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PA Health Policy Update for November 10

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

2023 General Election

Pennsylvania voters went to the polls this week to cast their ballots for a series of judicial, county, and municipal elections. Democrat Dan McCaffrey defeated Republican Carolyn Carluccio in a highly contested and expensive race to fill a vacancy on Pennsylvania’s Supreme Court. Democrats also won state-wide races for the superior and commonwealth courts. For detailed state and county election results, visit the Department of State’s website here. 

Governor Shapiro 

Governor Shapiro announced this week his administration will require all commercial insurers to “meet their obligations under Pennsylvania law” to provide coverage for autism benefits. Find additional information in this Pennsylvania Bulletin notice published by the Pennsylvania Insurance Department and this press release issued by the Shapiro administration. 

General Assembly

The state House of Representatives and Senate were in recess this week. Both chambers will return to Harrisburg next week and be in session Monday, November 13 through Wednesday, November 15.

Department of Human Services

The Department of Human Services (DHS) has issued several medical assistance bulletins relating to prior authorization for pharmacy services.

DHS has published final notice of the fee schedule rates for community participation support, Needs Group 5 Residential Habilitation and group music therapy, art therapy and equine assisted therapy services funded through the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers. Find additional information in this Pennsylvania Bulletin notice.

DHS is issued a Remittance Advice Alert notifying providers that a claims recovery was done to recoup monies paid in error due to date of death discrepancies uncovered in a recent audit.

DHS has published an updated Medicaid Managed Care Organization (MCO) Directory.  

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the beginning of the open enrollment period for Pennie, Pennsylvania’s official health insurance marketplace, for 2024 coverage. The enrollment period will last until December 15. Find additional information in this PID press release. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) held its Emerging Drug Trends Symposium this week. This annual event gathers key stakeholders to review current drug trends, innovative approaches to connect people who use drugs to treatment and other social services, identify gaps in services, and provide a venue for stakeholders to network. Find additional information in this DDAP press release. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – November 16

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 16 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-11-17T20:58:20+00:00November 10th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for November 10
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PA Health Policy Update for October 27

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

Governor Shapiro 

Governor Shapiro signed House Bill 1351 into law this week. Act 15 of 2023, as it is now known, reauthorizes the hospital Quality Care Assessment, increases Medicaid reimbursement for ambulance transportation, and makes changes to the skilled nursing facility case-mix rate. 

General Assembly

The Senate convened for voting session this week. The following is an overview of selected health-related legislative activity.

  • The Senate Health & Human Services Committee met on Tuesday, October 24 and favorably reported the following relevant bills.
    • Senate Bill 668, which allows certified nurse aides (CNAs) to pursue medication administration certification.
    • Senate Bill 828, which provides the Department of Health with the ability to create and utilize a stroke registry.
    • House Bill 507, which requires health care providers to receive explicit patient consent for all procedures and exams performed under anesthesia for training purposes.
  • The Senate passed Senate Bill 959 on Wednesday by a vote of 30-20. This legislation would establish a new process for scheduling newly added controlled substances after the U.S. Food & Drug Administration’s initial classification. The bill was received in the House of Representatives and referred to the Judiciary Committee.

The state House of Representatives will convene again for voting session on Monday, October 30.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin advising providers of updates to the Medical Assistance (MA) Program Dental Fee Schedule and the MA Program Dental PROMISe Provider Handbook.

DHS has published the minutes of the September 28, 2023 Medical Assistance Advisory Committee (MAAC) meeting.

Department of Health   

The Department of Health (DOH) has published minimum standard requirements for sexual assault evidence collection. The minimum standard requirements published in this Pennsylvania Bulletin notice should be observed by all health care facilities and child advocacy centers in the commonwealth. 

Insurance Department 

The Insurance Department has notified all basic insurance coverage insurers and self-insured participating health care providers that the annual MCARE assessment for 2024 will be 26 percent applied to the prevailing primary premium for each participating health care provider. Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Organ Donation Advisory Committee – November 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 2 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – November 16

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, November 16 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice

2023-10-27T19:59:06+00:00October 27th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 27
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PA Health Policy Update for October 20

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

General AssemblyHouse Chamber of the State House 

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

  • The House of Representatives voted 199-4 to concur with the Senate’s amendments to House Bill 1351, which reauthorizes the hospital Quality Care Assessment, increases Medicaid reimbursement for ambulance transportation, and makes changes to the skilled nursing facility case-mix rate. The bill has been presented to Governor Shapiro for his signature.
  • The Senate unanimously passed Senate Bill 941, which enables certain flexibilities for addiction treatment providers. The bill has been received in the House and referred to the Professional Licensure Committee.
  • The House of Representatives’ Health Committee met on Wednesday, October 18 and favorably reported the following bills.
    • House Bill 1417, which restores dental coverage for Medical Assistance recipients.
    • House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania.
    • House Bill 1694, which requires the Department of Drug & Alcohol Programs to create an annual report on the use of opioid settlement funds by state and county governments.
    • Senate Bill 500, which requires Medicaid coverage for medically prescribed pasteurized donor human milk. 

The Senate will return to session next Monday, October 23 through Wednesday, October 25. The House of Representatives is recessed until Monday, October 30.

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 November. Find the updated calendar here.

Department of Health   

The Department of Health has recommended long-term care facilities use its  COVID-19 Infection Control and Outbreak Response Toolkit for Long-Term Care when preparing for and responding to a COVID-19 outbreak. A 2023-2024 Influenza Toolkit is also available. For assistance on COVID-19 infection prevention and control, providers are strongly encouraged to reach out to LTC-RISE and Project Firstline.

The DOH Bureau of Family Health has announced a funding opportunity for community-based, non-profit organizations to provide direct, individualized services to families who qualify for the Community to Home (C2H) program. The application will be open through December 19, 2023. Find additional information here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Chiropractic’s proposed rulemaking. Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Subcommittee of the MAAC – October 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, October 25 at 1:00 p.m. To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – October 26

The MAAC will hold a meeting on Thursday, October 26 at 10:00 a.m. To participate virtually, register here.

DOH – Organ Donation Advisory Committee – November 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 2 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-10-20T20:19:25+00:00October 20th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for October 20
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PA Health Policy Update for October 13

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

Governor Shapiro 

Governor Shapiro has announced that he signed Executive Order 2023-20 establishing the commonwealth’s first Behavioral Health Council. The 33-member council is tasked with developing a state-wide action plan to enhance and streamline the coordination and delivery of behavioral health care services and improve access to care. 

Governor Shapiro has signed House Bill 1209 and House Bill 1407 into law. These bills, now known as Act 11 and Act 9 of 2023, respectively, make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. 

General Assembly 

The state House of Representatives and Senate will convene for voting session next Monday, October 16 through Wednesday, October 18.

The House of Representatives’ Health Committee will meet on Wednesday, October 18 at 9:45 a.m. in Room G50 of the Irvis Office Building to consider the following bills.

  • House Bill 1417, which restores dental coverage for Medical Assistance recipients.
  • House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania.
  • House Bill 1694, which requires the Department of Drug & Alcohol Programs to create an annual report on the use of opioid settlement funds by state and county governments.
  • Senate Bill 500, which requires Medicaid coverage for medically prescribed pasteurized donor human milk. 

The Senate Appropriations Committee is scheduled to meet off the floor on Monday, October 16 to consider, among other bills, Senate Bill 941, which enables certain flexibilities for addiction treatment providers. 

Department of Human Services

The Department of Human Services (DHS) has published final notice of its intent to increase to the funding and change the payment methodology for a class of disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for Fiscal Year (FY) 2022-2023. These payments will provide financial relief to hospitals that provided access to acute care services for Medical Assistance (MA) beneficiaries during the COVID-19 pandemic. Find additional information in this Pennsylvania Bulletin notice.

DHS has announced that PROMISe will have an extended maintenance window beginning 9:00 p.m. on October 20 to 2:00 p.m. on October 22.  During this window all PROMISe functions, including provider enrollment applications, will be unavailable.  For Pharmacy claims, DHS is directing pharmacies to dispense 5-day supplies of drugs and submit claims when the system is back online.

Auditor General  

Auditor General Tim DeFoor has announced the department will conduct a performance audit of state contracts and oversight of Pharmacy Benefit Managers (PBMs) used by the Department of Human Services’ HealthChoices Medicaid Program. 

Medicaid Continuous Coverage Unwinding 

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – October 20

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – November 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, November 2 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-10-13T19:39:11+00:00October 13th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for October 13
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PA Health Policy Update for October 6

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

FY 2023-20204 Budget Update 

The General Assembly continues to work on finalizing the FY 2023-2024 state budget. This week the state House of Representatives passed an amended version of the Fiscal Code (House Bill 1300) by a vote of 121-82 and sent it back to the Senate for consideration. The House of Representatives also passed an addendum to the General Appropriations Act (House Bill 1456) and a tax code (House Bill 1219) and sent them to the Senate for consideration. These pieces of legislation were not negotiated with Senate leadership in advance, so it is unclear how the Senate will proceed, or when the FY 2023-2024 budget process will be completed. 

General Assembly 

  • The state House of Representatives and Senate convened for session in Harrisburg this week. The following is an overview of selected health care focused legislative activity.
    • The House of Representatives adopted House Resolution 165, which directs the Legislative Budget and Finance Committee to examine the effect of workforce shortages on state-supported Medicaid home and community-based services waiver programs.
    • The Senate Health & Human Services Committee held an informational meeting on Tuesday to examine barriers to addiction treatment. Immediately following the information meeting, the committee held a voting meeting and favorably reported the following bills.
      • Senate Bill 941, which enables certain flexibilities for addiction treatment providers.
      • Senate Bill 721, which establishes the Women, Infants, and Children (WIC) advisory board.
      • House Bill 1351, which makes certain changes to the Rural Health Redesign Center Authority.

Find a recording of the hearing here.

    • The House Health Committee’s Subcommittee on Health Facilities held an informational meeting on Wednesday to examine the effects of hospital consolidation. Find a recording of the hearing here.
    • The House Human Services Committee and Aging & Older Adult Services Committee held a joint informational meeting Wednesday on personal care homes and assisted living facilities. Find a recording of the hearing here.
  • The state House of Representatives and Senate are now recessed until Monday, October 16. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to make one-time enhanced supplemental payments to eligible public and non-public Medical Assistance (MA) nursing facilities. Find additional information in this Pennsylvania Bulletin notice.
  • DHS Secretary Dr. Val Arkoosh has reminded Pennsylvanians who receive health care coverage through Medicaid or CHIP that the cost of COVID-19 vaccines, tests, and treatments are covered by the programs. Find additional information in this press release issued by DHS.
  • DHS has issued a Medical Assistance Bulletin announcing the addition of new procedure codes to the Medical Assistance (MA) program for vaccine administration.
  • DHS has issued a Medical Assistance Bulletin notifying providers about updates to the provision of Medicaid-covered services to beneficiaries experiencing homelessness when delivered in their lived environment, also known as “street medicine.”
  • DHS has published Provider Quick Tip #270 with important information for providers who are required to revalidate clinicians at multiple locations.
  • DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on September 28.

Department of Health 

The Department of Health (DOH) has invited stakeholders to participate in an information-gathering listening session regarding patient access to controlled substances in the commonwealth. The listening session will be held on Wednesday, October 11 from 10:00 – 11:30 a.m. Find additional information on how to register and participate here.

DOH has announced it will be implementing new regulatory requirements for all long-term care facilities beginning October 31. The new requirements include changes to the application for licensure, which will require additional information, documentation, and public disclosure. DOH has provided interpretive guidance for these changes on its website here.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.1 billion in General Fund revenue in September, which was $140.2 million, or 3.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $9.8 billion, which is $167.4 million, or 1.7 percent, below estimate. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – October 20

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-10-10T14:33:03+00:00October 6th, 2023|Financial, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 6
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PA Health Policy Update for September 29

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

Governor Shapiro

Governor Shapiro announced the launch of a new economic development strategy this week that aims to make Pennsylvania a leader in job creation and innovation. Tuesday’s announcement was the first step in creating the state’s first comprehensive economic growth strategy in almost two decades.  The strategy will be an assessment of the areas of strength, an analysis of barriers to growth, and concrete goals and initiatives to guide policymaking and investment decisions moving forward. 

General Assembly 

  • The state House of Representatives convened in Harrisburg this week. The following is an overview of selected health care focused legislative activity.
    • The Health Committee met on Wednesday, September 27 and favorably reported, among other bills and resolutions, House Resolution 143, which directs the Joint State Government Commission to study Pennsylvania’s response to COVID-19. Find a recording of the hearing here.
    • The Aging & Older Adult Services Committee met on Wednesday, September 27 and favorably reported, among other bills, House Bill 1527, which increases the personal needs allowance for Medical Assistance-eligible residents living in nursing facilities, and House Resolution 165, which directs the Legislative Budget and Finance Committee to examine the effect of workforce shortages on state-supported Medicaid home and community-based services waiver programs. Find a recording of the hearing here.
  • The state House of Representatives and Senate will convene in Harrisburg next Monday, October 2 through Wednesday, October 4 for voting session.
  • The House Health Subcommittee on Health Facilities will hold an informational meeting on Wednesday, October 4 at 9:00 a.m. to examine hospital closures and consolidation.
  • The House Human Services Committee and Aging & Older Adult Services Committee will hold a joint informational meeting on Wednesday, October 4 at 9:00 a.m. on personal care homes and assisted living facilities.  

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin announcing the addition of new procedures codes to the Medical Assistance (MA) program for vaccine administration.

DHS has issued a Medical Assistance Bulletin to notify dental providers of updates to the 2023 Pediatric Dental Periodicity Schedule.

Insurance Department 

The Pennsylvania Insurance Department has announced the 2024 individual and small group Affordable Care Act (ACA) health insurance rates. The open enrollment period for Pennsylvania’s state-based insurance exchange, Pennie, will be November 1 to December 15.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its annual list of 35 diseases, procedures, and medical conditions for which data shall be required. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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, 6340 Flank Drive, Harrisburg, PA in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2023-09-29T19:55:37+00:00September 29th, 2023|long-term care, Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 29
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PA Health Policy Update for September 15

The following is an update of selected state health policy developments in Pennsylvania from September 11 – 15.  (Some of the language used below is taken directly from state documents.) 

Governor Shapiro 

The Shapiro administration announced on Monday, September 11 that the Department of Human Services will begin reviewing and updating the data used to set rates for home and community-based services for Pennsylvanians with intellectual disabilities and autism. Find additional information in the administration’s press release here. 

General Assembly 

  • The House Health Committee will hold a public hearing on Wednesday, September 20 at 9:30am on House Bill 1657, which amends the Clean Indoor Air Act. The legislation clarifies the definition of a workplace, expands the definition of smoking to include e-cigarettes, and gives all localities the ability to enact smoke-free ordinances that exceed minimum state standards. The hearing will be held in Room 523 of the Irvis Office Building and will be livestreamed here.
  • The state Senate will convene for voting session Monday, September 18 through Wednesday, September 20. The state House of Representatives will remain in recess next week. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers of the expansion of childhood nutrition and weight management services for Medical Assistance (MA) beneficiaries under 21 years of age. The expansion includes pharmacotherapy as a result of changes to coverage of obesity drugs and updated guidance from the American Academy of Pediatrics, as well as coding changes stemming from the 2023 Healthcare Common Procedure Coding System updates.
  • DHS has issued a Medical Assistance Bulletin advising providers of procedure code updates to the MA program fee schedule for the provision of pediatric shift care services provided by home health aides through home health agencies to MA beneficiaries under 21 years of age. The changes are effective with dates of service on and after October 1, 2023.
  • DHS has published Provider Quick Tip #269 to remind providers that they may bill for, and prescribers may order, certain incontinence products.
  • DHS has issued a Remittance Advice (RA) Alert notifying community support service providers of the Federal Financial Participation rate change for the new federal fiscal year, which begins on October 1, 2023.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 717) with important information for providers regarding severe Vibrio vulnificus (V. vulnificus) infections in the United States associated with exposure to coastal waters. Since May 2023, there have been three Pennsylvania residents with V. vulnificus infections, all of whom were exposed to coastal water in the days leading up to disease onset.

Department of Aging 

The Department of Aging has released a Master Plan for Older Adults White Paper, which is intended to serve as a reference guide for aging stakeholders and interested individuals as they formulate and submit comments for the state’s master plan for older adults. Additional information about the development of the state’s master plan for older adults and how to comment may be found here. 

Board of Nursing 

The State Board of Nursing has published proposed rulemaking regarding opioid prescribing and organ donation education for certified registered nurse practitioners (CRNPs). Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events  

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

2023-09-15T20:01:07+00:00September 15th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for September 15
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PA Health Policy Update for September 8

The following is an update of selected state health policy developments in Pennsylvania from September 4 – 8.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

General Assembly

  • The House Commerce Committee held an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. A recording of the hearing can be viewed here.
  • The House Republican Policy Committee held a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” More information on the hearing can be found here.
  • The House Health Committee will hold a public hearing on Wednesday, September 20 at 9:30am on HB 1657, which amends the Clean Indoor Air Act. The legislation would clarify the definition of a workplace, expand the definition of smoking to include e-cigarettes, and give all localities the ability to enact smoke-free ordinances that exceed minimum state standards. The hearing will be held in Room 523 of the Irvis Office Building and will be livestreamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule for the provision of pediatric home health aide services by family members employed by home health agencies. Learn more in this Pennsylvania Bulletin notice.
  • DHS has published Provider Quick Tip #207 advising health care providers of updates to the procedure codes that are subject to the MA cost avoidance process under Act 62. The purpose of the updates is to bring procedure code descriptions in alignment with national procedure code descriptions. The changes became effective September 5, 2023.
  • The Office of Long-Term Living (OLTL) has announced that Public Partnerships, LLC, has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA) for financial management services for Fee-for-Service OLTL-administered programs related. The new contract became effective September 1, 2023.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs (DDAP) has announced the start of its state-wide stakeholder engagement tour. The kick-off event was held in northeastern Pennsylvania in partnership with the Columbia, Montour, and Snyder Drug and Alcohol Program. DDAP’s goal is to gather feedback that will help craft the agency’s plan for increased community and treatment provider engagement while also gaining stakeholder insight to assist the agency’s work on regulation reform.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in August, which was $27.1 million, or 0.9 percent, less than anticipated. Fiscal year-to-date collections total $5.8 billion, which is $27.2 million, or 0.5 percent, below estimate.

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

2023-09-08T20:37:35+00:00September 8th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 8
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PA Health Policy Update for July 7

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

FY 2023-2024 Budget Update 

The Fiscal Year (FY) 2023-2024 budget remains in flux. Earlier this week the House of Representatives voted to concur with the Senate-passed General Appropriations bill (House Bill 611) by a vote of 117-86. The vote occurred after Governor Shapiro issued a statement announcing his intent to line-item veto the full $100 million intended for the Pennsylvania Award for Student Success (or PASS) voucher program – an initiative adamantly opposed by House Democrats and among the chief points of contention leading to the budget impasse. House Bill 611 was subsequently signed in the House and is awaiting signature in the Senate before it can be sent to the governor.

It is unclear when the Senate will return to Harrisburg or when a final agreement between the various parties will be reached. Senate Republican leadership released a statement criticizing Governor Shapiro and indicating they will “continue to await legislative action by the House on the remaining budgetary components.” 

Governor Shapiro

Governor Shapiro held a press conference touting House Bill 611’s $45.5 billion spending plan and its critical investments in mental health, education, and law enforcement. The governor implored the Senate to return to Harrisburg and sign the bill so it can be sent to his desk. Governor Shapiro also urged the Senate Republicans and House Democrats to meaningfully engage and enact enabling legislation (Fiscal Code, etc.) that would allow the budget to be fully implemented.

Governor Shapiro signed SB 262 into law on Thursday July, 6, which is now known as Act 5 of 2023. Act 5 amends the Maternal Mortality Review Act to require the Maternal Mortality Review Committee to annually publish severe maternal mortality data. 

General AssemblyHouse Chamber of the State House

The House returned to Harrisburg this week for voting session and adjourned to the call of the chair, noting that they do not anticipate returning for voting session in the immediate future. The following are selected health-related proceedings.

  • The House Human Services Committee held a voting meeting July 5 to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The bill was reported as committed. A recording of the meeting can be viewed here.
  • The House passed HB 1515 to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments and HB 1218 which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bills now go to the Senate for consideration.
  • The House Aging and Older Adult Services Committee previously scheduled a voting meeting Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting was not held.

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin announcing its intent to reimburse health care providers for services rendered to Medicaid beneficiaries experiencing homelessness. Eligible services include but are not limited to, “primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder, and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.” DHS has updated the MA Program Fee Schedule accordingly. Find additional information in the department’s press release announcing the policy change.

  • DHS has announced it will require prior authorization of all prescriptions for Amyloid-Targeted Monoclonal Antibodies and certain drugs not included on the Statewide Preferred Drug List (PDL). These prior authorization requirements will apply to prescriptions dispensed on or after July 10, 2023.
  • DHS has provided final notice of its funding allocation for FY 2022-2023 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to general acute care hospitals. The department is not otherwise changing the qualifying criteria or payment methodology for these payments.
  • DHS has announced the end-dating of three procedure codes related to COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #267 with additional information regarding the department’s delayed implementation of Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals. 

Revenue Collection Update 

The Department of Revenue announced the commonwealth ended FY 2022-2023 with $44.9 billion in General Fund revenue collections, which is $1.3 billion, or 3.1 percent, above estimate.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published the public comments it received regarding DHS’ adult protective services proposed rulemaking. The comments may be viewed in this Pennsylvania Bulletin notice. 

Stakeholder Events

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Renal Disease Advisory Committee – July 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 21 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – August 3

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 3 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-07-07T20:27:07+00:00July 7th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for July 7
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PA Health Policy Update for June 16

The following is an update of selected state health policy developments in Pennsylvania from June 12 – 16.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

U.S. Health & Human Services (HHS) Secretary Xavier Becerra has sent a letter to governors urging states to adopt all options that HHS has offered to help eligible individuals and families maintain their health coverage during the redetermination process and leverage all partners to support individuals and families to complete renewal forms. 

Governor Shapiro

Governor Shapiro signed House Bill 739 (Act 2 of 2023) into law on Wednesday. Act 2 creates new cyber security-related requirements for health insurers and allows the Insurance Commissioner to adopt National Association of Insurance Commissioners (NAIC) Valuation Manual exemptions by notice in the Pennsylvania Bulletin. 

General Assembly

The state House returned to Harrisburg for voting session Monday, June 12. The following are selected health-related proceedings.

  • The House Insurance Committee held a voting meeting Monday, June 12 at 11:00am to consider HB 1050, requiring health insurers to cover preventive health care services without cost-sharing. The bill was reported as amended. A recording of the meeting can be viewed here. The Insurance Committee was expected reconvene on Wednesday, June 14 to consider HB 1140; however, the meeting was cancelled.
  • The House Health Committee held a voting meeting Wednesday, June 14 to consider the following bills:
    • HB 78, establishing the Medical Debt Relief Program. The bill was reported as amended by a vote of 18-3.
    • HB 807, providing for perimenopause and menopause education. The bill was reported as committed by a vote of 20-1.
    • HB 817, amends the Pharmacy Act to provide education on drug take back programs. The bill was reported as committed by a vote of 20-1
    • HB 818, creates the Pharmaceutical Collection Sites Educational Program within the Department of State. The bill was reported as amended by a vote of 18-2.
    • HB 1209 and HB 1407, add two enforcement mechanisms to the Tobacco Product Manufacturer Directory Act and the Tobacco Settlement Agreement Act, which resolved legal claims between the commonwealth and participating manufacturers relating to health care costs for treating smoking-related illnesses. The bills were unanimously reported as committed.
    • HB 1351, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership.
    • SB 262, amends the Maternal Mortality Review Act to would add “severe maternal morbidity” to the list of reportable events within the Pennsylvania Department of Health. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here. 

The Senate will return to Harrisburg Monday, June 19 and the House will return Tuesday, June 20 for voting session. The following are selected health-related proceedings.

  • The Senate Health & Human Services Committee will hold a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which require an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership.
    • SB 817, which creates a primary care workforce initiative for our Federally Qualified Health Centers (FQHCs).
  • Immediately following, the Senate Health & Human Services Committee will hold a public hearing to consider the nomination of Dr. Latika Davis-Jones for Secretary of the Department of Drug and Alcohol Programs (DDAP).

Both meetings will be held in Room 8E-A East Wing and will be live streamed here. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (2023 – PAHAN – 704) notifying providers of an anticipated increase in Legionellosis cases due to seasonality.

Department of Human Services

  • The Department of Human Services (DHS) has shared the agenda for the June 22 Medical Assistance Advisory Committee (MAAC) meeting. In advance of the meeting, DHS has also shared the public input it received regarding the Drug Utilization Review (DUR) Board prior authorization guideline briefing documents discussed at the May 25 meeting.
  • DHS has issued a Medical Assistance Bulletin informing providers the department has rescinded the statement of policy codified at § 1101.51a, which clarified the term “within a provider’s office” and updated the process for the enrollment or revalidation of providers that are in co-located arrangements. Effective January 14, 2023, providers who are in co-location arrangements no longer need to complete the attestation form during enrollment or revalidation in the MA Program.
  • The Executive Board approved a reorganization of DHS. Additional information and a revised organizational chart is available in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of a procedure code to the Medical Assistance (MA) Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc. The effective date and MA Fee for the code is indicated in this Pennsylvania Bulletin notice. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued Licensing Alert 04-2023 to provide clarification on how to calculate client to counselor ratios for inpatient, non-hospital treatment and rehabilitation facilities for regulatory compliance. 

Department of Aging 

The Department of Aging held its first regional town hall in southeastern Pennsylvania to seek input on Pennsylvania’s Master Plan for Older Adults, which will be a 10-year, state-led strategic plan designed to transform the infrastructure and coordination of services for older Pennsylvanians. Governor Shapiro’s executive order directing the department to develop the plan is available here. 

Stakeholder Events

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here. 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-17T00:10:13+00:00June 16th, 2023|Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for June 16
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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