Pennsylvania Medicaid Expansion Archives - Page 2 of 4 - Safety-Net Association of Pennsylvania

PA Restores Substance Abuse Services to Medicaid Patients

Pennsylvania’s Department of Human Services (DSH) has restored access to drug and alcohol treatment services to Medicaid recipients who were placed in new Medicaid private coverage option plans that do not cover such care.
At fault was a glitch in the implementation of the Healthy Pennsylvania Medicaid expansion in which some Medicaid recipients were placed in “low risk” insurance plans that do not cover drug and alcohol treatment. DHS staff combed the rolls of Medicaid recipients who joined those plans in search of recipients who needed those services and shifted them into plans that provide such coverage.
About 8500 Medicaid beneficiaries affected by the problem have been moved into plans that enable them to resume resume treatment.
Some providers chose to continue treating their Medicaid patients who lost their coverage and have suffered financial problems as a result. The state intends to address those situations on a case-by-case basis, according to acting DHS secretary Ted Dallas.
Some of those recipients may eventually be on the move again as the Wolf administration continues phasing out the Healthy Pennsylvania program in favor of expanding the state’s pre-Healthy Pennsylvania Medicaid program.
For a close look at this problem, how it affects patients and providers, and how the state corrected it, see this Philadelphia Inquirer article.

PA Safety Net Admin2015-03-12T06:00:39+00:00March 12th, 2015|Pennsylvania Medicaid policy|Comments Off

PA Outlines Medicaid Transition Timetable

Pennsylvania should complete by the end of September its transition from former Governor Tom Corbett’s Healthy Pennsylvania Medicaid expansion program to new Governor Tom Wolf’s more traditional approach to Medicaid expansion.
According to Ted Dallas, acting secretary of the Department of Human Services, the transition involves combining the addition of newly eligible Pennsylvanians onto the state’s Medicaid rolls, moving all eligible participants into a single benefit plan instead of the two-tiered plan employed under Healthy Pennsylvania, and updating the state’s information systems to accommodate these changes.
Adding the newly eligible Pennsylvanians to the state’s Medicaid rolls and moving them into a single benefit plan should be completed by the end of April. Updating the state’s information systems will take longer and should be completed by the end of September.
For more on the planned transition, see this Philadelphia Inquirer article.

PA Safety Net Admin2015-03-06T06:00:54+00:00March 6th, 2015|Pennsylvania Medicaid policy|Comments Off

New Web Site for PA Medicaid Expansion

Along with the Wolf administration’s decision to exit the Healthy Pennsylvania Medicaid expansion in favor of a more conventional approach comes a new web site dedicated to that expansion: HealthChoices PA.
The new HealthChoices PA site features sections that describe the program and address the immediate implications of the state’s shift from Healthy Pennsylvania to HealthChoices PA. It also offers an FAQ, resources for consumers and providers, and a gateway for applicants.
The address of the new site is http://www.healthchoicespa.com. Find it here.

PA Safety Net Admin2015-02-18T14:40:15+00:00February 18th, 2015|HealthChoices PA, Pennsylvania Medicaid policy|Comments Off

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its January 2015 newsletter.
Among the articles in it are pieces on the launch of the Healthy Pennsylvania Medicaid expansion; an update on the temporary extension of the state’s Select Plan for Women; information on how Medicaid recipients who believe they need the state’s new Medicaid “Healthy Plus” benefits package can seek that enhanced coverage; and news on who should consider shifting from a health insurance plan purchased on the federal marketplace to Medicaid.
Find the newsletter here.

PA Safety Net Admin2015-02-04T06:00:34+00:00February 4th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Issues Bulletin Detailing Healthy PA Benefits

The benefits offered through Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion program are detailed in a new Medical Assistance Bulletin issued by the state’s Department of Human Services.
In addition to describing both the benefits and the processes the state will employ for seeking exceptions to the established benefits, the Bulletin includes several attachments: a benefit plan comparison chart; automatic benefit limit exceptions for APR-DRG; automatic benefit limit exceptions for radiology and imaging; automatic benefit limit exceptions for laboratory services; automatic benefit limit exceptions for durable medical equipment; and automatic benefit limit exceptions for medical supplies.
The program, the benefits, and the new guidelines take effect on January 1.
Find this Medical Assistance Bulletin here.

PA Safety Net Admin2014-12-22T06:00:27+00:00December 22nd, 2014|Healthy PA, Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Medicaid Primary Care Fees to Plummet

Payments to Pennsylvania primary care physicians who serve Medicaid patients will fall 52.4 percent after the first of the year, when the Affordable Care Act’s two-year increase in those payments ends.
The temporary fee increase was included in the Affordable Care Act to encourage more primary care physicians to serve Medicaid patients in anticipation of the significant growth of Medicaid as a result of the reform law’s Medicaid expansion. Under that law, Medicaid primary care fees were raised to the level of Medicare primary care rates for two years. Nation-wide, the average Medicaid primary care fee will fall 42.8 percent.
So far, 15 states plan to use their own money to prevent the dramatic reduction of Medicaid primary care payments. Pennsylvania is not among them.
The cut will be especially damaging to the state’s safety-net hospitals because they serve so many more Medicaid patients than the typical hospital and expect to serve even more such patients when the state’s Medicaid program expands beginning on January 1.
Learn more about the upcoming Medicaid payment cut in the new Urban Institute report Reversing the Medicaid Fee Bump: How Much Could Medicaid Physician Fees for Primary Care Fall in 2015?, which you can find here, on the Urban Institute’s web site.

PA Safety Net Admin2014-12-17T06:00:15+00:00December 17th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Pennsylvania Health Law Project Newsletter

Among the articles in the November newsletter are a piece on how some immigrants currently covered by the state’s General Assistance program may be able to retain their coverage under Healthy Pennsylvania and another on differences in how the state’s Medicaid expansion population will obtain behavioral health services from private option plans participating in that expansion.
Find the November newsletter here.

PA Safety Net Admin2014-12-10T06:00:45+00:00December 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Contacts Medicaid Recipients About Benefits

The Pennsylvania Department of Public Welfare is in the process of sending letters to all current adult Medicaid recipients in the state advising them of changes in their Medicaid benefits to take effect on January 1 as a result of the state’s Healthy Pennsylvania Medicaid expansion.
The Pennsylvania Health Law Project has published an explanation of the situation, including sample copies of the letters the state is sending, information about the different benefit packages available to Medicaid recipients, and advice on how recipients who believe they have more serious medical problems can apply for a benefits package better suited to their needs.
Find the Pennsylvania Health Law Project notice here.

PA Safety Net Admin2014-11-10T09:05:50+00:00November 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Enrolling in PA’s Medicaid Expansion Program

On December 1, Pennsylvanians who believes they may be eligible for Medicaid under the state’s expanded eligibility criteria – part of the Healthy Pennsylvania program – can begin submitting applications for coverage, which will begin on January 1.
People can apply in four ways:

the state’s online application process – at https://www.compass.state.pa.us/
the healthcare.gov site
a dedicated call center set up by the Affordable Care Act – 866-550-4355
a paper application at any county assistance office

PA Safety Net Admin2014-10-02T06:00:05+00:00October 2nd, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Unanswered Questions About PA Medicaid Expansion

With only 60 days until approximately 600,000 newly eligible Pennsylvanians can begin enrolling in the state’s Medicaid program on December 1, the state still has not clarified some aspects of its Healthy Pennsylvania Medicaid expansion program.
The newly eligible, for example, will be classified into high-risk or low-risk health plans – but the criteria for making those classification decisions remain unknown.
Also unknown is exactly what benefits the newly eligible will be entitled to receive.
In addition, the state is thought to be in negotiations with federal officials about reducing the benefits that the 2.2 million Pennsylvanians already eligible for Medicaid may receive.
For a closer look at these and other issues that remain to be addressed before Pennsylvania expands its Medicaid program on January 1, see this Philadelphia Inquirer article.

PA Safety Net Admin2014-09-30T06:00:49+00:00September 30th, 2014|Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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