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PA Health Policy Update for August 1

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

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

Fiscal Year 2025-26 Budget Update 

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

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

Department of Human Services  

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

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

Department of Health 

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

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

Department of Aging 

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

Around the State  

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

Stakeholder Meetings

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

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

DOH – Organ Donation Advisory Committee – August 7

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

DOH – Infant Hearing Screening Advisory Committee – August 7

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

2025-08-01T20:53:57+00:00August 1st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for August 1
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PA Health Policy Update for July 11

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

Fiscal Year 2025-26 Budget Update 

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

Governor Shapiro 

Governor Shapiro signed the following bills into law this week.

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

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

General Assembly

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

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

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

Department of Human Services 

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

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

Department of Community & Economic Development

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

Independent Regulatory Review Commission (IRRC) 

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

Around the State  

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

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

Stakeholder Meetings

DOH – HIV Planning Group – July 16-17

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

DOH – WIC State Advisory Board – July 22

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

DOH – Infant Hearing Screening Advisory Committee – August 7

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

2025-07-11T20:14:15+00:00July 11th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for July 11
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PA Health Policy Update for June 13

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

General Assembly

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

  • The Senate unanimously passed Senate Bill 95, which permits EMS providers to leave naloxone with a caregiver of a patient who overdosed. The bill also places certain disclosure requirements on pharmacies related to the retail and generic versions of prescribed medications. The bill was subsequently received in the House and referred to the Veterans Affairs and Emergency Preparedness Committee.
  • The House of Representatives passed House Bill 1549, which increases the state’s minimum wages, by a party-line vote. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1460, which provides for more oversight of health care entity merger and acquisition activities. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1088, which expands maternal blood pressure monitoring coverage. The bill will now be sent to the Senate for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Wednesday, June 11 and favorably reported, among other bills, Senate Bills 535 & 536, which amend the Osteopathic and Medical Practice Acts to enable genetic counselors to order genetic tests as appropriate.
  • The Senate Health & Human Services Committee met on Wednesday, June 11 and favorably reported, among other bills, the following.
    • Senate Bill 461, which seeks to improve testing and insurance coverage for Lyme disease testing.
    • Senate Bill 715, which extends the Rare Disease Advisory Council’s sunset date to 2028.
    • House Bill 27, which requires operating rooms to utilize surgical smoke evacuation systems.
    • House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP).

A recording of the meeting is viewable here.

  • The House Human Services Committee met on Tuesday, June 10 and favorably reported House Bill 1100, which creates a grant program to provide eligible public-school entities with funding to acquire and distribute menstrual hygiene products, and House Bill 1590, which supports Pennsylvania’s implementation of a new federal Medicaid flexibility that waives the longstanding “four walls” requirement for outpatient behavioral health clinics. A recording of the hearing is viewable here.
  • The House Health Committee met on Tuesday, June 10 and favorably reported House Bill 1442, which places requirements on coroners to report Sudden Unexpected Death in Epilepsy (SUDEP), and House Bill 1527, which extends the Rate Disease Advisory Council’s sunset date to 2028. A recording of the meeting is viewable here.
  • The House Aging & Older Adult Services Committee met on Tuesday, June 10 for an informational hearing on the Older Adult Protective Services Act (OAPSA) and financial exploitation of older adults. A recording of the hearing is viewable here.
  • The Legislative Budget & Finance Committee (LBFC) met on Wednesday, June 11 and released its report on the effect of home and community-based workforce shortages on commonwealth-supported Medicaid waiver programs. The full report is viewable here and highlights from the report are viewable here. 

The state House of Representatives will reconvene in Harrisburg for voting on Monday, June 16. The Senate is recessed until Monday, June 23.

Department of Human Services

  • The Department of Human Services (DHS) has announced it will hold another listening session in its “Food is Medicine Stakeholder Engagement Series,” which is part of the Bridges to Success: Keystones of Health demonstration waiver. The next session, which will focus on medically tailored meals, will take place on June 16 at 1:00 p.m. Find additional information and registration details here.
  • DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Statewide Preferred Drug List (PDL) related to glucose sticks made at the April 23 Pharmacy & Therapeutics (P&T) Committee meeting. The PDL changes are effective July 7, 2025.
  • DHS has announced changes to the Medical Assistance (MA) program fee schedule. The department is adding and end-dating codes as a result of the 2025 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The changes are effective for dates of service on and after June 16, 2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has released a document with revisions to the participating drug companies list for the Medicaid Drug Rebate Program.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of July. Find the updated calendar here.
  • DHS has issued a Remittance Advice Alert regarding action needed to continue submitting claims and eligibility requests electronically with PROMISe™. 

Department of Health

The Department of Health (DOH) has published notice of intent to issue a final notice to temporarily schedule any material, compound, mixture, or preparation which contains any quantity of the several Nitazene substances. This final notice to temporarily schedule will place this group of substances in Schedule I under The Controlled Substance, Drug, Device and Cosmetic Act. 

Independent Fiscal Office

The Independent Fiscal Office (IFO) has published a budget brief highlighting Pennsylvania Medicaid enrollment and funding trends from FY 2018-19 through the administration’s proposal for FY 2025-26. It also provides projections of the impact for certain Medicaid provisions included in the federal reconciliation bill passed by the U.S. House of Representatives. 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced that the largest health insurers operating in the commonwealth are taking steps to expand coverage for medications used to treat postpartum depression and related maternal mental health conditions. Find additional information in this press release. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has shared an opportunity from the Health Resources and Services Administration (HRSA),  the Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program. The program offers up to $250,000 in student loan repayment for eligible professionals who commit to six years of full-time work providing direct SUD treatment or recovery support at an approved facility. The program is open to a range of providers, including medical, behavioral health, and peer support professionals. Applications are due July 10, 2025. 

Around the State  

  • Spotlight PA has published an article on the potential impact of the budget reconciliation bill being considered by the U.S. Congress on the state’s Medicaid program. 
  • The Wall Street Journal has written an article about the Pennsylvania General Assembly’s efforts to enact legislation creating more scrutiny over health care entity transactions involving private equity. 
  • LancasterOnline covered Senate Appropriations Committee Chairman Scott Martin’s comments about the state budget unpredictability created federal budget discussions. 

Stakeholder Meetings

Pharmaceutical Assistance Advisory Board – June 16

The Department of Aging has announced the Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, June 16 from 1:00 p.m. to 2:30 p.m. Find information on how to participate in this Pennsylvania Bulletin notice. 

Patient Safety Authority – June 17

The Patient Safety Authority has announced it will hold a meeting of the Authority’s board on Tuesday, June 17 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Preventative Health Services Block Grant Advisory Committee – June 17

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, June 17 from 9:30 a.m. to 10:30 a.m. The purpose of the meeting is to present the Federal Fiscal Year 2025 Workplan and budget information. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-06-13T19:46:49+00:00June 13th, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 13
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PA Health Policy Update for May 16

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

Election Update

Pennsylvania’s 2025 Primary Election will be held next Tuesday, May 20. On the ballot there are judicial candidates seeking to fill vacancies on the Commonwealth and Superior Courts, along with municipal races. Find additional election information on the Department of State’s website here.  

Governor Shapiro 

On Thursday, May 15 Governor Shapiro visited Crozer-Chester Medical Center, which is ceasing operations, in Delaware County to highlight efforts to support impacted workers, maintain emergency medical services, and “hold private equity firms accountable.” Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate convened for voting session this week. The following is an overview of selected legislative activity that occurred.

  • The House of Representatives passed an amended House Bill 561, which while still prioritizing non-narcotic medication-assisted treatment (MAT) expands Act 80 to include all FDA-approved MAT. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 309, which amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license. The bill will now be sent to the Senate for consideration. 
  • The House Health Committee met on Wednesday, May 14 and favorably reported House Bill 704, which establishes the “Pennsylvania Neurodegenerative Disease Research Program.” A recording of the hearing is viewable here. 
  • The House Aging & Older Adult Services Committee held a joint hearing with the House Health Committee on Wednesday, May 14 regarding Pennsylvania’s registered nurse aide program. A recording of the hearing is viewable here. 
  • The Senate Banking & Insurance Committee met on Tuesday, May 13 and favorably reported Senate Resolution 27, which directs the Legislative Budget and Finance Committee to study the feasibility of establishing a no-fault catastrophic loss fund to provide payment for claims brought as the result of birth-related neurological injuries. A recording of the hearing is viewable here. 
  • The House Human Services Committee met on Tuesday, May 13 and favorably reported House Bill 1429, which requires a study on the feasibility of implementing chip-enabled electronic benefit cards (EBT) for the Supplemental Nutrition Assistance Program (SNAP). A recording of the hearing is viewable here. 
  • The Senate Veterans Affairs & Emergency Preparedness Committee met on Monday, May 12 and favorably reported, among other bills, Senate Bill 95, which permits EMS providers to leave naloxone with a caregiver of a patient who overdosed.

The House of Representatives and the Senate are now recessed until Monday, June 2. 

Department of Human Services

  • The Department of Human Services (DHS) has announced it will hold a listening session on May 19 from 1:00 – 2:30 p.m. entitled, “Food is Medicine: Screening and Referral.” This is part of DHS’ Keystone of Health Section 1115 demonstration waiver initiative. The listening session is intended for representatives from health care and other settings that interact with consumers that may be eligible for Food is Medicine programs. Find additional information and register here.
  • DHS has announced that the Office of Mental Health and Substance Abuse Services (OMHSAS) is conducting a survey, which will be the first step to begin the development of one proposed chapter of licensing regulations for inpatient psychiatric services in psychiatric units of general hospitals, private psychiatric hospitals, and extended acute care services located within those inpatient settings. The survey is for all stakeholders, including licensed providers, and will remain open until May 26. Find the survey here.
  • DHS has issued a Medical Assistance Bulletin with the U.S. Department of Health & Human Services’ (HHS) Centers for Disease Control and Prevention (CDC) 2025 recommended child and adolescent immunization schedule.
  • DHS has also issued a Medical Assistance Bulletin to advise dental providers enrolled in the Medical Assistance (MA) program that will accept the 2024 American Dental Association (ADA) claim form effective May 1, 2025.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of June. Find the updated calendar here.
  • DHS has announced the implementation of the 2025 Federal Poverty Income Guidelines (FPIG), which were issued by HHS and published at 90 FR 5917 on January 17, 2025. Find additional information in this Pennsylvania Bulletin notice. 

Around the State

  • Spotlight PA has written an article about private equity, its role in health care companies, and the scrutiny its drawing from critics. Spotlight also wrote an article about health systems’ opposition to initiatives aimed at implementing more stringent health care transaction oversight.  
  • The Pittsburgh Post-Gazette has published an article about Medicaid cuts being contemplated by Congress and their potential impact on providers in Fayette County. 
  • The Associated Press covered Governor Shapiro’s remarks about the potential impact of Medicaid proposals being considered by Congress. 
  • The Philadelphia Inquirer has reported about this what is anticipated to be this year’s biggest election issue, the retention of three sitting Pennsylvania Supreme Court justices. 

Stakeholder Meetings

DHS – Consumer Sub-MAAC – May 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 21 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – May 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 22 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Spinal Cord Research Committee – May 23

The Spinal Cord Research Advisory Committee will hold a public meeting on Friday, May 23 from 10:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-05-16T19:25:46+00:00May 16th, 2025|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 16
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PA Health Policy Update for April 11

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

General Assembly

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

  • The House of Representatives passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Monday, April 7 to examine potential updates to the Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.
  • The House Human Services Committee met on Tuesday, April 8 and favorably reported House Bill 561, which expands Act 80 to include all FDA-approved medication assisted treatment, and House Bill 1117, which updates language defining DDAP’s duties and responsibilities. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, April 8 and favorably reported House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, April 9 and favorably reported, among other legislation, the following pertinent bills. A recording of the meeting is viewable here.
    • House Bill 69, which expands the existing Cancer Drug Repository program to other prescription drugs.
    • House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements.
    • House Bill 1104, which caps the costs of obtaining electronic medical records.

The House of Representatives and the Senate have now recessed. The House will reconvene Tuesday, April 22 and the Senate will reconvene Monday, May 5. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to remind physicians, physician assistants (PAs), and certified registered nurse practitioners (CRNPs) enrolled in Medicaid that they are able render topical fluoride varnish (TFV) services to Medicaid beneficiaries.
  • DHS has issued a reminder to all participating Medicaid providers of the need to complete a “MA 112 Form” after the birth of a child to a mother enrolled in Medicaid in order to notify the mother’s respective county assistance office (CAO).  The “MA 112 Form” should be completed and submitted within three working days of the child’s birth.
  • DHS has published final notice of its funding allocation for FY 2024-25 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to Medicaid-enrolled, qualifying inpatient acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice. 

Around the State  

  • CBS News has published an article about the continued challenges facing Crozer Health in Delaware County. An attorney for Prospect Medical Holdings, the parent company of Crozer, indicated Crozer would start transitioning certain service lines to other providers.
  • Pennsylvania’s home care industry and its need for additional funding was the focus of an article by Politics PA this week.
  • The Pennsylvania Capital-Star has published an article about increasing measles cases in the state and some counties’ lagging vaccination rates. 

Stakeholder Meetings

DOH – WIC State Advisory Board – April 22

The WIC State Advisory Board will hold a public meeting on April 22 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate 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 and information on how to participate in this Pennsylvania Bulletin notice. 

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

DHS – Consumer Sub-MAAC – April 23

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

DHS – Medical Assistance Advisory Committee – April 24

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

DOH – Renal Disease Advisory Committee – April 25

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 25 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-11T22:36:44+00:00April 11th, 2025|Governments, Medical Assistance Bulletin, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 11
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PA Health Policy Update for April 4

The following is an update of selected state health policy developments in Pennsylvania from March 31 – April 4.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

The Shapiro administration has announced it joined a multi-state lawsuit against the Trump administration’s decision to cancel more than $500 million in public health grant funding that supported programs in the Department of Health, Department of Human Services, and the Department of Drug & Alcohol Programs. Find a copy of the lawsuit here and additional information in this press release. 

General Assembly

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

  • The Senate passed Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, by a vote of 38-11. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Institutional Sustainability & Innovation Committee held an informational hearing on Tuesday, April 1 examining the commonwealth’s life science sector and Pennsylvania’s innovation economy. A recording of the hearing is and testimony offered to the committee is viewable here.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, April 1 and favorably reported, among other bills, Senate Bill 115, which provides skills competency examination opportunities to individuals seeking employment as a direct caregiver in lieu of successfully obtaining a high school diploma or GED equivalency, and Senate Bill 411, which implements a statewide stroke registry.

The Senate has now recessed until Monday, May 5. The state House of Representatives will reconvene Monday, April 7 through Wednesday, April 9. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS is implementing an alternative payment methodology for federally qualified health centers (FQHCs) and rural health clinics (RHCs) for a supplemental payment at the Medicaid fee schedule rate for a long-acting reversible contraceptive (LARC) device and its insertion, or the removal of a LARC device.

DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death.  Find the notice here. 

Revenue Collection Update  

The Department of Revenue has announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $70.0 million, or 1.1 percent, more than anticipated. Fiscal year-to-date General Fund collections total $33.2 billion, which is $34.3 million, or 0.1 percent, below estimate. 

Board of Pharmacy ission, 

The State Board of Pharmacy has published a notice in the Pennsylvania Bulletin of the current income levels necessary for participation in the Cancer Drug Repository program. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin that it has received the following final form rulemaking which will be considered at its May 15 meeting.

IRRC has also published a notice in the Pennsylvania Bulletin announcing it has issued comments to the State Board of Nursing regarding its proposed rule on nursing education programs issued January 25, 2025. Find IRRC’s comments here. 

Around the State

  • The Philadelphia Inquirer has published an article about Independence Blue Cross’, the largest health insurer in southeastern Pennsylvania, reported financial loss in 2024 due, in part, to Medicare and Medicaid rates. 
  • Governor Shapiro’s decision to join a multi-state lawsuit against the Trump administration’s decision to cancel public health grant funding was reported by the Pennsylvania Capital-Star. 
  • The Pennsylvania Capital-Star also published an article about the potential impact Medicaid cuts at the federal level may have on rural health care access. 
  • Spotlight PA has published an article about the Department of Aging’s decision to revise a policy that previously required the tracking of the cause of death for every adult who died during an active abuse or neglect investigation. 

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

PHC4 – Meeting Schedule

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Payment Data Advisory Group meeting for April 10 at 1:00 p.m., a Data Systems Committee meeting for April 15 at 10:00 a.m., an Education Committee meeting for April 23 at 10:00 a.m., and a Council meeting for May 1, 2025, at 10:00 a.m. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-04T20:41:43+00:00April 4th, 2025|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 4
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PA Health Policy Update for March 28

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

Special Election Update 

Two special elections occurred this week on Tuesday, March 25 to fill vacancies in the state House of Representatives and Senate. Democrat Dan Goughnour won the special election to represent House District 35, which was vacated after the passing of Representative Matt Gergely. His election sustains the Democratic one-vote majority in the House. In a surprising outcome, Democrat Jim Malone narrowly defeated Republican Josh Parsons to replace the Senate seat formerly held by Ryan Aument who resigned to work for U.S. Senator Dave McCormick. Malone’s election will narrow the Republican majority in the Senate to 27-23. 

General Assembly

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

  • The House of Representatives passed a package of bills that seek to codify federal Affordable Care Act (ACA) patient protections in state statute.
    • House Bill 404, which enables an adult child to receive insurance coverage until age 26.
    • House Bill 535, which prohibits annual and lifetime coverage limits.
    • House Bill 618, which prohibits the denial of health insurance coverage due to pre-existing conditions.
    • House Bill 755, which maintains access to preventative health care services.
  • The House Aging & Older Adult Services Committee met on Monday, March 24 and favorably reported, in addition to other legislation, House Bill 372, which requires the Department of Aging to publicly release a compliance report on the Area Agencies on Aging (AAAs).
  • The House Labor & Industry Committee met on Tuesday, March 25 and favorably reported, among other bills, House Bill 926, which seeks to prevent health care workplace violence by placing several requirements on health care facilities.
  • The Senate Judiciary Committee met on Tuesday, March 25 and favorably reported, among other bills, Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, and Senate Bill 326, which amends the Controlled Substance, Drug Device, and Cosmetic Act to automatically schedule a controlled substance when one is added by the federal government and removes the Secretary of Health’s ability to reschedule a controlled substance.

The Senate will reconvene on Monday, March 31 through Wednesday, April 2. The House of Representatives is now recessed until Monday, April 7. 

Department of Human Services 

The Department of Human Services (DHS) has issued an updated Pennsylvania Medicaid Managed Care Directory.

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

Independent Regulatory Review Commission  

The Independent Regulatory Review Commission (IRRC) has issued comments to the State Board of Nursing regarding its proposed rule on nursing education programs issued January 25, 2025. Find IRRC’s comments here.

IRRC has announced it received the following final form rulemaking which will be considered at its May 15 meeting.

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release of a report on Cancer Surgery Volume, giving stakeholders insight into cancer surgeries performed at hospitals and ambulatory/outpatient settings. 

Around the State  

  • The New York Times has written an article about Democrat Jim Malone’s surprising victory in a district that strongly supported President Trump in the 2024 election. Spotlight PA also published an article about this story. 
  • The Pennsylvania Capital-Star has written an article about a package of bills that passed the state House of Representatives this week codifying federal Affordable Care Act (ACA) protections in state statute.
  • Fox43 has published a piece about unions representing Pennsylvania nurses and their efforts to pass legislation addressing workplace violence. 

Stakeholder Meetings

DOH – Special Pharmaceutical Benefits Program Advisory Committee – April 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, April 24 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 – Medical Marijuana Advisory Board – 2025 Meeting Schedule

The Medical Marijuana Advisory Board has provided notice in the Pennsylvania Bulletin of its upcoming meeting dates. Meetings will be held from 10:30 a.m. to 12:30 p.m. on each day listed in the Capitol Media Center, Room 1, East Wing, Harrisburg, PA 17126, with an option for board members to participate virtually.

2025-03-28T19:22:00+00:00March 28th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for March 28
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PA Health Policy Update for March 7

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

General AssemblyHarrisburg, PA capital building

  • The state House of Representatives and Senate concluded their hearings on Governor Shapiro’s FY 2025-26 budget proposal this week. The following are the health-related agency budget hearings that occurred this week.
  • The Department of Human Services (DHS) appeared before the House Appropriations Committee on Tuesday, March 4. A recording of that hearing is viewable here and here.
  • DHS also appeared before the Senate Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here and here.
  • The Pennsylvania Insurance Department and PENNIE appeared before the House Appropriations Committee on Wednesday, March 5. A recording of that hearing is viewable here. 
  • The House Health Committee held an informational meeting on Monday, March 3 to examine the practice of community health workers. A recording of the meeting is viewable here.
  • The House Human Services Committee held a voting meeting on Wednesday, March 5 and favorably reported the bills below. A recording of the hearing is viewable here. 
  • House Bill 269, which requires the Department of Health, in consultation with the Department of Drug & Alcohol Programs, to develop opioid overdose public education materials. 
  • House Bill 640, which updates the annual reporting requirements for the Department of Drug & Alcohol Programs.
  • House Bill 749, which requires the Department of Human Services to conduct a study of Pennsylvania’s SNAP payment distribution. 
  • The Senate Democratic Policy Committee will hold a meeting on Monday, March 10 at 2:00 p.m. to discuss “health care accessibility and the impacts of hospital closures.” The meeting will be held at Neumann University in Aston, PA and virtually. Find additional details here. 
  • The House and Sente are currently recessed until Monday, March 17 and Monday, March 24, respectively, 

Department of Health 

  • The Department of Health (DOH) has announced the 2024-25 Patient Safety Surcharge (MCARE) letter and invoices for hospitals, ambulatory surgery centers, abortion facilities, and birthing centers have been emailed. Payment is due by June 1, 2025. If you have any questions, please call the Division of Acute and Ambulatory Care (DAAC) at 717-783-8980 or email RA-DAAC@pa.gov.
  • DOH has announced the Event Reporting System (ERS) has been updated with a new Flu A and separate Flu B, as well as RSV reporting enhancement to streamline the reporting of these event types. DOH has shared a Quick Start Guide (opens as a separate Microsoft Word document) for the new enhancement. This enhancement will function in the same manner as the COVID-19 enhancement initiated in March of 2021.

Department of Human Services

The Department of Human Services (DHS) has shared the following presentations utilized at the Medical Assistance Advisory Committee (MAAC) meeting on February 27.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $2.9 billion in General Fund revenue in February, which was $44.0 million, or 1.6 percent, more than anticipated. Fiscal year-to-date General Fund collections total $27.0 billion, which is $104.3 million, or 0.4 percent, below estimate. 

Around the State  

WHYY has published an article about Prospect Medical Holdings’ plan to file a preliminary request to begin closing its remaining Delaware County hospitals. 

The Patriot-News has reported about potential for significant Medicaid cuts in Washington, D.C. and the concern that has raised in Pennsylvania with medical professionals and state legislators. 

Stakeholder Meetings

DOH – Health Policy Board – March 21

The Health Policy Board of the Department of Health will meet on Friday, March 21 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 25

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Tuesday, March 25 from 10:00 a.m. until 12:00 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.

 

2025-03-07T22:13:24+00:00March 7th, 2025|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for March 7
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PA Health Policy Update for February 14

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

Governor Shapiro

Governor Shapiro has announced his administration filed a lawsuit challenging the Trump administration’s freeze of federal funding. Despite court orders to release the federal funds and the Shapiro administration’s engagement with Pennsylvania’s federal representatives, state agencies remain unable to access $1.2 billion in federal funding, with an additional $900 million requiring an undefined review by federal agencies before it can be received. Find the full complaint here.

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 will begin hearings on Governor Shapiro’s FY 2025-26 budget proposal next week. The House Appropriations Committee’s full hearing schedule is viewable here and the Senate Appropriations Committee’s full hearing schedule is viewable here.

Following are the health-related agency budget hearings scheduled for next week.

  • The Department of Health will appear before the Senate Appropriations Committee on Wednesday, February 19 at 1:00 p.m. in Hearing Room 1 of the North Office Building.
  • The Department of Health and the Department of Drug & Alcohol Programs will appear before the House Appropriations Committee on Friday, February 21 at 10:00 a.m. on the House floor. The hearing will be livestreamed here. 

Department of Health  

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 784) with guidance on Influenza A subtyping for hospitalized patients. 

Independent Fiscal Office

The Independent Fiscal Office (IFO) has announced that it updated the commonwealth’s budget deficit projections based on new spending data, largely for the Department of Human Services, included in Governor Shapiro’s FY 2025-26 Executive Budget. The revised deficit projection for FY 2025-26 is $6.0 billion under current laws and policies. Find the full report here. 

Around the State  

  • Spotlight PA has written an article about a study commissioned by the state’s Insurance Department that found health insurers’ provider directories commonly had errors that went uncorrected for extended periods of time. 
  • New Castle News has published an article about the proposed investments in hospitals included in Governor Shapiro’s FY 2025-26 budget proposal. 
  • Writing for The Philadelphia Inquirer, Harold Brubaker has continued to cover challenges related to the bankruptcy of Prospect Medical Holdings, the parent company of Crozer Health in Delaware County.  
  • WESA has published an article about a federal judge’s decision to temporarily halt proposed funding cuts at the National Institutes of Health (NIH) that could have a detrimental impact on the state’s life sciences sector. 

Stakeholder Meetings

DHS – Consumer Sub-MAAC – February 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 26 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – February 27

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 27 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – HIV Planning Group – March 12

The Statewide HIV Planning Group will hold a public meeting on Wednesday, March 12 from 9:00 a.m. to 5:00 p.m. and on Thursday, March 13 from 9:00 a.m. to 4:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-02-14T20:58:44+00:00February 14th, 2025|Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2026 budget|Comments Off on PA Health Policy Update for February 14
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PA Health Policy Update for January 31

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

Governor Shapiro 

Governor Shapiro will deliver his Fiscal Year (FY) 2025-2026 budget address to a joint session of the Pennsylvania General Assembly on Tuesday, February 4. 

General AssemblyHarrisburg, PA capital building

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

  • The Senate Health & Human Services Committee met on Monday, January 27 and favorably reported Senate Bills 155, 156, and 157, which are part of a package of bills aimed at eliminating waste, fraud, and abuse in public assistance programs.
  • The House Aging & Older Adult Services Committee convened for an informational meeting on direct care workers and the homecare industry. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, January 28 and favorably reported, among other bills, House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile.  A recording of the meeting is viewable here.
  • The House Human Services and Insurance Committees jointly convened on Wednesday, January 29 for an informational hearing on traumatic brain injury care needs and coverage options. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, January 29 and favorably reported House Bill 27, which requires health care facilities to adopt and implement policies to mitigate exposure to surgical smoke through the use of a smoke evacuation system for each procedure that generates surgical smoke, and House Bill 33, which implements greater oversight of medical marijuana labs and product testing. A recording of the hearing is viewable here.
  • The House Professional Licensure Committee met on Wednesday, January 29 and favorably reported House Bill 309, which enables team physicians traveling internationally with their club or national team to treat their team players on site during games without requiring a Pennsylvania medical license. A recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for session in Harrisburg again next week. The chambers will hold a joint session on Tuesday, February 4 for Governor Shapiro’s FY 2025-2026 budget address. 

Department of Human Services 

The Department of Human Services (DHS) has issued an updated PA Promise™ Provider Handbook for providers who submit claims via the 837 Professional format or the CMS-1500 Claim Form.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on January 23.

Health Department  

The Shapiro administration, including the Department of Health (DOH) and the Department of Drug & Alcohol Programs (DDAP), highlighted its $3.6 million investment to develop regional maternal health coalitions. Find more information in this press release. 

Around the State

  • The Philadelphia Inquirer has published an article about Governor Shapiro’s plan to again propose the legalization of recreational marijuana in his budget address next week as a strategy to address the state’s growing budget shortfall.  
  • WESA has reported about the potential for a significant increase in premiums for Pennsylvanians enrolled in Pennie, the state’s health insurance marketplace, if federal tax credits are allowed to expire in 2026. The average premium increase would be 81 percent.
  • Democratic lawmakers in Harrisburg introduced a package of bills this week seeking to codify protections provided by the Affordable Care Act (ACA) in Pennsylvania state law, as reported by the Pittsburgh Post-Gazette. 

Stakeholder Meetings

DOH – Organ Donation Advisory Committee – February 6

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 6 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – WIC State Advisory Board – February 11

The WIC State Advisory Board will hold its next regular meeting on February 11 from 11:00 a.m. to 12:00 p.m. This is a rescheduling of the board’s January 14 meeting, which was cancelled due to technical challenges. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – February 13

The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, February 13 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – February 18

The Patient Safety Authority will hold a meeting of the Authority’s board on Tuesday, February 18 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-01-31T22:45:42+00:00January 31st, 2025|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 31
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  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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