Pennsylvania Medicaid Archives - Page 13 of 20 - Safety-Net Association of Pennsylvania

PA Revises Guidelines for Medicaid Presumptive Eligibility

The Pennsylvania Department of Human Services has revised its guidelines for hospitals qualified to make presumptive eligibility determinations for potentially Medicaid-eligible patients who seek services but are uninsured.
The revisions are described in Medical Assistance Bulletin 01-15-08, “Revised Presumptive eligibility as Determined by Hospitals,” which was issued on February 24 but is retroactive to January 1.
In support of that new guidance the state also has issued an addendum for providers outlining their responsibilities and a worksheet for hospitals to use in determining eligibility.

PA Safety Net Admin2015-03-05T06:00:02+00:00March 5th, 2015|Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Governor Proposes New Budget With Medicaid Implications

Yesterday Pennsylvania Governor Tom Wolf presented his proposed FY 2016 budget to the state’s General Assembly.
Included in that budget are proposed spending levels for Medicaid, including supplemental payments and other programs that affect the state’s private safety-net hospitals.
The Safety-Net Association of Pennsylvania has prepared a detailed memo outlining the budget’s broader themes and then details its potential implications for safety-net hospitals. Hospital officials interested in requesting a copy of the memo can do so by hitting the “contact us” link on the upper right-hand corner of this screen.

PA Safety Net Admin2015-03-04T16:56:41+00:00March 4th, 2015|Proposed FY 2016 Pennsylvania state budget|Comments Off

“Super-Utilizers” Costing PA Millions, Report Shows

“Super-utilizers” – people who visit hospital emergency rooms often and are admitted to hospital beds with unusual frequency – are costing the health care system millions of dollars a year.
According to a new report from the Pennsylvania Health Care Cost Containment Council (PHC4), super-utilizers – people admitted to the hospital at least five times in a year – while just three percent of hospital patients in FY 2014, accounted for 17 percent of the state’s Medicaid expenditures for inpatient care ($216 million) and 14 percent of Medicare inpatient expenditures ($545 million). In all, 18 percent of Medicaid hospital admissions in Pennsylvania in FY 2014 were for super-utilizers.
PHC4 identified the three leading reasons for these admissions as heart failure, septicemia, and mental health disorders.
Learn more about super-utilizers and their impact on hospital admissions and health care spending in the PHC4 report, which can be found here.

PA Safety Net Admin2015-02-20T11:06:56+00:00February 20th, 2015|Uncategorized|Comments Off

SNAP Looks to the Future

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The fourth of those papers, released this week, addresses the importance of innovation in addressing the challenges safety-net hospitals face in leading the way to serving Pennsylvania’s growing Medicaid population.
The paper describes the new demands being made of hospitals by insurers, government, and others; tools through which to pursue innovation; the goals of future innovation; and the role that SNAP and safety-net hospitals must play in that innovation.
The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
The third paper, “Transitioning Medicaid: Principles for Changing Course on Medicaid Expansion,” presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Find all four SNAP papers here.

PA Safety Net Admin2015-02-12T10:43:14+00:00February 12th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Expansion Glitch Hits Drug and Alcohol Patients, Providers

A flaw in the implementation of Pennsylvania’s Medicaid expansion has left many of the state’s Medicaid beneficiaries with no coverage for the treatment of their drug and alcohol problems – and some providers without payment for some care they have delivered.
Under the Healthy Pennsylvania Medicaid expansion program, beneficiaries with extensive health problems, like drug and alcohol issues, were supposed to be directed into the state’s “Healthy Plus” Medicaid benefits package, which covers services that address such problems. Instead, many were places in private, state-approved insurance plans for Medicaid beneficiaries, which do not cover those services.
State officials are aware of the problem and say they will soon have a plan to fix it.
Learn more about this glitch in Pennsylvania’s Medicaid expansion and how state officials hope to address it in this Philadelphia Inquirer article.

PA Safety Net Admin2015-01-30T06:00:14+00:00January 30th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

SNAP Principles for Changing Course on Medicaid Expansion in Pennsylvania

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The third of those four papers presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Those eight principles are:

communicate changes effectively to the provider community
ensure beneficiaries’ continuity of coverage and continuity of care
ensure the adequacy of provider networks
simplify beneficiary and provider enrollment
preserve vital supplemental payments to safety-net hospitals
continue pursuing Medical Assistance payment reforms
ensure the long-term financing of Medical Assistance in response to current and future threats to that financing
invest in innovative, population-based infrastructure and programmatic improvements

The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
Find all three SNAP papers here.

PA Safety Net Admin2015-01-28T06:00:12+00:00January 28th, 2015|Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Medicaid “Pay Bump” Worked, New Study Suggests

A federally mandated increase in Medicaid payments for primary care services appears to have achieved its goal of improving access to care for Medicaid recipients – especially in Pennsylvania.
The increase, part of the Affordable Care Act, called for raising payments for Medicaid primary care services to the same level as Medicare payments in the hope that such an increase would lead more primary care providers to serve Medicaid patients, thereby improving access to primary care services for those patients. Historically, primary care providers have been reluctant to serve Medicaid patients, citing low pay as their reason for avoiding such patients.
That Medicaid pay increase – often referred to as the “Medicaid pay bump” – was mandated for two years and expired at the end of 2014. One of the reasons policy-makers resisted extending it was the lack of proof that it achieved its goal of improving access. Now, a new study in the New England Journal of Medicine provides the first broad look at the program’s impact – and the first proof of its success.
In the study, researchers selected ten states and measured the availability and waiting times for primary care appointments for two limited periods of time. They found that

…The availability of primary care appointments in the Medicaid group increased by 7.7 percentage points, from 58.7% to 66.4%, between the two time periods. The states with the largest increases in availability tended to be those with the largest increases in reimbursements, with an estimated increase of 1.25 percentage points in availability per 10% increase in Medicaid reimbursements.

Among the ten states evaluated in the study was Pennsylvania, where the benefits of the Medicaid pay bump were especially noteworthy: while the availability of appointments rose eight percent overall in the states that were part of the study, appointment availability rose 13 percent in Pennsylvania.
One possible reason: the Medicaid pay bump doubled Medicaid primary care fees.
The study’s conclusion?

Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times.

Learn more about the study from this Allentown Morning Call article or find the New England Journal of Medicine article here.

PA Safety Net Admin2015-01-27T06:00:28+00:00January 27th, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

The Challenges Facing Pennsylvania’s Safety-Net Hospitals

With the arrival of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The second of those four papers describes the major health care and health policy challenges safety-net hospitals face. Those challenges include:

the distinct patients safety-net hospitals serve
inadequate payments for Medicaid services
the large numbers of uninsured and underinsured patients safety-net hospitals serve
threats to vital state Medicaid supplemental payments, such as Medicaid disproportionate share payments (Medicaid DSH
continuing change and reform in the health care system, including the delivery of care and how safety-net hospitals are paid for their services

The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
Find both SNAP papers here.

PA Safety Net Admin2015-01-23T06:00:07+00:00January 23rd, 2015|Safety-Net Association of Pennsylvania|Comments Off

Healthy Pennsylvania Medicaid Benefits Posted

The Pennsylvania Department of Human Services has published materials describing Medicaid benefits under the state’s Healthy Pennsylvania Medicaid expansion.
A Medical Assistance Bulletin (#99-15-02) describing the “Interim Healthy Benefit Plan” can be found here and tables comparing the benefits packages under the “Healthy” (low risk), “Healthy Plus” (high risk), and Private Coverage Option plans (PCO) can be found here.

PA Safety Net Admin2015-01-22T06:00:53+00:00January 22nd, 2015|Healthy PA, Meetings and notices, Pennsylvania Medicaid laws and regulations|Comments Off

PA Officially Ends Enhanced Medicaid Payments

The Affordable Care Act-mandated increase in Medicaid payments for primary care services ends on December 31.
While some states believe this increase improved access to care for their Medicaid population and will continue the increase using their own money, Pennsylvania will not, and a new Medical Assistance Bulletin informs primary care providers in the state that the fee-for-service rates they are paid will return to their previous level on January 1.
See the Medical Assistance Bulletin notice here.

PA Safety Net Admin2014-12-29T06:00:31+00:00December 29th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

SNAPShots

SNAPShots

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us