill 2283, which requires operating rooms utilize surgical smoke evacuation systems. The meeting will be held in Room G-50 of the Irvis Office Building. It will also be livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule as a result of the 2024 Healthcare Common Procedures Coding System (HCPCS) updates. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 751) with information for health care providers about 2024 West Nile and other arboviral infections in Pennsylvania.

DOH has announced the publication of an updated list of academic clinical research centers (ACRC) under the Medical Marijuana program on the department’s website and established the time period during which applications for clinical registrants (CR) will be accepted by the department. Find additional information in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has announced it disapproved the Bureau of Professional and Occupational Affairs final-form regulation that lists criminal convictions directly related to each of the 29 professional and occupational licensing boards and commissions. IRRC indicated the regulation was not in the public interest due to the removal of certain offenses that may have direct bearing on the conduct, services, and practices of various occupations and professions. Find additional information in this Pennsylvania Bulletin notice. 

Stakeholder Events   

DHS – Long-Term Services and Supports Subcommittee – June 5

The Long-Term Services and Supports Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on Wednesday, June 5 at 10:00 a.m. Find additional information and details on how to participate here. 

The Patient Safety Authority – June 20

The Patient Safety Authority will hold a public meeting of the Authority’s Board on Thursday, June 20 at 10:30 a.m. The meeting will take place at the Central Penn College conference center (600 Valley Road, Summerdale, PA 17093). The meeting will also be held virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-06-03T17:47:33+00:00May 31st, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 31

PA Health Policy Update for May 24

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

General Assembly

The state House of Representatives returned to Harrisburg this week for voting session. Following is a selection of health care-related legislative activity that occurred.

  • The House passed Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board, on final consideration by a vote of 119-83. The bill will now be sent to the governor’s desk.
  • The House passed House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service, by a vote of 154-48. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana, by a vote of 196-6. The bill will now be sent to the Senate for consideration.
  • The House Health Committee convened on Tuesday, May 21 and favorably reported, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Wednesday, May 22 for an informational hearing on the Living Independence for the Elderly (LIFE) program. A recording of the hearing is viewable here.

The state House and Senate are both recessed until Monday, June 3.

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding and end-dating procedure codes as a result of the 2024 updates published by CMS to the Healthcare Common Procedure Coding System (HCPCS). These changes are effective for dates of service on and after May 28, 2024.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June 2024. Find the updated calendar here.
  • The Office of Long-Term Living (OLTL) has communicated to personal care homes and assisted living residences that unlicensed staff persons may not administer Glucagon-like peptide (GLP)-1 agonist medications, such as Ozempic (Semaglutide) and Trulicity (Dulaglutide) via subcutaneous injection unless they seek a regulatory waiver and submit it to ra-pwarlheadquarters@pa.gov. 

Department of Health 

  • The Department of Health (DOH) has announced it is extending the temporary scheduling of any material, compound, mixture or preparation which contains any quantity of Nitazene substances for an additional year. Find additional information in this Pennsylvania Bulletin notice. 
  • DOH has issued a Health Advisory (PA-HAN 749) with Influenza A/H5N1, a highly pathogenic avian influenza (HPAI) virus, guidance for health care providers.
  • DOH also issued a Health Advisory (PA-HAN 750)  alerting healthcare providers of an increase in meningococcal disease, linked to Umrah travel to the Kingdom of Saudi Arabia. 

Health Insurance Exchange Authority 

The Pennsylvania Health Insurance Exchange Authority, which is the state-affiliated entity that operates the commonwealth’s state-based health insurance marketplace, has issued a proposed regulation that would require insurers selling qualified plans through the Exchange Authority to be accredited in health equity. 

Around the State   

  • PennLive has published an article about legislative efforts to require state-regulated commercial insurers to cover blood pressure monitors when necessary during pregnancy and for up to a year after delivery. 
  • The Philadelphia Inquirer has reported about an effort to subpoena Philadelphia mayor Cherelle Parker’s administration regarding its plans to expand addiction treatment services in the city. 
  • An article published by PennLive highlights the Shapiro administration’s efforts to seek a Medicaid 1115 waiver to provider continuous Medicaid coverage for children from birth through age six.
2024-06-03T17:42:15+00:00May 24th, 2024|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for May 24

PA Health Policy Update for May 17

The following is an update of selected state health policy developments in Pennsylvania from May 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

  • The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
  • The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024. 

Department of Health 

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page. 

State Board of Medicine 

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice 

State Board of Osteopathic Medicine 

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.
  • City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.
  • The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120. 

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

PA Health Policy Update for May 3

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

General AssemblyHarrisburg, PA capital building

The state House of Representatives and Senate convened for voting session this week. Following is an overview of selected health care-related legislative activity that occurred.

  • The House unanimously passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to the Senate.
  • The House Human Services Committee met on Monday, April 29 and favorably reported, among other bills, House Bill 1783, which requires the development of opioid-related overdose public information, and House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program. A recording of the meeting is viewable here.
  • The House Health Committee met on Tuesday, April 30 and favorably reported the following bills.
    • House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
    • House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana.
    • Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board.

A recording of the meeting is viewable here.

  • The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 30 at 10:00 a.m. regarding local Area Agencies on Aging. A recording of the meeting is viewable here.
  • The House Human Services Committee held an informational meeting on Wednesday, May 1 regarding performance-based contracting for the Department of Human Services’ Office of Developmental Programs. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session in Harrisburg next Monday, May 6 through Wednesday, May 8. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Insurance Committee will convene on Monday, May 6 at 10:00 a.m. in Room 60 of the East Wing to consider, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.

The meeting will be livestreamed here.

  • The House Labor & Industry Committee will meet on Tuesday, May 7 at 9:30 a.m. in Room 523 of the Irvis Office Building to consider House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee will hold an informational meeting on the nursing workforce crisis. The meeting will be livestreamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (PA-HAN 746) with important information about Lyme Disease and other tickborne diseases in the commonwealth. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers of additions and updates to the Medical Assistance (MA) program fee schedule.
  • DHS has provided final notice of its funding allocation for FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to qualifying acute care general hospitals enrolled in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the final annual case-mix per diem payment rates for FY 2023-2024 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin regarding the removal of lifetime employment bans for individuals convicted of certain criminal offenses in the Older Adults Protective Services Act.
  • DHS has added information to its website about the Technology Assessment Group (TAG), which reviews requests for new and emerging technologies and recommends coverage decisions for the MA program. Find the TAG’s website here.
  • DHS has announced the peer group, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities. Find additional information in this Pennsylvania Bulletin notice.

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $373.3 million, or 7.0 percent, more than anticipated. Fiscal year-to-date General Fund collections total $38.5 billion, which is $739.3 million, or 2.0 percent, above estimate. 

Around the State   

  • The Tribune-Review reported about the many professional counselors that could be approved for associate licenses soon due to the implementation of Act 4, which establishes two new license types in Pennsylvania.
  • Spotlight PA has published an article about the counties’ use of tens of millions of dollars in opioid settlement funds.
  • A news segment published by KDKA highlighted the drug shortage challenges that health care providers and patients are currently confronting in Pennsylvania and across the country.  

PA Health Policy Update for April 19

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

General Assembly

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

  • The House passed House Bill 1633, which prohibits non-compete agreements for health care practitioners and establishes certain notification requirements, by a vote of 150-50. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee met on Monday, April 15 and favorably reported House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. A recording of the meeting is viewable here.
  • The House Children and Youth Committee met on Tuesday, April 16 and favorably reported House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 321, which establishes an implementation deadline for the Department of Human Services’ enterprise case management system. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. A recording of the meeting is viewable here.
  • The House Democratic Policy Committee held a roundtable discussion on Tuesday, April 16 examining maternal health deserts. Find the agenda and testimony presented to the committee here.
  • The Senate Democratic Policy Committee held an informational meeting on Monday, April 15 examining pharmacy deserts. Find a recording of meeting and testimony presented to the committee here.

The state House of Representatives and the Senate are in recess until Monday, April 29. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 745) with information regarding recent increases in reported congenital syphilis. The department is recommending that pregnant individuals be offered a test for Syphilis at the first prenatal visit, at the third trimester of pregnancy, and at delivery. 

Department of Human Services 

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin with the 2024 recommended child and adolescent immunization schedule.
  • DHS has published a Medical Assistance Bulletin to advise providers that the department will begin paying for ground ambulance mileage for each loaded mile in addition to increasing the fees for certain ambulance services on the Medical Assistance (MA) program fee schedule, effective with dates of service on or after January 1, 2024.
  • DHS has published the minutes of the March 28, 2024 Medical Assistance Advisory Committee (MAAC) meeting.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through May 2024. Find the updated calendar here. 

Stakeholder Events  

DHS – Consumer Sub-MAAC – April 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 1:00 p.m. Find the agenda here and register to participate here. 

DHS – Medical Assistance Advisory Committee – April 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 25 at 10:00 a.m. Find the agenda here and register to participate here. 

DOH – HIV Community Prevention Planning Committee – May 1

The Human Immunodeficiency Virus (HIV) Prevention Planning Committee will hold a public meeting on Wednesday and Thursday, May 1-2, 2024. The meeting will be held in person and virtually. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Organ Donation Advisory Committee – May 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, May 2 from 10:15 a.m. to 1:15 p.m. The meeting will be held virtually and in person. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – May 3

The Brain Injury Advisory Board will hold a public meeting on Friday, May 3, 2024 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional details in this Pennsylvania Bulletin notice.

2024-04-19T20:14:21+00:00April 19th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 19

PA Health Policy Update for April 5

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

General Assembly 

The Senate Aging & Youth Committee held an informational hearing on Wednesday, April 3 to examine challenges facing Pennsylvania’s children and youth services agencies. A recording of the hearing and copies of testimony provided to the committee are viewable here.

The state House of Representatives and Senate will reconvene for session Monday, April 8 through Wednesday, April 10. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Human Services Committee will meet on Monday, April 8 at 9:00 a.m. to consider House Resolution 373, which recognizes the week of April 11 through 17, 2024, as “Black Maternal Health Week” in Pennsylvania. The meeting will be held in Room 515 of the Irvis Office Building.
  • Following its voting meeting, the House Human Services Committee will hold an informational meeting on the delivery of quality home care services under Community HealthChoices. The meeting will be livestreamed here.
  • The House Health Committee will hold an informational meeting on Thursday, April 11 on advancing social equity through cannabis legalization. The meeting will be held in Room 60 of the East Wing and livestreamed here. 

Department of Human Services

After one year of processing Medicaid eligibility redeterminations following the end of pandemic-related continuous eligibility, the Department of Human Services (DHS) has reported that less than 600,000 applications are left to be processed and it should be completed with this effort by June 30.

About 70 percent of individuals remained eligible for Medicaid following their redetermination. To continue assisting Medicaid recipients with their annual redeterminations, providers are reminded to:

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has provided an update on certification entities. Clinical supervisors and counselors that provide clinical treatment services in licensed substance use disorder (SUD) treatment facilities have a number of ways to meet minimum qualifications. One of those ways is full certification by a statewide certification body that is a member of a national body. In Pennsylvania, the Pennsylvania Certification Board (PCB) has historically been one of the entities that provides that certification. In addition to PCB, the newly developed Pennsylvania Certification Commission for Addiction Professionals (PCC AP), which is part of the Pennsylvania Association of Addiction Professionals, an affiliate of the National Association of Addiction Professionals (NAADAC), is also an option for certification for clinical counselors and supervisors.  

Department of Insurance

The Department of Insurance has published guidance on how insurers should govern the development, acquisition, and use of certain artificial intelligence (AI) technologies. This department has also informed insurers of the type of information and documentation that the department may request during an investigation or examination of any insurer regarding its use of the technologies and AI systems. Find additional information in this Pennsylvania Bulletin notice. 

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $6.3 billion in General Fund revenue in March, which was $289.9 million, or 4.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.8 billion, which is $366.0 million, or 1.1 percent, above estimate. 

Stakeholder Events 

PHC4 – Meeting Dates

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled the following meetings.

  • Data Systems Committee meeting on April 17, 2024, at 9:00 a.m.
  • Council meetings on May 4 at 8:30 a.m. and July 11 at 10:00 a.m.
  • Payment Data Advisory Group meetings on April 18, May 23, and June 20 at 10:00 a.m.

Agendas will be available 24 hours in advance here. Find details on how to register and participate here. 

Patient Safety Authority – April 25

The Patient Safety Authority will hold a meeting of the authority’s board on Thursday, April 25 at 1:00 p.m. The meeting will be held virtually. Find details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – April 25

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, April 25, 2024, from 10:00 a.m. to 3:00 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.

2024-04-06T06:34:47+00:00April 5th, 2024|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 5
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