Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work.
Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.
With the state budget still lacking a plan to raise revenue to underwrite expenses, the Wolf administration is beginning to withhold payments to the state’s creditors.
Including those who provide services to the more than 2.8 million Pennsylvanians enrolled in the state’s Medicaid program.
Last week the Wolf administration announced that it withhold $1.2 billion in Medicaid provider payments.
Unless the problem is resolved, more state payments could be withheld in the coming weeks.
Learn more about what the Wolf administration is doing and how it might affect Medicaid and Medicaid providers in this Philadelphia Inquirer article.
The combination of Congress attempting either to repeal and replace or repair the Affordable Care Act and Pennsylvania facing a multi-billion budget shortfall has led some policy-makers in Harrisburg to begin talking about ways to better manage or reduce the state’s Medicaid costs.
Those costs climbed from $3.9 billion in 2004 to $6 billion in 2014.
Among the possibilities state lawmakers are discussing: tighter rules for participation, greater efficiency, work and work search requirements for able-bodied Medicaid recipients, charging premiums for high-income families for which Medicaid provides coverage for their profoundly disabled children, and a pilot program to test whether a recipient care management program might eliminate medical errors, improve recipient health, and reduce health care costs.
Learn more about some of the Medicaid ideas Pennsylvania policy-makers are considering in this PennLive article.
SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians.
Among the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections.
See the complete letter here.
The Pennsylvania Health Law Project has published its April 2017 newsletter.
Included in this edition are articles about:
Find the latest edition of PA Health Law News here.
The Safety-Net Association of Pennsylvania has joined 13 other groups in writing to members of the state’s congressional delegation to warn about shortcomings in the American Health Care Act, health care reform legislation currently being considered by the U.S. House of Representatives.
The letter warns that the American Health Care Act would “…dramatically reduce Medicaid coverage and strain resources for this critical program.”
Read that letter here, on SNAP’s web site.
Pennsylvania’s Medicaid program is moving toward greater use of value-based purchasing in its Medicaid behavioral health programs.
Last week, the state’s Office of Mental Health and Substance Abuse Services held a webinar to offer information about the state’s plan for employing value-based purchasing in Medicaid and how it will do so for behavioral health services in particular. Go here to see the presentation delivered at that webinar.
The manner in which Pennsylvania operates its county assistance offices would change under a new proposal from the Department of Human Services that was included in Governor Wolf’s proposed FY 2018 budget.
Under the plan, the state would consolidate county assistance office back-office operations in five new regional processing centers. While every county will have what DHS is calling a county assistance office “presence,” the new approach would lead to the lay-off of 70 of the county assistance office program’s nearly 7000 employees.
The process of determining Medicaid eligibility in Pennsylvania either begins or works its way through the state’s county assistance offices.
Learn more about the proposal to change some aspects of county assistance office operations in this DHS notice.
One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing.
In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts.
Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently chosen to serve the state’s Medicaid population through the HealthChoices physical health program.
For a closer look at Medicaid value-based purchasing, go here to read the National Association of Medicaid Directors’ issue brief “Medicaid Value-based Purchasing: What Is It & Why Does It Matter?”
A new study suggests that greatly expanding access to new drugs that essentially “cure” Hepatitis C would cost Pennsylvania’s Medicaid program a great deal of money but save relatively few lives.
The study found that in many cases, Hepatitis C progresses so slowly that by the time many of the people who suffer from it truly need the new generation of expenses drugs they will be old enough for Medicare, which would leave the federal government, rather than the state, with the cost of paying for the treatment.
Patient advocates maintain that all Medicaid beneficiaries with Hepatitis C should have access to the drugs and Pennsylvania’s Medicaid program appears to be on a path toward making that possible.
Learn more about the study and its findings in this Philadelphia Inquirer story.