Pennsylvania Medicaid Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for May 8

The following is an update of selected state health policy developments in Pennsylvania from May 4 –May 8 (Some of the language used below is taken directly from state documents).

Rural Health Transformation Program

The Center for Rural Pennsylvania held a public hearing on PA’s Rural Health Transformation Program and its implementation and utilization of federal RHTP funds. The Penn Capital-Star reported on the hearing, sharing a summary of some of the topics discussed such as EMS and the 988 hotline.

General Assembly

The House and Senate held session earlier this week addressing the following healthcare related issues:

Tuesday
- The House Communications & Technology Committee passed HB 1925 out of committee with amendment with a 19-7 vote. This bill would provide regulation and standards of AI use in healthcare.
Wednesday
- The House Health Committee held an informational hearing on the Uniform Healthcare Decision Act.
- The House Insurance Committee convened a voting meeting on HB 2427; consolidation of utilization management statutes, HB 2464; replacing outdated references in PA’s Insurance Law, and HB 2473; repealing obsolete insurance laws and completed statutorily required studies. All three bills advanced unanimously out of committee.
- The Senate Banking & Insurance Committee advanced SB 1321 which would prohibit state funds from being used for certain gender affirming care services.
- HB 1251 was signed into law as Act 12 of 2026, which allows nurse midwives to refer patients to pelvic floor therapy.
- SB 507 was signed into law as Act 14 of 2026, which implements licensure for certified midwives and modernizes other midwifery practices.
Thursday
- The Senate Institutional Sustainability and Innovation Committee held a hearing on SB 792, which would provide for an increase in the Research & Development Tax Credit program in PA.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Rep. Bridget Kosierowski introduced HR 513 which would direct a study on the financial impact of outdated hospital regulations on Pennsylvania hospitals.
Rep. La’Tasha Mayes introduced HR 517 recognizing May 2026 as Preeclampsia Awareness Month in Pennsylvania.
A co-sponsor memo was filed by Rep. Kristin Marcell for legislation requiring insurance coverage for Ovarian Cancer Screening.

The House and Senate will now break from session until June to accommodate Pennsylvania’s upcoming Primary Elections on Tuesday, May 19^th.

Department of Aging

The Department announced an RFP for a READY Community funding collaborative to help support the implementation of PA’s Aging Our Way PA strategic plan. The collaborative will work across the Shapiro Administration and Pennsylvania philanthropic leaders to support funding opportunities to advance the Aging Our Way PA plan. The RFP closes on Friday June 12, and the department will host a webinar for prospective applicants on Tuesday, May 19 at 1:00pm.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

DHS released a bulletin notice with its methodology for determining case-mix rates for nonpublic nursing facilities across several peer groups in State Fiscal Year 25-26.

The Department issued a bulletin notice detailing its annual Nonpublic and County Nursing Facility Per Diem Rates for State Fiscal Year 25-26.

DHS issued a notice of Implementation of the Qualitrac® Provider Portal for Prior Authorization and Program Exception Submissions.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold a public meeting on May 20^th from 9am to Noon.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2026-05-08T20:21:37+00:00May 8th, 2026|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Rural Health Transformation Program|Comments Off

PA Health Policy Update for May 1

The following is an update of selected state health policy developments in Pennsylvania from April 27 –May 1 (Some of the language used below is taken directly from state documents).

Rural Health Transformation Program

Applications are being accepted today for providers to submit their RHTP eligibility certification and required documentation to show they meet all of the qualifications for providers:

Licensed as a hospital, health care provider, or rural health facility;
Currently in operation in Pennsylvania at the time of application and at the time funding is received;
Located in one of the RHTP-eligible rural counties or in a HRSA-defined rural census tract of a county of the second class A or third class.

DHS released FAQs to help address provider questions. Submissions can be made via email to: RA-HHRRLHLTHTRNSPLAN@pa.gov.

Submissions will be reviewed for those providers to receive Rapid Response Stabilization payments of at least $10,000 and up to $1 million to be used for the purchase of supplies, equipment, renovations, or structural improvements in alignment with the goals outlined in the commonwealth’s RHTP application to the federal government.

General Assembly

The House held session earlier this week addressing the following healthcare related issues:

Monday
- The House Aging & Older Adult Services Committee held a public hearing on Rep. Maureen Madden’s HB 2435, providing for dementia training for EMS personnel.
Tuesday
- The House Health Committee passed HB 916, legislation to update the Child Blood Lead Testing Act, as amended by a vote of 14-12.
- The House Human Services Committee unanimously advanced House Resolution 134, a resolution directing a comprehensive review of home & community-based services waiver programs and areas of improvement that can be identified.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Rep. Darisha Parker introduced House Bill 2464 which would replace outdated terminology in PA’s Insurance Company Law.
Rep. Anthony Bellmon circulated a co-sponsor memo for a resolution designating May 2026 as Guillain-Barre Syndrome Awareness Month.
A co-sponsor memo issued by Rep. Russ Diamond proposes a resolution designating October 13^th as Metastatic Breast Cancer Awareness Day in 2026.
Rep. Kerry Benninghoff released a co-sponsor memo for Childhood Cancer Awareness Month in September of 2026.
Rep. Arvind Venkat issued a cosponsor memo for legislation to establish timelines for the processing of Medical Assistance applications in long-term care and another for a resolution directing a study on medical schools and their promotion of careers in primary care.
Rep. Kathy Rapp issued co-sponsor memos for resolutions designating Surgical Technologist Week and Idiopathic Pulmonary Fibrosis Research Awareness Week.
A co-sponsor memo was filed by both Rep. Tina Davis and Sen. Steve Santarsiero for legislation requiring the sharing of emergency plans and contacts for nursing facilities with local emergency responders.
Sen. Tina Tartaglione issued co-sponsor memos for resolutions designating Mental Health Awareness Month and Older Americans Month.
Sen. Amanda Cappelletti and Sen. Steve Santarsiero released a co-sponsor memo for legislation requiring insurance coverage for breastfeeding and feeding support services.
Sen. Michele Brooks issued a co-sponsor memo for a resolution designating National Hospital Week.
Sen. Judy Ward released a co-sponsor memo for a resolution designating Nursing Week in Pennsylvania.
A co-sponsor memo circulated by Sen. Elder Vogel for a resolution designating May 14^th as IgA Nephropathy Awareness Day in PA.

The House and Senate are scheduled to return to session this upcoming week where the following activity is anticipated:

Tuesday
- The House Communications & Technology Committee will hold a voting meeting to consider HB 1925, which would provide regulations and parameters on the use of AI in Healthcare.
- The House Aging & Older Adult Services and Human Services Committees will hold a joint public hearing on In Lieu of Services.
Wednesday
- The House Health Committee will hold an informational hearing on the Uniform Healthcare Decision Act.
- The House Insurance Committee will hold a voting meeting on HB 2427; consolidation of utilization management statutes, HB 2464; replacing outdated references in PA’s Insurance Law, and HB 2473; repealing obsolete insurance laws and completed statutorily required studies.
Thursday
- The Senate Institutional Sustainability and Innovation Committee will hold a hearing on SB 792, which would provide for an increase in the Research & Development Tax Credit program in PA.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department released a bulletin notice announcing the approval of doula services’ inclusion in the PA Medicaid State Plan by CMS retroactive to Jan. 1, 2025, as required by Act 115 of 2024.

DHS issued a provider tip for streamlining provider revalidation submissions.

The Department released their latest updated PA Managed Care Directory.

Stakeholder Meetings

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on May 7^th from 10am-1:30pm.

DOH’s Statewide HIV Planning Group will hold a public meeting on May 20^th from 9am to Noon.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2026-05-01T20:28:03+00:00May 1st, 2026|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance, Rural Health Transformation Program|Comments Off

PA Health Policy Update for April 24

The following is an update of selected state health policy developments in Pennsylvania from April 20 –April 24 (Some of the language used below is taken directly from state documents).

Rural Health Transformation Program

Today, DHS announced the qualifications for providers to receive Rapid Response Stabilization payments of at least $10,000 and up to $1 million to be used for the purchase of supplies, equipment, renovations, or structural improvements in alignment with the goals outlined in the commonwealth’s RHTP application to the federal government. Providers may submit the eligibility certification and required documentation beginning on May 1 to show they meet all of the following criteria:

Licensed as a hospital, health care provider, or rural health facility;
Currently in operation in Pennsylvania at the time of application and at the time funding is received;
Located in one of the RHTP-eligible rural counties or in a HRSA-defined rural census tract of a county of the second class A or third class.

This program payment is limited to one payment per qualified entity. Under the first tranche of this program request, program payments are limited to two program payments per region. There is a planned second tranche of funds to be made available after June 1, 2026 and that second tranche will not be limited by region.

DHS will authorize program payments in the order eligibility certifications are received, as evidenced by the date and time the email containing the full eligibility certification and receipt of all required documents. Providers should begin preparing the required documentation and budget narrative now for email submission on May 1. Submissions can be made via email to: RA-HHRRLHLTHTRNSPLAN@pa.gov.

General Assembly

The Senate held session earlier week addressing the following issues:

Monday
- The Senate passed Sen. Rosemary Brown’s SB 998, by a measure of 43-4, which would provide an expansion of resources for accredited nursing programs in PA through the Nurse Education Capacity Expansion Grant program.
Tuesday
- The Senate Local Government Committee advanced HB 1442, which would require that all autopsies include a review to whether a seizure or epilepsy was part of the cause of death.
Wednesday
- HB 1251, which is part of the “MOMNIBUS 2.0” bill package, will now head to the Governor’s desk following a 45-2 final passage vote. This legislation would allow nurse midwives to refer patients to physical therapy for access to pelvic floor therapy.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Sen. Amanda Cappelletti circulated a co-sponsor memo for legislation requiring the inclusion of Gaucher’s Disease on Pennsylvania’s Newborn Screening Panel and a co-sponsor memo for legislation that would allow access to PrEP and PEP medications without prescriptions.
Sen. Elder Vogel issued a co-sponsor memo for a resolution recognizing IgA Nephropathy Awareness Day in Pennsylvania.
Senator Michele Brooks released a co-sponsor memo for a resolution to designate May 2026 as Lyme Disease & Tick-Borne Illness Awareness Month in PA.
Rep. Frank Burns introduced HB 2431 which would require PBMs to accept Medicaid prescriptions from any pharmacy and pharmacist in good standing with the State Board of Pharmacy and US DEA.
Rep. Maureen Madden introduced HB 2435, providing for dementia training for EMS personnel. This legislation will receive a public hearing in the House Aging & Older Adult Services Committee on Monday April 27th.

The House is scheduled to return to session this upcoming week. In addition to the hearing on HB 2435, the following activity is anticipated:

On Monday, the House Human Services Committee will meet to consider House Resolution 134, a resolution directing a comprehensive review of home & community-based services waiver programs and areas of improvement that can be identified.
On Tuesday, the House Health Committee will meet to consider HB 916, legislation to update the Child Blood Lead Testing Act.

Both the House and Senate will return to session on May 4^th.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities. Recently highlighted in DHS’ Human Services Helpers Substack was a toolkit for Long-Term Care Services & Caregivers to help all parties better understand and navigate the enrollment process.

DHS is currently hiring Regional Policy Specialists and an Executive Policy Specialist to help implement PA’s Rural Health Transformation Plan.

The Department issued its March 2026 HealthChoices Enrollment Report.

DHS announced its schedule for onboarding provider types to begin using the Qualitrac electronic prior authorization portal for MA fee-for-service claims. For each wave of the rollout, providers will receive a kickoff communication with instructions on how to register for the portal, then complete the registration and attend an initial training session focused on how to use the portal for their specific review type. There is no deadline at this time for mandatory use of Qualitrac for these authorizations, but DHS strongly encourages providers to use the portal once they are ready.

Department of Health

The Department released a Health Advisory Network alert for an increase in emergency department visits for tick bites and urging providers to heighten suspicion for tickborne diseases.

DOH, the Patient Safety Authority, and other stakeholders released updated guidance to acute care facilities regarding the definition of serious events, incidents, or infrastructure failures.

Stakeholder Meetings

The Patient Safety Authority will hold a public meeting on April 28^th at 1pm.

DOH’s Special Pharmaceutical Benefits Program will hold a public teleconference on April 30^th from 10am to Noon.

The Department of Health’s Spinal Cord Research Advisory Committee Meeting will hold a public meeting on May 1^st from 9am – 10am and the Brain Injury Advisory Board Meeting will also hold their public meeting on May 1^st from 10am – 3pm.

DOH’s Statewide HIV Planning Group will hold a public meeting on May 20^th from 9am to Noon.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2026-04-24T20:24:41+00:00April 24th, 2026|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for March 27

The following is an update of selected state health policy developments in Pennsylvania from March 23 –March 27 (Some of the language used below is taken directly from state documents).

Budget Update

House Appropriations Committee Chairman Jordan Harris has introduced and begun to advance budget bills to kick off the legislative budget process for this year. HB 2400, the General Appropriations Bill, HB 2401, the Capitol Budget Bill, and HB 2402, the Capitol Budget Itemization Bill, were all introduced and moved out of the House Appropriations Committee this week along with other budget-related bills.

Rural Health Transformation Program

The Department of Human Services has released a registration link for their Rural Health Transformation Program (RHTP) Webinar scheduled for March 31^st at 3:30pm where the Department will share information and details on Pennsylvania’s approach to dispersing and operationalizing the $193M RHTP funds awarded to the Commonwealth. We will be joining to monitor the webinar but we encourage you to sign up as well to hear the Shapiro Administration’s plans to deploy these dollars in Year 1.

General Assembly

Both the House and Senate were in session this week. Four new members of the House, Ana Tiburcio (D) in HD 22 from Lehigh County, Jen Mazzocco (D) in HD 42 from Allegheny County, Andrea Verobish (R) in HD 79 from Blair County, and Catherine Wallen (R) in HD 193 from Adams County were seated this week following special elections. The House still must fill a vacancy in the 196^th District from York County and will have a new vacancy at the end of the month with the resignation of Stephanie Scialabba of Butler County.

In the Senate, SB 1211, legislation to include Medicaid Fee for Service coverage for biomarker testing, passed unanimously and will now advance to the House Human Services Committee for consideration. The Senate also advanced SB 614, FQHC Preceptorship legislation, which included an amendment to broaden eligible entities and to address role of and opportunity for Rural Health Transformation Program funds to be used for this purpose, among other changes. The bill passed by a measure of 26-23, sending it to the House Health Committee. Lastly, the Senate advanced SB 804 which prohibits usage of IV solutions or medical equipment with certain additives. The bill passed 49-1 and now moves to the House Health Committee.

In the House, the House Health Committee met for a public joint hearing held along with the House Communications & Technology Committee on Tuesday examining the role of AI in Healthcare. The Health Committee met again for a voting meeting on Wednesday to consider several resolutions as well as House Bill 2265, which would require onsite, board-certified or board-eligible Emergency Physicians in all hospital emergency departments. The bill advanced out of committee with an amendment further clarifying some of the bills requirements and aligning with existing regulations, addressing some stakeholder concerns. The House also unanimously passed HB 1851 which would expand midwifery services in PA.

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Rep. Paul Friel formally introduced HB 2315, legislation to compel the creation of regulations to allow direct primary care providers to submit referrals for individuals covered under HMO plans.
Rep. Justin Fleming introduced a co-sponsorship memo for additional safety measures around the sale and usage of compounded GLP-1 products in PA.
Rep. Bridget Kosierowski issued a co-sponsor memo for legislation to expand insurance coverage of wheelchair maintenance.

The House will return to session the week of April 13^th and the Senate is scheduled to return the week of April 20^th.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

DHS issued the following notices in the PA Bulletin effectuating special legislative payments for certain nursing facilities as outlined by the Budget and various code bills:

The Department released a bulletin notice for the Nursing Facility Assessment Program for FY 25-26.

Department of Health

DOH shared an announcement from the Pennsylvania Commission on Crime and Delinquency (PCCD) regarding the future implementation of Track-Kit, Pennsylvania’s statewide sexual assault kit (SAK) tracking system. This change is in response to Act 122 of 2024, which directed PCCD to establish and operate a statewide system to track sexual assault kits throughout the custody and testing process.

The Department released an RFA for neurodegenerative research with a due date of April 23rd. This funding was a result of new state dollars included in last year’s budget legislation.

Stakeholder Meetings

DOH’s Infant Hearing Screening Advisory Committee will hold their public meeting on March 31^st from 9am-11am.

The Department of Health’s Renal Advisory Committee will hold their quarterly public meeting on April 17^th from 10am-Noon.

DOH’s Special Pharmaceutical Benefits Program will hold a public teleconference on April 30^th from 10am to Noon.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2026-03-27T20:36:44+00:00March 27th, 2026|Federal Medicaid issues, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2027 budget, Pennsylvania Rural Health|Comments Off

PA Health Policy Update for January 16

The following is an update of selected state health policy developments in Pennsylvania from January 12 – January 16 (Some of the language used below is taken directly from state documents).

General Assembly

The following are healthcare-related bills or cosponsor memos released by legislators this past week:

Rep. Joe Webster introduced House Bill 2115 which creates antitrust review processes in healthcare transactions.
Rep. Greg Scott introduced HB 2134 to modernize the State Fire Commission Fire Company & EMS Grant Program
House Bill 2135, introduced by Rep. Morgan Cephas, would provide workplace protections and accommodations for menopause and perimenopause.
Sen. Nick Pisciottano introduced SB 1113, which would regulate the use of AI in healthcare.
Senate Bill 1133, sponsored by Sen. Frank Farry, would add two additional members to the State Board of Pharmacy – a pharmacy tech and an additional acute care institutional pharmacist.
Reps. Borowski, Friel, and Kutz have released a cosponsor memo to allow for companies to apply for a state pharmaceutical licensure concurrently with FDA approvals.

Department of Human Services

Check out DHS’ Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

DHS issued an MA Bulletin on Orthopedic footwear.

The Department released its proposed renewal of the Adult Autism Waiver for a 30 day public comment period. Proposed updates would change the lifetime limit on assistive technology to an annual limit, continue supports for competitive, integrated employment, and update Specialized Skill Development services.

Stakeholder Meetings

DOH’s Statewide HIV Planning Group will hold public meetings on Jan. 21-Jan. 22 from 9am-3pm on both days.

DHS has a scheduled Medical Assistance Advisory Committee meeting for Thurs. Jan. 22^nd at 10am.

DOH’s WIC State Advisory Board meeting will be held on Tues. Jan. 27^th from 1-2pm.

The Department of Health’s Special Pharmaceutical Benefit Program Advisory Council will meet on Thurs. Jan. 29 from 10a.m. to 12p.m. The Council will offer guidance and recommendations to the Department on the program’s drug formulary, covered lab services, drug utilization review, clinical programs, eligibility and program management.

DOH’s Brain Injury Advisory Board will hold a public meeting on Fri. February 6^th from 10am to 3pm.

The Patient Safety Authority will hold a public board meeting on Tues. Feb. 10^th at 1pm.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2026-01-16T22:13:12+00:00January 16th, 2026|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off

PA Health Policy Update for December 12

The following is an update of selected state health policy developments in Pennsylvania from December 8 – December 12 (Some of the language used below is taken directly from state documents).

General Assembly

The Senate held its final voting days for the calendar year this past week during which, the Senate Education Committee unanimously advanced SB 116, legislation by Sen. Dave Argall, which would allow high school juniors and seniors to earn course credits toward their graduation requirement for employment in a nursing facility, personal care home, assisted living residence, or hospital.

The House will return for non-voting session on December 15^th when the House Communications & Technology Committee will hold a public hearing on HB 1925, Rep. Arvind Venkat’s AI in Healthcare legislation.

The House will hold voting session on the 16^th & 17^th and on Wednesday, the House Health Committee will meet to consider HB 1202 & HB 1851. Rep. David Zimmerman’s HB 1202 would create a Commonwealth Medical Stockpile which could be accessed by healthcare facilities. HB 1851, sponsored by Rep. Gina Curry, would allow nurse-midwives to sign fetal death certificates.

Below are several healthcare-related bills or co-sponsor memos issued this week:

Sen. Nikil Saval introduced SB 1085 which would create a Direct Care Worker Wage Board.
Rep. Bryan Cutler introduced HB 2088 which would require Certificates of Merit in Healthcare liability claims.
HB 2096, sponsored by Rep. Seth Grove, would implement a Direct Primary Care payment model in Pennsylvania.

Department of Health

DOH issued notice that effective January 1, 2026, the certain fees may be charged by a health care facility or health care provider in response to a request for production of medical charts or records.

The Department released Call for Cases Health Alert Network advisory for Multistate Cluster of Extensively Drug-Resistant Acinetobacter baumannii and Enterobacter cloacae complex.

Department of Human Services

DHS launched Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

DHS shared updated RA Mailing Dates Remittance Advice (RA) Mailing Dates/Electronic Remittance Advice (ERA) Delivery Dates.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-12-12T22:55:51+00:00December 12th, 2025|Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off

PA Health Policy Update for December 5

The following is an update of selected state health policy developments in Pennsylvania from November 24 – December 5 (Some of the language used below is taken directly from state documents).

Shapiro Administration Staffing Changes

The Shapiro Administration announced a change in senior leadership with Budget Secretary Uri Monson leaving his post to serve as Executive Director at the PA Public School Employees Retirement System (PSERS). The Governor has appointed Zach Reber, current Deputy Secretary for Fiscal Policy and Program Coordination in the Budget Office, to serve as the next Secretary of the Budget.

General Assembly

The Senate returns next week for three voting session days from December 8^th through the 10th. The House will return for non-voting session on December 15^th and voting session on the 16^th & 17^th.

On Monday, Dec. 15th at 1pm, the House Communications & Technology Committee is holding a public hearing on HB 1925, Rep. Arvind Venkat’s AI in Healthcare legislation.

Rep. Bryan Cutler released a cosponsor memo for Certificates of Merit in Healthcare liability claims.

Department of Health

DOH updated its respiratory virus outbreak toolkit with minor changes and issued a new FAQ about Fall 2025 respiratory viral illness guidance.

Department of Human Services

DHS is launching Human Services Helpers, on the Substack platform – a media platform for video, podcasts, etc. – that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department issued Medical Assistance Bulletins on the following areas:

DHS released its October 2025 Managed Care Enrollment Report.

The Department issued revisions to its list of drug companies participating in the Medicaid Drug Rebate Program.

DHS issued a notice of intent to update its Chapter 5100 Mental Health Procedures Regulations to align with Act 32 of 2022.

Independent Fiscal Office

The IFO released a report detailing its assessment of factors contributing to anticipated structural deficits for Pennsylvania’s budget.

Independent Regulatory Review Commission

IRRC approved the final form covered outpatient drug regulations, which updated the payment methodology for pharmaceutical services, recognized the prescriptive and dispensing authority of certified registered nurse practitioners and midwives as well as made technical amendments to recognize advances in information technology.

Pennsylvania Health Care Cost Containment Council

The PA Health Care Cost Containment Council (PHC4) released its 2024 Hospital Performance Report, which examines trends on mortality and readmissions, among other data points.

Stakeholder Meetings

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-12-05T20:44:06+00:00December 5th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for November 14

The following is an update of selected state health policy developments in Pennsylvania from November 10 – November 14 (Some of the language used below is taken directly from state documents).

Budget Update

After a stalemate lasting 135 days, the General Assembly has passed a comprehensive Fiscal Year (FY) 2025-2026 budget. The state House of Representatives passed Senate Bill 160 – the General Appropriations Act – by a vote of 156-47. Senate passed it by a vote of 40-9.

In total, the FY 2025-2026 budget spends $50.1 billion, which represents a $2.3 billion or 4.7 percent increase over the prior fiscal year. It is nearly $1.4 billion less than the budget proposed by Governor Shapiro in February. The budget is balanced primarily by utilizing prior-year funding lapses and special fund balances in state agencies totaling $3 billion. Using these funds in the 2025-26 budget prevented draining the state’s emergency reserves in the Rainy Day Fund, while leaving more than $200 million in the fund’s balance.

The budget includes a new Working Families Tax credit program. However, it does not include many of the spending initiatives highlighted in the governor’s proposal, such as additional mass transit funding, taxation for skill games, minimum wage increases, or legalization and taxation of recreational adult use cannabis. Also part of the deal includes the Commonwealth ending its participation in the Regional Greenhouse Gas Initiative.

In addition to the General Appropriations Bill, the General Assembly also passed code bills related to the budget and its enactment. House Bill 416 is an amended Fiscal Code which includes various instructions to help effectuate passage of the budget bill. House Bill 749 is an update to the Human Services Code which includes several policy provisions below:

Regulatory alignment with federal rules on MA reimbursement for behavioral health in telehealth settings – the “Four Walls” Requirement,
Requires DHS to report to the General Assembly on SNAP recipient data and lottery winnings, resources, and vehicles owned by public assistance recipients
Crosschecking MA and SNAP beneficiaries with data from DOH’s Vital Records system and wage records from the Department of Labor & Industry
Requires DHS to study the feasibility of a brokerage model for nonemergency Medical Transportation Services
Allows indefinite suspension of MA benefits for incarcerated individuals while incarcerated, among other provisions.

General Assembly

On Monday, November 17^th, the House Human Services Committee will hold an informational hearing on the federal SNAP changes in HR 1 and their impacts on Pennsylvania. The livestream link will be made available here.

The House Health Committee will meet on Tuesday Nov. 18^th to consider HB 1652 and HB 1715. Both bills would amend the Newborn Child Testing Act to update newborn screening requirements to include Gaucher Disease (HB 1652) and Duchenne Muscular Dystrophy (HB 1715), respectively.

Department of Health

The Department issued a Health Alert Network notice urging providers’ awareness for Acute Flaccid Myelitis through late Fall.

DOH updated the residency criteria for the Chronic Renal Disease Program effective November 15, 2025.

Department of Human Services

DHS is launching Human Services Helpers, a Substack that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities.

The Department has announced it has restarted issuing full November Supplemental Nutrition Assistance Program (SNAP) benefit payments.

DHS shared a suicide prevention resource guide in recognition of National Suicide Prevention Month.

The Department released a Medical Assistance Bulletin with revisions to the MA Fee Schedule and prior authorization requirements.

The Department issued an updated Preferred Drug List which will be effective Jan. 1, 2026.

DHS released MA Bulletins on updated prior authorization policies for several drug classes in response to recommendations from the Pharmacy and Therapeutics Committee.

The Department released an updated Managed Care Directory.

Stakeholder Meetings

The Department of Health’s Statewide HIV Planning Group will hold their public meeting on Wednesday Nov. 19^th and Thursday November 20^th both from 9am-3pm.

The DHS Medical Assistance Advisory Committee plans to meet December 4^th at 10am. You can register for the meeting here.

The Patient Safety Authority will hold a virtual public meeting on Tuesday, December 9, 2025, at 1 p.m. Find registration and details here.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-11-14T21:03:25+00:00November 14th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for October 24

The following is an update of selected state health policy developments in Pennsylvania from October 20- October 24 (Some of the language used below is taken directly from state documents).

Budget Update

Earlier this week, the Senate passed Senate Bill 160 (PN 1258) by party line vote in yet another volleying of a General Appropriations Act bill to the House. The Senate’s amendments to the bill reduced the overall spend number to $47.9 billion, down from the House’s last proposal of $50.25 billion.

The bill reflects a prior version (PN 529) of the budget bill but with increased appropriations for debt service payments and school employees’ pensions, while also reducing operating expense line items for the General Assembly. The Governor labeled the Senate’s most recent effort as “unserious.”

As the impasse continues, meaningful impacts to Pennsylvanians and providers are becoming more frequent. Absent budget enactment, Head Start providers are signaling closures, Westmoreland County plans to furlough workers soon, and Lancaster County intends to pause social services payments.

The House and Senate are both set to return on October 27^th.

General Assembly

Last week, the Senate was in session and passed by a margin of 49-1, Sen. Rosemary Brown’s SB 507, legislation to update and modernize midwifery services in Pennsylvania. The bill will be considered by the House Professional Licensure Committee on October 28^th.

The Senate Labor & Industry Committee voted in support of SB 69 offered by Sen. Langerholc by a party line vote. This bill would create a “Recovery-to-Work” pilot program.

Next week, on October 28^th, the House Health Committee will hold an informational meeting on the Department of Health’s Newborn Screening program.

On October 29^th, the House Human Services Committee will meet to consider Rep. Benham’s HB 1939, and House Bill 1974 by Rep. Venkat. HB 1939 would require DHS to update fee schedule rates for home and community-based services provided through intellectual disability and autism programs based on the Consumer Price Index. HB 1974 proposes to create a Contingency Management Support Grant Program within the Department of Drug and Alcohol Programs (DDAP), enabling Single County Authorities to apply for grants supporting Contingency Management programs and activities like staff training, drug-testing supplies, incentive tracking systems, evaluation, and non-cash incentives.

The House Consumer Protection, Technology, and Utilities Committee will meet on October 29^th to vote on HB 1530 which would establish privacy protections for Pennsylvania consumers regarding their genetic data collected by direct-to-consumer genetic testing companies (e.g., commercial DNA testing services).

On October 27^th, the Senate State Government Committee will consider SB 125, Sen. Dush’s proposed constitutional amendment to address change of judicial venues.

Below is a list of health and human services-related legislation and co-sponsor memos released this week.

Marla Brown introduced HB 1962 which would cease state funding for any provider offering abortion services in PA.
HB 1965, introduced by Rep. Ryan Bizzarro, would allow EMS providers to perform community paramedicine services.
Paul Takac introduced HB 1980 which would require doctors to do an hour of medical nutrition continuing education every two years.
Mastriano introduced SB 1018 which would eliminate any mRNA vaccine mandates in Pennsylvania.
SB 1041 by Sen. Rosemary Brown would create the Complex Care Assistant Program, creating a certification program for family caregivers offering complex medical care to loved ones.
Senator Tartaglione introduced SB 1054 which would require the availability of opioid antagonists in Pennsylvania public schools.
Senator Collett has introduced SB 1055, companion legislation to HB 1881, which would expand pharmacists’ practice authority to provide vaccines in accordance with recommendations from Pennsylvania’s health authorities informed by professional medical societies in addition to FDA guidelines.

Department of Human Services

The Department of Human Services released September’s Physical Health Managed Care enrollment report.

Department of Health

In response to revised CMS guidance on conducting facility surveys during the federal shutdown, which will allow states to request approval from CMS to conduct revisit surveys, DOH notified providers that it will be reviewing outstanding surveys, their timelines, and the deficient practice(s) to request permission from CMS to perform revisit surveys that are necessary to prevent termination or the denial of payment for new admissions.

DOH updated the Resident Data Reporting Manual for long-term care facilities to reflect changes to use the Patient Driven Payment Model (PDPM) for the Pennsylvania case mix payment system.

Stakeholder Meetings

On Nov. 7 from 10am to 3pm, the Brain Injury Advisory Board will hold their quarterly meeting to discuss the Department of Health’s Head Injury Program.

Federal Update

Click here for a review of this week’s federal activities.

PA Safety Net Admin2025-10-24T19:20:42+00:00October 24th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Health Policy Update for September 19

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

Budget Update

The state budget impasse continues, and the House and Senate did not meet in session in Harrisburg this week. Various potential budget bills are positioned to be passed within a few days of a deal being reached. This article from Spotlight PA offers insight on the issues that are still preventing a deal, even as the issue of transit funding was taken out of the mix when the governor released funding to SEPTA and other regional authorities last week. The caucuses continue to disagree on issues including the overall spending amount, welfare program reforms, school choice, and education funding.

The Senate stands in recess to the call of the President Pro Tempore and the House will return for non-voting scheduled session on Monday, September 22.

General Assembly

Although legislators are not present at the Capitol, they have circulated a number of health care-related co-sponsorship memos this week:

Senator Michele Brooks (R), chairwoman of the House Human Services committee, issued a co-sponsorship memo about her intent to introduce a series of bills designed to strengthen Pennsylvania’s eligibility for new federal funding streams under the Rural Health Transformation Fund that was designed in the One, Big Beautiful Bill Act (OBBBA). The funding application offers states additional points in their total application score if they have adopted certain policy priorities of the Trump Administration or introduced legislation to do so.
House Aging & Older Adult Services Committee Chairs Maureen Madden (D) and Steve Mentzer (R) have circulated a co-sponsorship memo to introduce legislation intended to help ensure Pennsylvanians are fully informed of the Living Independence for the Elderly (LIFE) as an available long-term care option.
Senator Tim Kearney (D) circulated a memo announcing his plan to introduce a bill to create an all-payer claims database in Pennsylvania. This was an initiative in the governor’s budget proposal, which sought to allocate $4 million for the Pennsylvania Health Care Cost Containment Council (PHC4) to develop that tool.

Pennsylvania Commission on Crime and Delinquency

The Pennsylvania Commission on Crime and Delinquency (PCCD) is accepting applications for funding under the Local Hospital-based Violence Intervention Program (HVIP) Supports grant program. HVIPs are multidisciplinary programs that connect violently injured patients with trauma-informed care and long-term community supports that start at the emergency department or at the hospital bedside. Local governments should apply for this funding in collaboration with a designated provider, nonprofit organization, or institution of higher education. View the full notice of funding here. Applications are due October 30.

Department of Human Services

The Department of Human Services (DHS) issued a Provider Quick Tip to notify providers that the commonwealth’s Sterilization Consent Form (MA 31) will be issued soon with updates to reflect changes to the federal Consent for Sterilization Form (HHS-687). Stay tuned to this health policy update for an announcement of the updated form when it is released.

DHS has updated its calendar of Remittance Advice mailing dates to include October dates.

Department of Health

The Department of Health (DOH) added new training material to the Project Firstline training portal, which offers free on-demand training on infection prevention and control for all frontline workers in Pennsylvania. The new training is tailored for environmental services staff and discusses the importance of hand hygiene and the critical moments when hand hygiene matters most for these staff members. See this and more trainings and posters on the Project Firstline webpage and request free training materials through this form.

DOH issued the new income eligibility guidelines that will be used in the Special Pharmaceutical Benefits Program (SPBP) effective on October 1, 2025 for new enrollees and on the next date of renewal for any current program participants. The SPBP provides FDA-approved medications to low-income individuals living with HIV who are uninsured or have limited health care coverage. The department explained that due to the recent unprecedented increase in both program enrollment and the overall cost of medications, it is necessary for SPBP to lower the income limits as a measure to sustain the long-term viability of SPBP. Individuals that lose SPBP eligibility are encouraged to explore options on Pennie.

Around the State

Pennsylvania has joined a consortium of northeast states to make collaborative decisions about vaccination guidance and emergency response, in the wake of changes to the Centers for Disease Control and Prevention (CDC) vaccine approval process. See details in this article by the Pennsylvania Capital Star.
Several PA publications, including WHYY, raised the alarm this week about how 2026 costs could increase for Pennsylvanians who get their insurance coverage in the ACA marketplace unless Congress acts to expand enhanced federal tax credits. The PA Insurance Department reported that statewide average premium costs could increase by about 19 percent. The Kaiser Family Foundation has created a cost estimator tool for individuals to get personalized estimates of their costs with and without the tax credits.

Stakeholder Meetings

Medical Assistance Advisory Committee (MAAC) – Sept. 25

The DHS Medical Assistance Advisory Committee will meet virtually on September 25, 2025, at 10:00am. To register, click here.

PA Safety Net Admin2025-09-22T14:10:02+00:00September 19th, 2025|Meetings and notices, Pennsylvania proposed FY 2026 budget|Comments Off

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