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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its August 2022 Health Law News newsletter.

Included in this month’s issue are articles about:

  • Pennsylvania Medicaid beneficiaries who have been auto-assigned to a HealthChoices plan
  • an upcoming deadline for dual-eligible (Medicare and Medicaid) individuals to change Medicare plans
  • an introduction to the state’s new “Whole Home Repair Program” for low- and middle-income families
  • the new National Suicide Prevention Lifeline

Read about these subjects and more in the Pennsylvania Health Law Project’s August 2022 newsletter.

2022-09-07T15:38:12+00:00September 7th, 2022|HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Law Project Newsletter

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its June 2022 newsletter.

Included in this month’s edition are articles about:

  • Changes in HealthChoices managed care plans that take effect on September 1.
  • The July 1 transition to Tempus as the financial management services vendor for Community HealthChoices, which means Tempus will take over paying direct care workers hired by Community HealthChoices participants as part of that program’s self-directed care model.
  • A reduction of the deadline for requesting a fair hearing in response to Medicaid eligibility rejection or termination from the program from 90 days, which it has been since the start of the COVID-19 emergency, back to the 30 days it was before that time.  This change is retroactive to May.
  • A lifting of the pandemic-driven suspension of the need for prior authorization for shift nursing services for Medicaid beneficiaries under the age of 21, which will take effect on November 1.

Read about these subjects and more in the June 2022 edition of Health Law News, the Pennsylvania Health Law Project’s newsletter.

2022-07-06T21:19:51+00:00July 7th, 2022|COVID-19, HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

PA Health Policy Update for the Week of November 15-19

The following is an update of selected state health policy developments in Pennsylvania for the week of November 15-19, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf, the Department of Human Services, and the Department of Community and Economic Development announced a plan to spend nearly $300,000 on the state’s Pre-Apprentice and Apprenticeship Program to expand its nurse residency apprenticeship program.  Go here to read the announcement and here to learn more about the state’s apprenticeship programs.

General Assembly

  • The House of Representatives passed House Bill 1995 by a vote of 115-85 this week.  This legislation clarifies the Department of Drug and Alcohol Programs’ authority to promulgate regulations that affect licensed drug and alcohol treatment providers and subjects those regulations to the formal regulatory review process, including publication, notice, and comment.
  • The House Health Committee met on Tuesday, November 16 and favorably reported the following bills:
    • House Bill 1005 adds information to the prescription drug monitoring program (ABC-MAP) when Narcan/Naloxone is used to combat an overdose by emergency responders or medical professionals.
    • House Bill 1644 directs the Department of Human Services to develop a state-wide process to place patients enrolled in Medicaid who have behavioral health or other long-term-care needs in appropriate care settings in a timely manner.
    • House Bill 1959 authorizes the clinical study of the efficacy and cost/benefit optimization of psilocybin-assisted therapy in the treatment of post-traumatic stress disorder, traumatic brain injury, and various mental health conditions.
    • House Bill 2013 adds language to the state constitution establishing an individual’s right to refuse any medical procedure, treatment, injection, or vaccine.
    • House Bill 2033 extends the reporting requirement on the status of COVID-19 testing at the state laboratory until December 31, 2022.
    • House Bill 2077 creates certain exceptions to the COVID-19 vaccine requirement.
  • The House Human Services Committee held an informational hearing on reimbursement rates for drug and alcohol, mental health, and intellectual disability treatment.  A recording of the hearing may be viewed here.

Department of Human Services

Department of Health

  • The Department of Health shared updated guidance from the Centers for Medicare & Medicaid Services about visitation in nursing homes during the pandemic.
  • The Department of Health has produced a neonatal abstinence syndrome family guide toolkit in partnership with the Northwestern Pennsylvania Neonatal Abstinence Syndrome Coalition and the Ohio Perinatal Quality Collaborative to help educate families on the symptoms of neonatal abstinence syndrome and treatment resources.
  • The Department of Health has posted a notice on its message board explaining that its Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities that they are not required to call 1-877-PA-HEALTH or email Bureau of Epidemiology staff with each new case of COVID-19 identified in staff and residents.  Facilities should continue to call 1-877-PA-HEALTH only to report new outbreaks within their building.  Bureau of Epidemiology staff may request line lists or updates about the status of an outbreak during specific situations.  Facilities should continue to follow all other reporting mandates, including reporting to ERS, CMS, NHSN, or PA-NEDSS.

COVID-19:  By the Numbers

  • The general downward trend in new daily COVID-19 cases in Pennsylvania has ended.  The new case totals for Wednesday, November 16 and Thursday, November 17 were the highest the state has experienced since mid-April.
  • The number of new COVID-19-related deaths remains high.
  • “About nine in ten COVID-19 hospitalizations and deaths in Pennsylvania have involved people who are less than fully vaccinated against the virus, according to new data from the state health department,” PennLive reports.
  • All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
  • The number of Pennsylvanians hospitalized because of COVID-19, in hospital ICUs because of COVID-19, and on ventilators because of the virus, all of which had declined during the first two week of November, are now higher than they were on the first of the month.
  • 73.3 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people.  49,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $10 million in grant funding for stabilization payments to substance use disorder treatment providers to assist with pandemic-related expenses.  Learn more about the program and how to apply for funding in this department news release.  The deadline for funding applications is noon on December 8,

The Department of Drug and Alcohol Programs is in the process of implementing the ATLAS® (Addiction Treatment Locator, Analysis, and Standards) platform in Pennsylvania in the coming months.  Affected providers previously were asked to complete a survey for this purpose.  Find that survey here.  The following resources are available for those seeking assistance completing the survey:

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume two of its annual ambulatory surgery centers financial analysis for 2020.  Its analysis found that the average total margin for ambulatory surgery centers decreased 1.66 percentage points, from 25.04 percent in FY 2019 to 23.38 percent in FY 2020, with the state-wide average operating margin decreasing 2.88 percentage points, from 25.13 percent in FY 2019 to 22.25 percent in FY 2020.  Go here (under “Ambulatory Surgery Centers Volume Two”) for the agency’s news release about the report, the report itself, and a link to downloadable data from the report.

Pennsylvania Higher Education Assistance Agency (PHEAA)

“Pennsylvania-licensed nurses could soon have some of their student loan debt paid off for them,” reports PennLive, explaining that “A one-time student loan forgiveness program will provide up to $7,500 in debt reduction under a program that the Pennsylvania Higher Education Assistance Agency’s board authorized on Thursday.”  Learn more about the PHEAA board action here and about the PA Student Loan Relief for Nurses Program here.

Stakeholder Events

Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee Meeting – December 2

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will hold a virtual public meeting on Thursday, December 2 at 10:00 a.m.  To register to participate, go here.

Medical Assistance Advisory Committee – December 9

The Medical Assistance Advisory Committee will meet virtually on Thursday, December 9 at 10:00 a.m.  Go here to register for the web event.

Patient Safety Authority – December 9

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, December 9, 2021, at 1 p.m.  Go here for information about registering and participating.

2021-11-19T22:17:34+00:00November 19th, 2021|Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for the Week of November 15-19

PA Improves Access to Contraceptives

Citing the challenges and risks associated with unplanned pregnancies that occur within two years of a delivery, Pennsylvania’s Medicaid program is making long-acting contraceptives more readily available to program participants.
Pennsylvania State MapBeginning on December 1, Medicaid will pay for long-acting contraceptives administered after delivery and also will increase payments to doctors who provide those contraceptives. Currently, those costs are generally borne by hospitals in the lump-sum payment Medicaid makes for deliveries.
Learn more about the state’s new policy for encouraging the use of contraceptives among Medicaid beneficiaries who have delivered babies in this Lancaster Online article.

2016-12-09T06:00:58+00:00December 9th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Improves Access to Contraceptives
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