Pennsylvania Medicaid disproportionate share payments Archives

PA Health Policy Update for February 17

The following is an update of selected state health policy developments in Pennsylvania from February 11-17. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House of Representatives will convene for session on Tuesday, February 21 at 12:00 p.m. The state Senate is scheduled to return on Monday, February 27.

Department of Human Services

The fee-for-service subcommittee of the Department of Human Services (DHS) Medical Assistance Advisory Committee met on Wednesday, February 8. See the presentation made by Office of Medical Assistance officials during that meeting.
DHS’s Office of Long-Term Living offered a presentation during the February 14 meeting of the Medical Assistance Advisory Committee’s long-term services and supports subcommittee. Find that presentation here.
DHS has published a notice of its funding allocation for FY 2023 inpatient disproportionate share hospital (DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals; outpatient supplemental payments to qualifying inpatient acute-care general hospitals; direct medical education payments to qualifying inpatient acute-care general hospitals; and certain DSH and supplemental payments to new hospitals. It is not otherwise changing the qualifying criteria or payment methodology for these payments. These payments will amount to $257.76 million in total funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published a notice of its funding allocation for DSH payments to qualifying acute-care general hospital burn centers, to qualifying acute-care general hospitals providing obstetrical and neonatal services, to critical access and qualifying rural hospitals, and to qualifying acute-care general hospitals that treat a high percentage of Medical Assistance patients under 18 years of age. Together, the payments amount to $107.655 million in total state and federal funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published procedure codes and payment rates for the administration of the Pfizer and Moderna bivalent booster dose of the COVID-19 vaccines. Find the codes, the rates, and their effective dates in this Pennsylvania Bulletin notice.
DHS’s Office of Long-Term Living has informed stakeholders that the Centers for Medicare & Medicaid Services has approved renewal of the Community HealthChoices waiver, effective January 1, 2023, for five years. See the DHS message here.
DHS has published a notice announcing that it will increase fees in the Medical Assistance Program for certain ambulance transportation services in both the fee-for-service and managed care delivery systems, effective with dates of service on and after January 1, 2023. Those fees will be not less than $325 for basic life support ambulance transportation services, not less than $400 for advanced life support ambulance transportation services, and not less than $4 per loaded mile for each loaded mile beyond 20 loaded miles for ground ambulance transportation. Learn more from this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a health alert to providers advising them about a possible nation-wide increase in invasive group A streptococcal (iGAS) infections in children. This increase, however, reflects only a return to pre-pandemic levels. The alert includes information about the condition and offers guidance for clinicians and laboratories. Find the alert here.
DOH has published information about its Medical Care Availability and Reduction Error (MCARE) Act surcharge for FY 2023, a per unit assessment of approximately $156.56 payable by June 1. Learn more about the surcharge and the providers to which it applies from this Pennsylvania Bulletin notice.
DOH has published information about its Nursing Home Patient Safety Trust Fund surcharge for FY 2023. That surcharge will be $13.83 per nursing facility bed. Learn more from this Pennsylvania Bulletin notice.
DOH has published a list, as required by regulation, of hospitals that have chosen to exercise their religious or moral beliefs regarding the provision of certain contraception-related emergency services and will instead refer patients to other hospitals to receive such services. Learn more from this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week remained at the same levels as last week.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs declined 25 percent.
The CDC reports a six percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
For the week ending February 15, five Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 16 counties experienced a substantial rate of community transmission; and the remaining 46 counties experienced a high rate of community transmission – all the same numbers as last week.

Department of Drug and Alcohol Programs

In response to the continuing challenge health care providers are having maintaining an adequate workforce, the Department of Drug and Alcohol Programs is conducting a workforce climate survey among drug and alcohol service providers to learn about which jobs and positions are in short supply or understaffed, the challenges these providers face, what they are doing to address them, and how they think the state can help them address those challenges. Find that survey here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission has issued comments in response to regulations proposed by the State Board of Nursing that address licensure by endorsement and reactivation. Find those comments in this Pennsylvania Bulletin notice.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – February 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, February 22 at 1:00. Learn more from the meeting’s agenda and go here to register to participate.

DHS – Medical Assistance Advisory Committee Meeting – February 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 23 at 10:00. For the meeting agenda go here and to register to participate go here.

DHS – Managed Long-Term Services and Supports Subcommittee Meeting – March 1

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00. For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00. For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates: March 9 and May 16, both at 8:30. This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-02-17T21:42:53+00:00February 17th, 2023|COVID-19, DSH hospitals, long-term care, Medicaid supplemental payments, Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, October 7

The following is an update of selected state health policy developments in Pennsylvania for the week of October 3-7, 2022. (Some of the language used below is taken directly from state documents.)

Behavioral Health Commission for Adult Behavioral Health

The Wolf administration has released the recommendations of its Behavioral Health Commission for Adult Behavioral Health, which was created to advise the General Assembly on how to spend $100 million in one-time federal American Rescue Plan Act funding, including to support adult behavioral health needs addressed in the state’s 2022-2023 fiscal code. The commission recommended that the $100 million be used in the following manner:

$37 million to stabilize, strengthen, and expand the workforce
$23.5 million to improve the criminal justice and public safety systems
$39 million to expand capacity for services and supports
$500,000 for a future study of the impact of this spending

The commission’s recommendations are only advisory; the General Assembly will consider its recommendations in the coming weeks and decide if and how to appropriate the $100 million.

Find a Wolf administration news release about the report here and the report itself here.

Department of Human Services

The Department of Human Services has announced its intent to allocate funds for FY 2023 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Medical Assistance program and to provide financial relief to hospitals during the COVID-19 pandemic. It does not intend to otherwise change the qualifying criteria or payment methodology for these payments. Learn more from this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has updated its interim infection prevention and control recommendations for health care settings to reflect recent changes in federal CDC recommendations.
DOH has shared information on severe manifestations of monkeypox among patients who are immunocompromised due to HIV or other conditions. This is the same alert issued last week by the CDC.
DOH has added to its naloxone standing orders that enable residents and first responders to obtain naloxone products to help combat the rise of overdoses in Pennsylvania a non-prefilled syringe with two single-dose vials of liquid naloxone that is injectable. Residents can present a copy of the state’s standing order, which can be found here, at their local pharmacy to obtain the naloxone. The medication also is available for free for personal use through a statewide mail-based naloxone program.
DOH has issued an advisory about lead exposure in adults.

COVID-19: By the Numbers

According to the CDC, the number of new COVID-19 cases in Pennsylvania over the past week was down 20 percent from the previous week and the number of deaths fell 10 percent.
According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a seven percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions.
For the first time in several months, all, or almost all, of Pennsylvania’s 67 counties are not experiencing a high rate of community transmission. Currently, 60 counties are still experiencing a high rate of community transmission while six counties – Forest, Centre, Lycoming, Union, Snyder, and Delaware – are experiencing “only” a substantial rate of community transmission and Philadelphia’s rate is now classified as moderate.

Monkeypox

The CDC has posted an updated map showing the distribution of 26,385 confirmed cases of monkeypox in the U.S. as of October 6, up only slightly from 25,613 cases on September 29. 789 of those cases were in Pennsylvania, up from 713 a week ago.
As of October 3, 495 of those Pennsylvania monkeypox cases were in Philadelphia, up from 475 on September 25. Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued the research brief “Hospitalizations for Opioid Overdose, 2016 – 2021” that looks at trends among state residents, ages 15 and older, who have been admitted to Pennsylvania acute-care hospitals for opioid overdoses. Find a news release about the report here and the report itself here.

Centers for Medicare & Medicaid Services

CMS’s Center for Medicare and Medicaid Innovation has released materials presenting its evaluation of year two of the Pennsylvania Rural Health Model, which seeks to improve access to hospital services and improve population health in underserved rural communities. New evaluation materials include a summary of the evaluation of the program’s second year; the full report; the report’s executive summary; and an appendix to the report. Learn more about the Pennsylvania Rural Health Model, including a list of its participating hospitals, from the program’s web page.

Stakeholder Events

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers. The webinar will be held on Thursday, October 13 at 2:00. Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives. The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention. Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30. The meeting location will depend on COVID-19 mitigation efforts at that time. If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg. If the meeting is held virtually it will be held at bit.ly/ABC_MAP. To dial in, call 267-332-8737, conference ID 440 338 696#. Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00. Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00. Interested individuals may attend in person or participate virtually. For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg. Interested parties may attend in person or via webinar; those participating through the webinar must register in advance. For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

jsteinbock2022-10-07T21:24:30+00:00October 7th, 2022|COVID-19, DSH hospitals, Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

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