SNAPShots

SNAPShots

Feds Find Temporary Way to Overcome Medicaid Enrollment Problem

The problems plaguing the beleaguered healthcare.gov web site continue to make it difficult for people to find new health insurance, but a new approach devised by the federal government will make it easier for Medicaid applicants to overcome this problem.
While the Centers for Medicare & Medicaid Services (CMS) was having trouble sending completed Medicaid and CHIP applications to the states, it continued sending them basic data from Medicaid and CHIP applications on a weekly basis primarily to help them gauge possible interest in Medicaid enrollment.  Now, it is telling states they can use this limited data to enroll such individuals in their Medicaid programs without complete applications.
This process is expected to facilitate enrollment in states that have chosen to expand eligibility for their Medicaid programs.  To date, Medicaid enrollment has been one of the brightest aspects of the troubled launch of the Affordable Care Act’s insurance expansion.  While Pennsylvania is not expanding its Medicaid program at this time, the process could facilitate the enrollment of so-called woodwork applicants:  people who are already eligible for Medicaid and never enrolled but have been drawn to do so by all of the attention the Medicaid expansion and Affordable Care Act have received.
To learn more about the CMS workaround to this problem, read this Kaiser Health News report or read the letter CMS sent to state Medicaid directors describing how this process will work.

2013-12-05T06:00:58+00:00December 5th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Feds Find Temporary Way to Overcome Medicaid Enrollment Problem

Tobacco Money Loss Imperils Hospital Uncompensated Care Payments

Pennsylvania’s loss of $180 million from the national tobacco master settlement agreement could affect the state’s Tobacco Uncompensated Care program, which provides supplemental funding to hospitals that provide significant amounts of uncompensated care.
The $180 million cut represents 60 percent of the state’s overall tobacco revenue.
According to a news release from the governor’s budget office,

The reduction will occur in the state’s April 2014 MSA [master settlement agreement] payment, which supports spending in the current year’s budget.  This is forcing the state to freeze discretionary funding from the MSA, which will reduce funds for health research (Commonwealth Universal Research Enhancement [CURE] grants), Life Sciences Greenhouses, uncompensated care to hospitals, and discretionary funds related to tobacco prevention and cessation programs.

To learn more about the funding loss and its implications, see the news release “Administration Receives Notification on Impacts from Tobacco Master Settlement Agreement Arbitration Panel Decision” from the governor’s budget office.

2013-10-03T09:22:36+00:00October 3rd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on Tobacco Money Loss Imperils Hospital Uncompensated Care Payments

The Underlying Rationale For “Healthy Pennsylvania”

Reducing costs.
Sustainability.
Simplification.
Harrisburg, PA capital buildingThese are among the reasons that members of the Corbett administration offer for why the Medicaid expansion components of the governor’s Healthy Pennsylvania proposal are structured as they are.
The online publication PA Independent talked to a number of administration officials about why they have chosen the proposed path to health care reform in the state.  Read what they had to say in the article “PA looks to reform Medicaid, stave off cost increases” here, on the PA Independent web site.

2013-09-30T06:00:47+00:00September 30th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on The Underlying Rationale For “Healthy Pennsylvania”

Corbett Presents Health Care, Medicaid Proposal

Pennsylvania Governor Tom Corbett has unveiled a new “Healthy PA” proposal that includes the means through which the state would extend Medicaid coverage to approximately 520,000 additional people.
The new Medicaid recipients, instead of enrolling in the state’s traditional Medicaid program, would purchase their health insurance through the state’s health insurance exchange, a creation of the Affordable Care Act.
Funding for the new recipients would come almost entirely from the federal government, also through the Affordable Care Act.
Pennsylvania has long been one of the states that has resisted expanding its Medicaid population – a decision made optional by the Supreme Court after a challenge to the 2010 reform law’s constitutionality.
Read a summary of the Healthy PA plan, and find a link to the plan itself here, on the state’s own web site.
 

2013-09-17T06:00:26+00:00September 17th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off on Corbett Presents Health Care, Medicaid Proposal

PA Inching Closer to Medicaid Expansion

Pennsylvania state officials are working on a proposal to expand Medicaid eligibility in the state as provided for in the Affordable Care Act.
But newly eligible Pennsylvanians would not participate in the state’s current Medicaid program.
Speaking to a rotary club in York, Department of Public Welfare Secretary Bev Mackereth told her audience that because the state lacks confidence in the willingness of the federal government to continue funding care for new Medicaid enrollees, the state is developing a plan to present different Medicaid options to newly eligible people.
State officials continue to negotiate the terms of such a program with the federal government and anticipate submitting their proposal to the federal government in the near future.  If approved, they do not anticipate launching such an initiative until at least January of 2015.
Read more about the state’s plans in this Calkins Media report.

2013-08-30T06:00:24+00:00August 30th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on PA Inching Closer to Medicaid Expansion

PA Considering Medicaid Observation Rate

The Pennsylvania Department of Public Welfare is considering instituting a Medicaid observation rate for some hospital services.
According to a recently published Pennsylvania Bulletin,

The Department is considering the establishment of 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 is currently considering developing criteria under which observation services provided by a hospital may be compensable under the MA Program. The Department intends to establish a comprehensive rate to cover observation services determined to be compensable under the Program.

DPW will accept written comments about this proposal for the next 30 days.
Read the Pennsylvania Bulletin notice here.

2013-07-02T06:00:31+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Proposed FY 2014 Pennsylvania state budget|Comments Off on PA Considering Medicaid Observation Rate

DPW Seeks to Renew Philadelphia Assessment

The Pennsylvania Department of Public Welfare has announced its intention to seek renewal of the Philadelphia hospital assessment first authorized in 2008.
The purpose of the assessment is to generate additional revenue to fund state Medicaid expenditures for hospital outpatient and emergency department services in Philadelphia and to provide additional funding to support the city’s public health clinics.
Read the Pennsylvania Bulletin announcement of DPW’s intention here.

2013-07-02T06:00:20+00:00July 2nd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on DPW Seeks to Renew Philadelphia Assessment

DPW Announces Revisions of Medicaid Fee Schedule

The Pennsylvania Department of Public Welfare (DPW) has published a notice of its intention to implement changes in the Medicaid fee schedule and to update selected prior authorization requirements.
Those notices are published here, in the June 22 edition of the Pennsylvania Bulletin, and the changes took effect on June 24.
DPW also published a Medical Assistance Bulletin on the procedure code updates and a table showing the updates.  Find the bulletin here and the table here.

2013-06-26T06:00:45+00:00June 26th, 2013|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Announces Revisions of Medicaid Fee Schedule

Medicaid Pay Raise Isn’t Reaching Docs

The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians.
Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients.
The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions.  Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014.
Five months into 2013, however, only Maryland, Massachusetts, Nevada, and Michigan are making the higher payments.
Pennsylvania is among the states still not making the enhanced Medicaid payments, but state officials have promised further information about their plans in the coming days.
Learn more about the thinking behind the pay raise and why most states still are not paying it in this Washington Post article.

2013-05-21T06:00:54+00:00May 21st, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off on Medicaid Pay Raise Isn’t Reaching Docs

DPW Establishes Exceptions to Monthly Prescription Limit

Since January of last year, Pennsylvania’s Medical Assistance program has limited categorically needy adult recipients over the age of 21 to six prescriptions a month.
While Medical Assistance has established a process for seeking exceptions to this limit, the Department of Public Welfare has now published a new MA Bulletin that lists exceptions that will automatically be granted.
Find that list in thisBookshelf with law books MA Bulletin.

2013-05-03T06:00:51+00:00May 3rd, 2013|Medical Assistance Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on DPW Establishes Exceptions to Monthly Prescription Limit
Go to Top