PA Health Policy Update for Friday, December 23
The following is an update of selected state health policy developments in Pennsylvania for the week of December 19-23, 2022. (Some of the language used below is taken directly from state documents.)
Department of Human Services
- The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers about new procedures for dispensing 340B-purchased drugs to Medical Assistance beneficiaries and about the implementation of the program’s 340B drug exclusion list. Find the bulletin here. Find the policies this new bulletin replaces here.
- DHS has extended its schedule for sending Remittance Advice documents, Medicaid payment checks, and electronic transfers of payments into early February. Find the updated schedule here.
- DHS has announced that it will add several prescription drugs to the Medical Assistance program’s list of services and items requiring prior authorization: corticotropin; targeted systemic immunomodulators for atopic dermatitis, designated as preferred on the program’s preferred drug list (PDL); PCSK9 inhibitor lipotropics, designated as preferred on the PDL; and obesity treatment agents designated as preferred on the PDL. Learn more from this Pennsylvania Bulletin notice.
- DHS has posted revisions of the participating drug company list for the Medicaid drug rebate program.
- DHS has announced its intent to allocate funds in FY 2023 for several classes of inpatient disproportionate share hospital (DSH) payments (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals. It does not intend to otherwise change the qualifying criteria or payment methodology for these payments. See the announcement, including information about the different purposes for which Medicaid DSH payments will be made, in this Pennsylvania Bulletin notice.
- DHS has circulated the following materials from the December 7 meeting of the Medical Assistance Advisory Committee meeting.
Department of Health
- The Department of Health (DOH) has announced that Pennsylvania will receive $98 million in federal funding to enhance public health infrastructure, including staffing, health planning, and equity and data modernization efforts. A portion of the funding, from the CDC’s Public Health Infrastructure grant program will be allocated to 10 county and municipal health departments. Learn more from this Department of Health news release.
- DOH has issued a health advisory informing providers to be aware of possible increases in group A streptococcal infections. The alert also informs providers about symptoms, testing, and treatment; provides instructions for laboratories that identify cases; and reminds providers and laboratories that they are required to report such cases to DOH. Find the alert here.
- DOH has issued a health advisory with interim guidance for clinicians on how to prioritize antiviral flu treatment at a time when there is limited availability of the drug oseltamivir (Tamiflu). Find the advisory here.
- DOH has revised long-term-care nursing facility regulations recently approved by the Independent Regulatory Review Commission to correct typographic errors. Find the revised, final regulations in this Pennsylvania Bulletin notice.
COVID-19: By the Numbers
- The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level. The number of new deaths remains within the usual range for recent months.
- According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs remained steady over the past week but the number on ventilators rose 17 percent.
- The CDC reports no change over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
- As of December 21, 46 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 15 were experiencing substantial rates of community transmission; and six counties were experiencing a moderate rate of community transmission.
- As 2022 draws to a close, Pennsylvania has now experienced 3.4 million confirmed, reported cases of COVID-19 and suffered nearly 49,000 deaths from the virus.
The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services.
Included in this month’s edition are articles about:
The Department of Human Services bulletin outlines the purpose of the new PDL, provides background information, and describes how the PDL was developed and will work. In addition, it lists the past Medical Assistance Bulletins rendered obsolete by the new bulletin and describes the prior authorization procedures that will be employed when the new program takes effect on January 1, 2020.