Pennsylvania Medicaid Archives - Page 15 of 20 - Safety-Net Association of Pennsylvania

GAO Questions State Medicaid Financing

States are now financing more than a quarter of their share of Medicaid expenditures with money from sources other than state general funds, according to a new study by the Government Accountability Office (GAO).
According to the GAO, 26 percent of state share of Medicaid funding comes from taxes on health care providers, transfers from local governments and local government providers, and other sources. Such funding, the GAO noted, shifts additional Medicaid costs to the federal government.
Pennsylvania uses such funding mechanisms, including its gross receipts tax on Medicaid managed care organizations and state-wide and Philadelphia hospital assessments.
Exacerbating this problem, the GAO reports, is that the Centers for Medicare & Medicaid Services (CMS), which oversees Medicaid, does not assure that it receives complete and accurate data on funding sources from the states, leaving CMS without a complete understanding of how states are financing their Medicaid expenditures. In the report, the GAO recommends a stronger CMS effort to gather such data – a recommendation that CMS did not accept.
Learn more about the GAO study “States Increased Reliance on Funds From Health Care Providers and Local Governments Warrants Improved CMS Data Collection” by finding the complete report and a summary here, on the GAO web site.

PA Safety Net Admin2014-07-31T06:00:42+00:00July 31st, 2014|Pennsylvania Medicaid policy|Comments Off

PA Reverses “MAWD” Elimination

The Corbett administration has reversed an earlier decision and decided to retain Pennsylvania’s Medical Assistance for Workers With Disabilities program, frequently referred to as “MAWD.”
MAWD provides low-cost health insurance to Pennsylvanians with disabilities who do not otherwise qualify for Medical Assistance because they work and have earnings.
The program, which serves about 34,000 people, costs the state $7 million a year. A Department of Public Welfare spokesman said preserving the program is consistent with the Corbett administration’s Healthy Pennsylvania initiative.
Learn more about MAWD here and about the decision to retain it in this Insurance Net News article.

PA Safety Net Admin2014-07-29T06:00:28+00:00July 29th, 2014|Healthy PA, Pennsylvania Medicaid laws and regulations|Comments Off

SNAP Warns of Challenges Ahead

As Pennsylvania lawmakers contemplate the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania has issued a new position paper reminding those officials of the challenges the state’s private safety-net hospitals face in the current environment and the need for adequate, stable funding as they tackle those challenges.
Among those challenges are low-income patients with distinct needs, major cuts in federal Medicare payments that especially target safety-net hospitals, and powerful economic forces marshaled by government, insurers, and others that seek to compel hospitals to deliver care in different ways, be paid differently for their efforts, align their incentives differently with other providers, and invest heavily in information technology.
Pennsylvania’s safety-net hospitals are prepared to do all these things, but to achieve such progress, they need financial stability and predictability: they need to know that their Medical Assistance funding will not be at risk as the state experiences various budget challenges.
Read SNAP’s perspective on these issues in its new position paper, “Pennsylvania’s Safety-Net Hospitals: The Need for Stable and Predictable Funding Amid Increasing Challenges,” which can be found here, on SNAP’s web site.

PA Safety Net Admin2014-06-30T06:00:31+00:00June 30th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

SNAP Speaks Out on PA Budget Issues

In a series of three new position papers, the Safety-Net Association has laid out the case for why Pennsylvania needs to fund its Medicaid program adequately in the state’s upcoming 2015 fiscal year.
The first paper, “Pennsylvania Safety-Net Hospitals: Economic Engines Driving Pennsylvania Communities,” documents the degree to which safety-net hospitals not only provide significant numbers of jobs but also offer higher wages than other hospitals and other Pennsylvania employers.
The second paper, “The Importance of Preserving Uncompensated Care Payments,” notes that Pennsylvania’s safety-net hospitals, just 25 percent of the state’s acute-care hospitals, provide nearly 50 percent of the $1 billion worth of uncompensated care hospitals in the state provide every year. The state helps underwrite some of those costs through Tobacco Uncompensated Care fund payments – proceeds of the national tobacco settlement of 1998 – but that funding is now in jeopardy.
And the third paper, “The Need for Stable and Predictable Funding Amid Increasing Challenges,” outlines the enormous and at times conflicting pressures that government and others are exerting on hospitals and explains that while safety-net hospitals look forward to these challenges, they need stable and predictable Medicaid funding to help them rise to the occasion.
SNAP issues these papers as lawmakers in Pennsylvania struggle with an FY 2014 revenue shortfall of more than $500 million and an anticipated shortfall of another $880 million in the coming 2015 fiscal year.
See SNAP’s three new position papers here.

PA Safety Net Admin2014-06-20T06:00:20+00:00June 20th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Uncompensated Care Down in Medicaid Expansion States

Hospitals in states that chose to take advantage of the Affordable Care Act’s Medicaid expansion option are providing less charity care than hospitals in states that have not expanded their Medicaid programs.
So reports the Colorado Hospital Association after its survey of 465 hospitals in 30 states.
According to the survey, hospitals’ proportion of Medicaid patients increased in states that expanded their Medicaid programs and did not increase in states that did not expand their Medicaid program and uncompensated care fell in states that expanded their Medicaid programs but did not in other states.
Addressing the extent of these changes, the survey found that

The changes seen here are not only distinct, but also substantial. The Medicaid proportion of total charges increased over three percentage points to 18.8 percent in 2014 from 15.3 percent in 2013, representing a 29 percent growth in the volume of Medicaid charges. When compared to the first quarter of 2013, there was a 30 percent drop in average charity care per hospital across expansion states, to $1.9 million from $2.8 million. Similarly, total self-pay charges declined 25 percent in expansion states, bringing its proportion of total charges down to 3.1 percent from 4.7 percent. In contrast, the proportion of Medicare volume shows little variation through first quarter 2014.

Pennsylvania has not yet expanded its Medicaid program but is currently negotiating the terms of doing so with the federal government.
Find the complete Colorado Hospital Association report here.

PA Safety Net Admin2014-06-06T06:00:25+00:00June 6th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

No Observation Rate Yet for PA Medicaid

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin continuing its current payment methodology under the state’s Medicaid program but noting that it still has not developed an observation rate for the program.
Last year the state indicated that it wanted to establish such an observation rate, but it has not yet done so. The new notice states that

The Department also announced its intent to establish an observation rate for hospital cases for which an inpatient admission is not medically necessary, but medical observation of a patient is required. The Department received multiple public comments concerning an intended observation rate. At this time, the Department plans to develop a payment policy and rates for observation services and will provide an opportunity for public comment in a future notice of intent.

At the time the state expressed an interest in developing an observation rate, the Safety-Net Association of Pennsylvania wrote to the Department of Public Welfare expressing support for the concept. Read SNAP’s letter here.
Find the entire Pennsylvania Bulletin notice here.

PA Safety Net Admin2014-05-19T06:00:51+00:00May 19th, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

Lack of Transportation Benefit in PA Medicaid Proposal Hurts, Critics Say

Pennsylvania’s application for a waiver from selected federal Medicaid requirements includes a request for permission to eliminate transportation services for Medicaid recipients.
And that hurts, some critics say.
The private insurance plans in which newly eligible Medicaid recipients would enroll under the state’s proposed Medicaid expansion plan would not be required to offer medical transportation to low-income recipients, and one critic of the state’s proposal told the Pittsburgh Post-Gazette that “Entitlement to health services is meaningless if you can’t access it.”
Read more about medical transportation, other so-called wraparound benefits, and how the Medicaid expansion component of the state’s Healthy Pennsylvania plan treats them in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-04-07T11:50:30+00:00April 7th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Providers Must Re-enroll to Serve PA Medicaid Population

All health care providers that serve Pennsylvania’s Medicaid population must re-enroll with the state if they wish to continue doing so.
The requirement, established under the Affordable Care Act, applies to providers that participate in both the state’s Medicaid managed care and fee-for-service programs.
Additional information can be found about the requirement and how to re-enroll in this Medical Assistance Bulletin notice.

PA Safety Net Admin2014-03-14T06:00:34+00:00March 14th, 2014|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

First Round of Data on PA Health Insurance Sign-Ups

123,681 Pennsylvanians signed up for health insurance through the federally facilitated marketplace between October 1 and February 1, according to a new report from the U.S. Department of Health and Human Services.
Among Pennsylvanians who enrolled in new health insurance plans, 79 percent were eligible for financial assistance with their premiums and 56 percent are female while 44 percent are male.
Among those who enrolled in insurance plans through the marketplace, 26 percent are between the ages of 18 and 34; 15 percent are between the ages of 35 and 44; 22 percent are between 45 and 54; and 36 percent are between 55 and 64.
In all, the marketplace evaluated 286,926 Pennsylvanians for eligibility for subsidized insurance, Medicaid, and the Children’s Health Insurance Program (CHIP). 29,365 were found eligible for Medicaid or CHIP.
Learn more about the first round of Pennsylvanians who signed up for health insurance, including the types of plans they selected and more, in this Department of Health and Human Services report.

PA Safety Net Admin2014-02-14T06:00:26+00:00February 14th, 2014|Affordable Care Act|Comments Off

PA to Submit Healthy Pennsylvania Application Soon

Pennsylvania will submit its “Healthy Pennsylvania” Medicaid expansion waiver application to the federal government in about two weeks, Governor Tom Corbett told a central Pennsylvania public radio station last week.
Once the state submits that application, according to the Harrisburg Patriot-News, “…the process should go quickly, he [Corbett] said, since the details have been worked out through ‘constant negotiations’ with federal officials at the Department of Health and Human Services.”
Read more about Governor Corbett’s radio appearance and his thoughts on Healthy Pennsylvania and Medicaid expansion in this Harrisburg Patriot-News report.

PA Safety Net Admin2014-02-10T06:00:26+00:00February 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

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