The following is an update of selected state health policy developments in Pennsylvania for the week of November 1-5, 2021.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration announced that “Pennie,” the state’s new health insurance exchange, has now begun operations as this year’s Affordable Care Act open enrollment period begins.  Find Pennie here.

General Assembly

• The House and Senate will be in session next week on Monday (10/8), Tuesday (10/9), and Wednesday (10/10).  The following health care-related committee meetings have been scheduled:
• • The Senate Majority Policy Committee will hold an informational meeting on Monday, November 8 at 10:00 a.m. to examine COVID-19 vaccine mandates and their impact on the workforce.  The hearing will be live-streamed here.
  • The Senate Health & Human Services Committee will convene on Monday, November 8 at 12:30 p.m. to consider Senate Bill 471, which prohibits the mandatory vaccination of Pennsylvania residents by the state or as a condition of employment.  The committee will also consider House Bill 220, which specifies that a person does not need to test positive for drugs to begin addiction treatment.
  • The Senate Aging & Youth Committee will meet on Tuesday, November 9 at 12:00 p.m. to consider, among other bills, House Bill 1260, which increases the maximum income eligibility limits for PACENET from $27,500 to $33,500 for individuals and from $35,500 to $41,500 for married couples.

• The House of Representatives is planning to consider a few key behavioral health bills next week, including House Bill 1561 and House Bill 1563, which 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 more easily share patient mental health and substance use disorder treatment information.  The House is also planning to consider House Bill 1308, which enables local communities and agencies to establish overdose fatality review teams.

Department of Human Services

• The Department of Human Services (DHS) has issued updated requirements on the information needed to evaluate prior authorization requests for certain medications based on actions taken by its Pharmacy and Therapeutics Committee during its September 14 meeting.  These updated requirements take effect on January 3, 2022.
  • anti-hemophilia agents
  • Alzheimer’s agents
  • anti-hyperuricemics
  • antifungals
  • antibiotics, gastrointestinal, and related agents
  • anti-parasitics
  • anti-psychotics
  • anxiolytics
  • bladder relaxant preparations
  • bone density regulators
  • bronchodilators
  • cytokine and CAM antagonists
  • Dupixent
• DHS has updated its collection of regulations that have been suspended as a result of the COVID-19 emergency.
• DHS has announced changes in fee schedule rates for selected personal assistance services procedure codes in the Medical Assistance OBRA Waiver and the Act 150 Program.  The changes in the fee schedule rates for these services will take effect on January 1, 2022.  Learn about the changes in this Pennsylvania Bulletin notice.
• DHS’s Office of Long-Term Living has distributed the following message to stakeholders via its Community HealthChoices listserv:

This communication is intended for Department of Human Services (DHS) Sandata Electronic Visit Verification (EVV) and DHS Aggregator users for informational purposes regarding how the DHS Aggregator will be handling the end of Daylight Savings Time (DST) which is set to occur at 2:00 AM this Sunday, November 7, 2021.

For scheduled and completed visits that occur during or crossover the end of DST, the scheduling hours will appear to be short by an hour. This is expected behavior since DHS Aggregator times are calculated based on Coordinated Universal Time (UTC). Provider agencies and/or administrators should not adjust visit times related to DST. Visits during this event will continue to be calculated based on the actual visit times so there are no issues with billing requirements.  

Any questions related to this can be submitted to RA-PWEVVNOTICE@pa.gov

Department of Health

The Department of Health has rescinded a May 26, 2021 order that required skilled nursing facilities to make weekly reports of specified data on supplies and equipment.  The department has launched a new data dashboard with facility-level COVID-19 resident and staff cases, deaths, and vaccination rates that uses data that nursing homes are already required to report to the federal government.  The Survey 123 reporting requirement was eliminated effective October 29, 2021.

COVID-19:  By the Numbers

• While there has been a modest downward trend in new COVID-19 cases in recent weeks, the past two days have seen the two highest single-day counts of new cases since mid-October.
• Approximately 32,710 of the state’s total cases to date have been among health care workers.
• The number of COVID-19 cases among school-aged children (between 5-18 years old) is nearly three times greater this year than in 2020.  Between October 27 and November 2, 2020 there were 1,683 COVID-19 cases in school-aged children compared to 4,918 cases in the same age group during the same week this year.
• In licensed nursing and personal care homes there have been 79,250 resident cases of COVID-19 to date and 17,449 cases among employees for a total of 96,699 at 1,642 facilities in all 67 counties.
• The number of new COVID-19-related deaths remains high but did not rise during the past week.
• Sixty-six of Pennsylvania’s 67 counties currently are experiencing high rates of community transmission of COVID-19; Philadelphia County is experiencing “only” a substantial rate of community transmission.
• The number of Pennsylvanians hospitalized, in hospital ICUs, and on ventilators because of COVID-19 has fallen slightly since the first of the month.
• 72.2 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.5 million people.  38,000 Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Department of Drug and Alcohol Programs

The state’s Independent Regulatory Review Commission has approved the Department of Drug and Alcohol Programs’ proposed regulations for drug and alcohol recovery house licensure.  See the approval in this Pennsylvania Bulletin notice.

Stakeholder Events

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m.  To participate virtually or by phone, go here for further information.

Health Research Advisory Committee – November 15

The Department of Health’s Health Research Advisory Committee will hold a virtual public meeting on Monday, November 15 at 1:00 p.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Pennsylvania Rural Health Redesign Center Authority Board – November 16

The Department of Health’s Pennsylvania Rural Health Redesign Center Authority Board, which is charged with administering the Pennsylvania Rural Health Model, will hold a virtual public meeting on Tuesday, November 16 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

Newborn Screening and Follow-Up Technical Advisory Board – November 18

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Thursday, November 18 at 10:00 a.m.  For information on how to attend virtually, see this Pennsylvania Bulletin notice.

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.