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PA Health Policy Update for October 11

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

Governor Shapiro 

The Commonwealth of Pennsylvania is taking steps to address the state’s high maternal mortality rate through the development of a statewide “Maternal Health Strategic Plan.” The Shapiro administration is asking stakeholders to complete a survey through November 4 to help inform the development of the strategic plan. Along with the governor’s office, the health agencies involved include the departments of Health, Human Services, Drug and Alcohol Programs, and Insurance. Find the survey here. 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate unanimously voted to concur with House amendments to Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill will now be presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed Senate Bill 365, which amends the Workers’ Compensation Act to provide first responders with post-traumatic stress injury (PTSI) coverage. The bill was subsequently received in the House and referred to the Veterans Affairs & Emergency Preparedness Committee for consideration.
  • The Senate unanimously passed House Bill 2381, which allows a licensing board or commission under the Department of State’s Bureau of Professional and Occupational Affairs to promulgate temporary regulations necessary for the implementation of each interstate licensure compact enacted by the General Assembly. Since the bill was amended in the Senate, it will now go back to the House for concurrence.
  • The Senate unanimously passed House Bill 2268, which provides coverage for speech therapy for stuttering. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate passed House Bill 2084, which establishes a license for prescription drug virtual manufacturers. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously voted to concur with the House amendments to Senate Bill 668, which permits certified nurse aides to become certified medication aides in long-term care, assisted living residences, and personal care homes. The bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources. The House subsequently voted to concur with the Senate’s amendments and the bill was subsequently presented to Governor Shapiro for his signature.
  • The Senate unanimously passed House Bill 155, which removes the requirement that direct care workers be interviewed in-person for a position. The bill was subsequently presented to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2562, which prohibits health insurance companies from imposing annual and lifetime limits to the dollar value of core benefits provided under the policy to the enrollee. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2563, which provides for health insurance coverage of dependent children up to age twenty-six by a parent’s health insurance policy. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2564, which prohibits health insurance companies from imposing any rules for initial or continued eligibility for individuals having a preexisting condition. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed 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 presented to Governor Shapiro for his signature.
  • The Senate Health & Human Services Committee met on Monday, October 7 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the hearing is viewable here.
  • The House Labor & Industry Committee met on Wednesday, October 9 for an informational hearing on the Federated Insurance Company v. Summit Pharmacy court case. A recording of the hearing is viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers are scheduled to return to Harrisburg on Monday, October 21. 

Department of Human Services

The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced that the proposed Psychiatric Residential Treatment Facilities (PRTF) regulations have been posted for public comment. OMHSAS’ proposed regulations codify the minimum licensing standards, Medical Assistance participation requirements, and payment conditions for psychiatric residential treatment facilities which treat certain children, youth, or young adults under 21 years of age.

The Department of Human Services (DHS) has published proposed rulemaking to amend a data element in DHS’ case-mix payment system for non-public 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. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 773) with information about the first Marburg Virus Disease (MVD) outbreak in the Republic of Rwanda, including information about patient assessment and monitoring of U.S. health care workers who may have been in Rwanda within the last 21 days.

DOH has issued a notice to physicians renewing their licenses in Pennsylvania to ensure their practice information is up to date. 

Insurance Department  

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its intent to submit an application to extend the 1332 State Innovation Waiver Reinsurance Program (PA-Re) for another five years. The state reinsurance program helps moderate premiums in the state’s individual health insurance marketplace. Find additional information and details on how to comment in this Pennsylvania Bulletin notice.

PID has announced Pennsylvania’s 2025 Affordable Care Act (ACA) health insurance rates. The enrollment period for Pennie, Pennsylvania’s health insurance marketplace, will begin November 1 and go through December 15 for coverage that starts on January 1, 2025.

Around the State  

  • WHYY has published an article about the worsening shortage of IV fluids due to Hurricane Helene which damaged a factory in North Carolina that produces more than half the country’s supply of IV fluids. 
  • The New York Times has written an article about the consequential role Pennsylvania is currently playing in this year’s U.S. Presidential election and the amount of time and money the candidates are spending in Pennsylvania.
  • Health care professionals from across Pennsylvania rallied at the State Capitol on Tuesday along with gun violence awareness advocates. WGAL reports the rally is part of a new statewide coalition called PA Health Professionals to End Gun Violence. 

Stakeholder Events

DOH – WIC State Advisory Board – October 22

The WIC State Advisory Board will hold a meeting on October 22 from 1:00 – 2:00 p.m. The purpose of this meeting is to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-11T19:46:11+00:00October 11th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for October 11
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PA Health Policy Update for October 4

The following is an update of selected state health policy developments in Pennsylvania from September 30 – October 4.  (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. Following is a selection of relevant health care-related legislative activity.

  • The House of Representatives passed House Bill 2295 and House Bill 2294, which allow a physician assistant to work with either an allopathic or osteopathic physician without having to obtain a license from both medical boards. The bills were subsequently received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
  • The House Labor & Industry Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2548, which requires employers to provide paid sick leave. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Monday, September 30 for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care. A recording of the hearing is viewable here.
  • The House Insurance Committee met on Monday, September 30 and favorably reported, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. A recording of the hearing is viewable here. The Insurance Committee also met on Tuesday, October 1 for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes. A recording of the hearing is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, October 1 and favorably reported, among other bills, Senate Bill 1303, which lowers the influenza vaccine offering from age 65 and older, down to age 50 and older. A recording of the hearing is viewable here.
  • The Senate Health & Human Services Committee met on Tuesday, October 1 and favorably reported the following bills.
    • House Bill 155, which allows two-way video calls to satisfy the face-to-face requirement for job interviews for direct care workers.
    • House Bill 1608, which requires coverage of doula services in the Medical Assistance program.
    • House Bill 2084, which establishes a license for virtual prescription drug manufacturers.
    • House Bill 2127, which allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with information about postpartum depression and counseling resources.

A recording of the Senate Health & Human Services Committee is viewable here.

  • The House Health Committee met on Wednesday, October 2 and favorably reported the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • 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.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.

A recording of the Health Committee meeting is viewable here.

    • The Human Services Committee met on Wednesday, October 2 for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee held a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. A recording of the meetings is viewable here.

The state House of Representatives and Senate will convene again for voting session Monday, October 7 through Wednesday, October 9. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced a Request for Applications (RFA) seeking managed care organizations to administer services for the Children’s Health Insurance Program (CHIP) program. 
  • DHS has announced its intent to increase rates paid in its Behavioral HealthChoices program, which provides access to mental health, substance use disorder, and other behavioral health services for Medicaid recipients. Once approved by CMS, the new rates to the Behavioral HealthChoices Managed Care Organizations (MCOs) will be retroactive to July 1, 2024 for their current 2024 contract agreements. 
  • DHS announced an increase in the assessment fee that managed care organizations (MCOs) will pay per member per month as a means to generate federal matching funds to support the capitation payments. The increase, which becomes effective in January, is expected to generate an additional $223.531 million in assessment revenue for FY 2024-2025. 
  • DHS has shared the following presentations from the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee meeting on September 25.
  • The Independent Regulatory Review Commission (IRRC) approved the DHS Psychiatric Rehabilitation Services regulations that were first proposed in 2022. With this revision, the regulations expand eligibility for psychiatric rehabilitation services to include individuals 14 years of age or older but under 18 years of age and expand the diagnoses that allow individuals to access PRS without going through the exception process. Find more information in this Pennsylvania Bulletin notice. 

Department of Health 

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 772) regarding health care and long-term care facility preparedness for the 2024-2025 respiratory virus season.
  • DOH has issued a Health Advisory (PA-HAN 771) with information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo and prevention strategies for U.S. travelers visiting countries with an outbreak.
  • DOH has issued a Health Advisory (PA-HAN 770) announcing that has received adequate supplies of Benzathine Penicillin G (Bicillin L-A®) and is now lifting the restrictions for the administration of Bicillin L-A® for individuals who are diagnosed with or suspected of having syphilis. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued a licensing alert regarding DDAP’s implementation of the updated federal regulations for the certification of Opioid Treatment Programs (OTPs).

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.2 billion in General Fund revenue in September, which was $33.7 million, or 0.8 percent, less than anticipated. Fiscal year-to-date General Fund collections total $10.1 billion, which is $20.2 million, or 0.2 percent, above estimate. 

Stakeholder Events

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-07T15:57:14+00:00October 4th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 4
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PA Health Policy Update for September 27

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

General Assembly

The House Republican Policy Committee held an informational hearing on Monday, September 23 examining Pennsylvania’s drug crisis. Testimony offered at the hearing is viewable here and a video recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for voting session next Monday, September 30 through Wednesday, October 2. Following is a selection of relevant health care-related legislative activity currently scheduled.

  • The House Labor & Industry Committee will meet on Monday, September 30 at 9:00 a.m. in Room 60 of the East Wing to consider, among other bills, House Bill 2548, which requires employers to provider paid sick leave.
  • The House Aging & Older Adult Services Committee will meet on Monday, September 30 at 10:00 a.m. in Room 523 of the Irvis Office Building for a public hearing on House Bill 2320, which addresses Medicaid dependency and timely reimbursement for long-term nursing home care.
  • The House Insurance Committee will meet on Monday, September 30 at 10:30 a.m. in Room 60 East Wing to consider, among other bills, House Bill 2562, which prohibits annual and lifetime health care coverage limits. The Insurance Committee will also meet on Tuesday, October 1 at 9:00 a.m. in Room 60 of the East Wing for a public hearing on House Bill 1663 and the utilization of artificial intelligence (AI) in health insurance claims processes.
  • The House Health Committee will meet on Wednesday, October 2 at 9:00 a.m. in Room G50 of the Irvis Office Building to consider the following bills.
    • House Bill 2094, which establishes certain limitations on filial responsibility for outstanding medical bills.
    • House Bill 2549, which requires an autopsy to include an inquiry to determine whether the death was a direct result of a seizure or epilepsy.
    • 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.
    • Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting.
  • The Human Services Committee will meet on Wednesday, October 2 at 9:30 a.m. in Room 515 of the Irvis Office Building for a public hearing on House Bill 2560, which makes statutory changes to ensure Pennsylvania is in compliance with CMS’ “four walls” requirement. Immediately following, the Human Services Committee will hold a voting meeting on House Bill 2560 and House Bill 2533, which creates a 988 public education campaign. 

Department of Human Services 

The Department of Human Services (DHS) has announced the continuation of the alternative payment methodology for federally qualified health centers and rural health clinics for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. Find additional information in this Pennsylvania Bulletin notice. 

DHS has published its report on Medicaid managed care enrollment in Pennsylvania for the month of August. 

Insurance Department 

The Pennsylvania Insurance Department has announced it received approximately $635,000 from CMS to improve women’s access to health benefits. The funds will be used to launch a multi-faceted campaign focused on awareness and education about preventive care, including contraception. It will also be used to enhance benefit reviews and issuer education to reduce coverage barriers and improve compliance. Find additional information in this press release.

Around the State 

Spotlight PA has published an article about Auditory General Tim DeFoor’s report on pharmaceutical benefit managers (PBMs) and the politics surrounding the report in an election year. 

Stakeholder Events

DOH – HIV Community Prevention Planning Committee – October 1

The Statewide HIV Community Prevention Planning Committee will hold a public meeting on Tuesday, October 1 from 9:00 a.m. to 4:30 p.m. and Wednesday, October 2 from 9:00 a.m. to 4:30 p.m. The meeting will be held virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – October 10

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, October 10 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-27T21:37:45+00:00September 27th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 27
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PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. 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 published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20
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PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

  • Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.
  • Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release. 

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA).  These changes are effective for dates of service on or after September 9, 2024.
  • DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.
  • DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 13
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PA Health Policy Update for September 6

The following is an update of selected state health policy developments in Pennsylvania from September 2 – 6.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives has changed September 23, 24, and 25 to non-voting session days and added October 7, 8, and 9 as voting session days.

The House and Senate are currently recessed until Monday, September 30 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding new procedure codes based on clinical review, provider requests, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the FDA. DHS is also making changes to prior authorization requirements as a result of clinical review. Find additional information in this Pennsylvania Bulletin notice.

DHS has also announced updates to the Family Planning Services program fee schedule, effective for dates of service on and after July 1, 2024. Find additional information, including the procedure codes, in this Pennsylvania Bulletin notice. 

Department of Health

  • The Department of Health (DOH) has announced it is conducting its annual questionnaire of long-term care facilities for the data reporting period of July 1, 2023 through June 30, 2024. The mandatory questionnaire must be completed and electronically submitted to DOH by Friday, October 25. If a long-term care facility did not receive an email on September 4th with a link to the questionnaire, please contact Aicha Hassane Noma at ahassaneno@pa.gov  or email RA-dohbhssurveys@pa.gov.
  • Secretary of Health Dr. Debra Bogen visited the Meadville Area Ambulance Service this week to discuss the administration’s ongoing emergency medical services (EMS) recruitment and retention efforts and other investments in EMS professionals across Pennsylvania, including the expansion of a PILOT program to introduce high school students to the EMS profession and the launch of a $1 million tuition assistance program. Find additional information in this press release.
  • DOH has announced it is extending the deadline for the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) Provider Readiness Survey to September 20. The survey can be accessed here. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $53.9 million, or 1.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $5.9 billion, which is $53.9 million, or 0.9 percent, above estimate. 

Around the State 

  • Spotlight PA has published an article about the state Supreme Court and a number of cases related to abortion, gun control, and climate change that are awaiting decisions.
  • An article published in The Center Square highlights the concerning closure of several independent pharmacies and the Auditor General’s recently released PBM audit for Medicaid prescription drug benefits.
  • PennLive has reported on recent polling of Pennsylvania voters that shows Vice President Harris and former President Donald Trump are in a close race. The article also highlights polling for the Pennsylvania U.S. Senate race between incumbent Senator Bob Casey and challenger David McCormick.  

Stakeholder Events 

DOH – WIC State Advisory Board Meeting – September 10

The Department of Health has issued a correction notice in the Pennsylvania Bulletin with a revised link to join the board’s meeting scheduled for Tuesday, September 10 at 1:00 p.m. 

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority Board – September 19

The Patient Safety Authority has announced a meeting of the authority’s board to be held virtually on Thursday, September 19 at 1:00 p.m. The meeting is open to the public. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

2024-09-06T20:01:48+00:00September 6th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 6
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PA Health Policy Update for August 23

The following is an update of selected state health policy developments in Pennsylvania from August 19 – 23.  (Some of the language used below is taken directly from state documents). 

General Assembly

  • The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.
  • When they return, the Senate Aging and Youth and Banking and Insurance Committees announced they will meet on September 18 at 9:00 a.m. for a joint hearing on protecting seniors from financial exploitation. 

Department of Health 

  • The Department of Health (DOH) has issued a memo to hospitals outlining the department’s plan to comply with the federal government’s renewed data reporting requirements for COVID-19 and other respiratory illnesses. CMS will require weekly reporting beginning November 1 and facilities have the option for DOH to facilitate reporting on their behalf. In the memo, the Bureau of Emergency Preparedness and Response strongly encourages facilities to utilize this reporting pathway. More information, including required data elements and a data dictionary is forthcoming.
  • The DOH policy office has temporarily paused its efforts to collect input on potential amendments to the hospital licensure regulations. The department commenced a stakeholder engagement process earlier this month that was designed to solicit feedback from various stakeholders, including hospitals. DOH will reconvene stakeholder meetings in the fall or winter to inform proposed regulations to be released in Spring 2025.
  • DOH issued a health advisory (PA HAN 766) related to recent Oropouche virus activity in travelers who have visited the Amazon basin and other areas of South America. 

Department of Human Services 

  • The Department of Human Services (DHS) announced the results of the reprocurement of the Community HealthChoices program for plan years beginning in 2025 through at least 2029. Similar to today’s program, the selected applicants are identical for each of the five CHC operating zones and include Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan (AmeriHealth). The plans will begin a readiness review with DHS shortly which will include an examination of their provider network adequacy. Find the DHS announcement here.
  • DHS issued a Medical Assistance provider bulletin to advise providers of changes to the manual edit thresholds for electronic visit verification records in both personal care and home health services effective with dates of service on and after January 1, 2025.
  • The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) encourages providers to participate in a survey of provider readiness to introduce additional tobacco interventions as part of the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) funded by the CDC. The Public Health Management Corporation conducted a similar survey in 2021, and this 15-minute survey will be a useful measure of the initiative’s progress. Click here to access the survey, which will close on August 31. 

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – August 29 – CANCELLED

The statewide Human Immunodeficiency Virus (HIV) Planning Group has cancelled its public meeting on Thursday, August 29 from 9:00 a.m. to 4:30 p.m.

 

2024-08-23T20:40:15+00:00August 23rd, 2024|Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for August 23
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PA Health Policy Update for August 9

The following is an update of selected state health policy developments in Pennsylvania from August 5 – 9.  (Some of the language used below is taken directly from state documents). 

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 issued two Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health 

The Department of Health (DOH) has announced it distributed 50,000 xylazine wound care kits to provide relief for people with xylazine-associated wounds. The kits have been distributed to more than 200 medical and harm reduction organizations across the commonwealth. Find additional information in this press release. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new research brief, Hospitalizations for Pennsylvania Children with Cancer. The research brief examines inpatient hospitalizations for Pennsylvania children who were admitted to a Pennsylvania general acute care hospital with a diagnosis of cancer. 

Insurance Department 

The Pennsylvania Insurance Department has announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available here. Find additional information in this press release. 

Around the State   

  • The Philadelphia Inquirer has published an article about Crozer Health’s potential sale to New Jersey-based CHA Partners, and its conversion back into a non-profit. WHYY also wrote an article about the planned sale 
  • Vice President Kamala Harris’ decision to pick Minnesota Governor Tim Walz as her running mate over Pennsylvania Governor Josh Shapiro received a lot of media coverage this week, including this article published by The Philadelphia Inquirer.
  • PennWatch has published an article about the Shapiro administration’s efforts to distribute 50,000 xylazine wound care kits across the state. 

Stakeholder Events

DHS – Dual Diagnosis Conference – September 11

The Office of Developmental Programs (ODP) and the Office of Mental Health and Substance Abuse Services (OMHSAS) have announced the Dual Diagnosis Conference Services, “Insidious Trauma: Context, Impact, and Considerations for Care.” The conference will be held September 11 from 10:00 a.m. to 1:00 p.m. Find additional information and registration details here. 

DHS – OLTL Transportation Summit – September 17

The Office of Long-Term Living (OLTL) will host a transportation summit on Tuesday, September 17 from 9:00 a.m. to 12:00 p.m. The summit is an open forum for anyone interested in discussing transportation related issues in the Community HealthChoices (CHC) program. The summit will be held virtually. Find registration details here. 

DOH – Spinal Cord Injury Research Advisory Committee – September 18

The Spinal Cord Injury Research Advisory Committee will hold a public meeting on Wednesday, September 18 from 9:30 a.m. to 11:00 a.m. The meeting will be held in person at Saint John’s Evangelical Lutheran Church (910 Allentown Road, Sellersville, PA 18960) and virtually by means of Microsoft Teams. Find additional details in this Pennsylvania Bulletin notice.

2024-08-10T00:03:40+00:00August 9th, 2024|Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for August 9
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PA Health Policy Update for August 2

The following is an update of selected state health policy developments in Pennsylvania from July 29 – August 2.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The House Republican Policy Committee held an informational hearing on Thursday, August 1 about health care options for small businesses. The agenda and written testimony are viewable here. Find a recording of the hearing here.

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 published its report on Medicaid managed care enrollment in Pennsylvania for the month of June. 

Department of Health 

  • The Department of Health (DOH) has issued a Health Advisory (PA-HAN 762) with information, including treatment recommendations, about medetomidine, a potent non-opioid veterinary sedative, that has been detected in the illicit drug supply.
  • DOH has also issued a Health Advisory (PA-HAN 763) regarding an increasing number of emerging substances, including designer benzodiazepines, nitazines, tianeptine, and carfentanil, circulating in the illicit drug supply.
  • DOH has announced its annual long term care facility questionnaire will launch on September 1 and will seek to collect data for the state fiscal year timeframe of July 1, 2023 through June 30, 2024. An email with the questionnaire and log-in information for each facility will be sent to the email contact on file. As a reminder, completion of the questionnaire is mandatory. If a facility doesn’t receive the email on September 1, please contact Aicha Hassane Noma via email at ahassaneno@pag.gov. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3 billion in General Fund revenue in July, the first month of the 2024-25 fiscal year. July collection data does not include a comparison against anticipated amounts because revenue estimates for each month are not yet finalized. 

Around the State   

  • WHYY has published an article about a recent Commonwealth Fund survey report that found fewer than half of people who experienced insurance denials fought them due to a lack of knowledge about their right to do so. The article also highlights the Pennsylvania Insurance Department’s independent review program.
  • The Times-Tribune has written about Community Health Systems’ (CHS) plan to sell its three hospitals in Northeastern Pennsylvania to the newly formed non-profit health system Woodbridge Healthcare.
  • Harold Brubaker has written an article in The Philadelphia Inquirer about Thomas Jefferson University’s completed acquisition of Lehigh Valley Health Network.
  • Amid continued speculation about whether Governor Josh Shapiro will be the running mate of Vice President Kamala Harris, Newsweek has published an article about Shapiro’s last-minute schedule changes this coming weekend.
2024-08-02T20:27:51+00:00August 2nd, 2024|Financial, Governments|Comments Off on PA Health Policy Update for August 2
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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.
2024-07-26T20:18:58+00:00July 26th, 2024|Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for July 26
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  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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