Pennsylvania Medicaid Archives - Page 13 of 21 - Safety-Net Association of Pennsylvania

Pennsylvania Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the July edition of Health Law News, its monthly newsletter.
Included in this edition are articles about the continued expansion of Pennsylvania’s Medicaid program; the next steps in Pennsylvania’s managed long-term services and supports (MLTSS) initiative; the state’s selection of its benchmark essential health benefits insurance plan for 2017; and about how the state will phase out its current AIDS waiver while continuing to serve those covered by the waiver.
Find the latest edition of Health Law News here.

PA Safety Net Admin2015-08-05T06:00:29+00:00August 5th, 2015|Affordable Care Act, long-term care, Pennsylvania Medicaid policy|Comments Off

SNAP Calls for HealthChoices Improvements

The Safety-Net Association of Pennsylvania has urged Pennsylvania’s Department of Human Services to pursue transformative innovation in the state’s HealthChoices Medicaid managed care program.
In particular, SNAP has called on DHS to create regional health collaboratives consisting of both insurers and providers to work together to deliver better, more coordinated care to Pennsylvania’s Medicaid population.
SNAP also recommended that the state finance innovation by implementing a Delivery System Reform Incentive Payments program, better known as DSRIP, to fund innovation in the state’s Medicaid program.
SNAP’s suggestions came in response to a request for information issued by the state seeking recommendations for how to improve the HealthChoices program in anticipation of the state’s plan to rebid HealthChoices managed care contracts later this year.
See the state’s request for information here and find SNAP’s comment letter here.

PA Safety Net Admin2015-06-29T06:00:03+00:00June 29th, 2015|HealthChoices PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

PA Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the May edition of Health Law News, its monthly newsletter.
Included in this edition are articles about the Wolf administration’s newly released Medicaid managed long-term supports and services proposal; the increase in Medicaid enrollment since the state’s Medicaid expansion began on January 1; the Medical Assistance Transportation Program; and the state’s application to the federal government to establish Pennsylvania’s own health insurance marketplace.
Go here to see the latest edition of PA Health Law News.

PA Safety Net Admin2015-06-09T06:00:56+00:00June 9th, 2015|Uncategorized|Comments Off

GAO Examines Medicaid Section 1115 Waivers

The U.S. Department of Health and Human Services (HHS) frequently exercises the authority granted to it under section 1115 of the Social Security Act to authorize Medicaid expenditures for uses not strictly permitted under that law if those uses extend Medicaid coverage to populations not already served by Medicaid or promote Medicaid objectives.
Pennsylvania’s Medicaid program has long taken advantage of section 1115 waivers.
At the request of the chairmen of the Senate Finance Committee and the House Energy and Commerce Committee, the U.S. Government Accountability Office (GAO) examined recently approved section 1115 waivers to evaluate whether those waivers met the criteria for the exemptions and whether the documents HHS issues when approving those waiver requests adequately convey what the approved expenditures are for and how they will promote Medicaid’s objectives.
As part of its investigation, GAO reviewed waiver requests from 25 states covering 150 programs and found that HHS lacked formal, written criteria for waivers and suggested that the agency more clearly express, in its approval documents, the objectives it expects programs to achieve in return for their exemption from some federal Medicaid requirements.
For a closer look at the study and its findings, see the report Medicaid Demonstrations: Approval Criteria and Documentation Need to Show How Spending Furthers Medicaid Objectives here, on the GAO web site.

PA Safety Net Admin2015-05-19T06:00:33+00:00May 19th, 2015|Pennsylvania Medicaid policy|Comments Off

PA Moves to Streamline Medicaid Provider Enrollment

In response to the challenges the state has encountered processing Medicaid provider enrollment applications, the Pennsylvania Department of Human Services (DHS) has unveiled what it believes will be an improved approach to tackling this problem.
The improvements include electronic enrollment, standardization of policies and procedures, and additional provider enrollment staffing.
At the heart of the backlog are Affordable Care Act requirements.
Go here to see a message from DHS acting secretary Theodore Dallas on this subject.

PA Safety Net Admin2015-04-23T06:00:08+00:00April 23rd, 2015|Affordable Care Act, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Releases Document Outlining Transition to “Traditional Medicaid Expansion”

The Pennsylvania Department of Human Services (DHS) has posted a document outlining its plan for transitioning from the Healthy Pennsylvania Medicaid expansion to what it terms a “traditional Medicaid expansion.”
The document summarizes what the state is doing, why it is doing it, and how it plans to move from the previous approach to the new one. It also includes links to expansion-related documents and explanations, presents the cost of the transition and the new program, and explains to interested parties how they can comment on the state’s plans.
Find the notice document “Transition to Traditional Medicaid Expansion” here.

PA Safety Net Admin2015-03-23T06:00:57+00:00March 23rd, 2015|Pennsylvania Medicaid policy|Comments Off

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February newsletter.
This edition features articles on Medicaid expansion in Pennsylvania; problems posed by Healthy Pennsylvania for individuals who receive drug and alcohol or mental health services and how the state is addressing those problems; and the new, special enrollment period for those who are uninsured to sign up through the federal marketplace and avoid the fine for failing to secure health insurance.
The newsletter also lists upcoming state legislative budget hearings that will address health care issues and raises the possibility of the state establishing an Affordable Care Act-authorized “Community First Choice” program, which gives a state access to additional federal matching funds to pay for attendant services for Medicaid beneficiaries with severe intellectual or physical disabilities.
Find the latest edition of Health Law PA News here.

PA Safety Net Admin2015-03-13T06:00:18+00:00March 13th, 2015|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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

SNAPShots

SNAPShots

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

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