The following is an update of selected state health policy developments in Pennsylvania for the week of June 27 to July 1, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

As of 2:00 p.m. on Friday, July 1, Governor Wolf and the General Assembly continue to work on finalizing Pennsylvania’s FY 2023 budget.  Despite indications that a framework for a budget agreement has been reached, the state missed its June 30 deadline to enact a spending plan.  The General Assembly is scheduled to return to session next Tuesday, July 5 to continue its work. The short-term impact of not having a budget by July 1 will be minimal; the state is obligated to maintain essential operations and cover Medicaid expenditures, state employee payroll, and debt payments.

General Assembly

The state House and Senate cancelled session this weekend and are schedule to return to session on Tuesday, July 5.  Depending on the outcome of budget negotiations and the progress of budget-related legislation, they may have to add additional session days next week.

• The Senate passed House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
• The Senate passed Senate Bill 225 on third and final consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.  The bill was sent to the House and referred to the Insurance Committee for consideration.
• The House passed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.
• The House passed Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers in Pennsylvania with those permitted by the federal Centers for Medicare & Medicaid Services (CMS), on third and final consideration.  Since the bill was amended, it was sent back to the Senate for concurrence.
• The House passed House Bill 2679 on third and final consideration.  The bill, which was subsequently sent to the Senate for consideration, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five years of age and older.
• The House unanimously voted to concur with Senate amendments to House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.  The bill will now be sent to the governor for his signature.
• The House passed House Bill 2293 on third consideration and final passage and sent it to the Senate for consideration.  This bill requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.

Governor Wolf

Governor Wolf has signed into law House Bill 2401, which extends regulatory waivers that went into effect over the course of the COVID-19 pandemic.  This extension will permit many waivers to remain in place until October 31, 2022 unless the waivers are related to federal exemptions.  Waivers related to federal exemptions will remain in place until the last day of the federal public health emergency or the last day the federal exemptions are authorized, whichever is later.  House Bill 2401 also makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.  Learn more from this Wolf administration news release.

Governor Wolf has signed Senate Bill 709, which establishes the CMV Education and Newborn Screening Act and requires the Department of Health to make available on its website certain information regarding cytomegalovirus (CMV), one of the most common viral infections that infants are born with in this country.  Health care providers will be required to provide parents or guardians of newborns with information on CMV and to offer a screening or referral within 21 days if the newborn child fails the initial newborn hearing screening.  Learn more from this Wolf administration news release and Senate Bill 709 (now Act 29).

Department of Human Services

• In response to the COVID-19 emergency, the federal Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in April of 2020 issued an exemption to opioid treatment programs from the requirement to perform an in-person physical evaluation for any patient who will be treated by such programs with buprenorphine if a program physician, primary care physician, or an authorized health care professional under the supervision of a program physician determines that an adequate evaluation of the patient can be accomplished via telehealth.  Based on positive response to this practice, SAMHSA is extending this flexibility for one year from the formal end of the COVID-19 public health emergency.  Learn more from SAMHSA’s guidance.
• The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services has issued a bulletin to update its guidelines for payment of behavioral health services delivered using telehealth technology.  Find the bulletin here and attachments here and here.  The new guidelines take effect immediately.
• DHS’s Breast & Cervical Cancer Prevention & Treatment Program provides eligible individuals treatment for confirmed cases of breast and cervical cancer or pre-cancerous conditions of the breast or cervix.  DHS has posted a notice to providers reminding them how to determine whether patients may be eligible for services under the program and, if they are, how they can enroll in the program.  Find that notice here.
• DHS has issued a Medical Assistance Bulletin informing providers that as of November 1 it will reinstate the prior authorization requirements for shift care services provided to beneficiaries under the age of 21 in the Medical Assistance fee-for-service program.  Medical Assistance managed care organizations may reinstate the prior authorization requirements for these services provided to children under the age of 21.  Providers rendering services in the managed care delivery system should contact the appropriate managed care organization regarding any questions about prior authorization requirements.  Learn more from this Medical Assistance Bulletin.
• DHS has announced a funding opportunity for home and community-based service (HCBS) providers to improve and strengthen HCBS programs and services to better serve HCBS participants.  Under the program DHS will provide up to $40,000 for each approved request to help HCBS providers implement a series of specific types of service improvement projects.  Funding is limited to providers of services through the Community HealthChoices and OBRA 1915(c) waivers for activities that supplement HCBS services rather than supplant existing services.  Learn more about the funding program and the specific types of projects DHS is interested in supporting from this DHS news release.  For more detailed information, see this DHS description of the program, the funding guidelines, and how to apply.  Applications will be accepted until December 31 or whenever the $38 million allocated for this purpose has been committed.  All awarded funds must be spent by July 1, 2023.
• DHS is seeking partners to help it through the public health emergency unwinding process during which people will need to re-establish their eligibility for Medical Assistance benefits.  Specifically, it seeks individuals and organizations that will help guide current Medical Assistance beneficiaries through the eligibility renewal process or direct them to other resources for possible health care coverage.  Learn more about what DHS seeks and how to participate in this undertaking from this DHS message.
• DHS has decreased from 90 to 30 days the period of time individuals have to request a hearing appealing a Medicaid termination or denial.  The time limit previously was 30 days, was extended to 90 days at the start of the COVID-19 public health emergency, and has now been restored to 30 days.  Find the notice in this DHS memo (on page 7, in red).
• DHS and the Department of Transportation have been awarded a $750,000 grant from the Federal Transit Administration to expand its Find My Ride online tool, Pennsylvania’s “one-stop shop” for access to human services transportation.  The program was developed collaboratively with transit agencies and streamlines the application process for the five largest transportation assistance programs in the state, including the Senior Share Ride program, the Medical Assistance Transportation Program, ADA complementary paratransit, the Persons with Disabilities Program, and the Free Transit Program.  The program enables third parties, such as family members or health care providers, to apply for services on behalf of riders.  Learn more from this Wolf administration news release.

Insurance Department

The Insurance Department has received a federal grant as part of the State Flexibility to Stabilize the Market Grant Program Cycle II.  One of the proposed projects includes studying the availability of providers in various specialties and geographic areas.  The goal of this study is to understand areas of need based on the current availability of providers to accept new patients and the amount of time it takes to get an appointment with these providers and to assess network adequacy considerations based on the findings.  The Insurance Department is seeking public comment from organizations, consumer advocates, providers, and consumers about their experience with getting appointments or finding available specialists.  Learn more about the project and the areas of medical specialty the analysis may consider, and on which the department is interested in comments, in this Pennsylvania Bulletin notice.  Comments are due by August 5.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder.  Last year the program awarded $599,000 to 12 organizations and this year the Department of Drug and Alcohol Programs plans to award approximately three to five grants of up to $600,000 each to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.  Learn more about this funding opportunity from this department news release and a program overview that describes eligible applicants and outlines the application process.  Applications are due by July 29 for projects that begin on October 1 and end by September 30, 2023.

COVID-19:  By the Numbers

• After four weeks of falling case counts the number of new reported COVID-19 cases rose over the past week.
• During this past week, Pennsylvania’s total of COVID-19 cases since the beginning of the pandemic rose past three million.
• COVID-19-related deaths rose slightly during the week.
• The number of Pennsylvanians hospitalized with COVID-19 remained steady over the past week but the number in hospital intensive care units and on ventilators declined.
• Thirty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 55 counties last week.  Four counties experienced a moderate rate of community transmission and the remaining 18 experienced a substantial rate.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 7

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 to help nursing facility staff recognize expressions of behavior among residents living with dementia.  The webinar will be held on Thursday, July 7 at 2:00.  Learn more about the webinar and how to participate from this notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.