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PA Health Policy Update for September 13

The following is an update of selected state health policy developments in Pennsylvania from September 9 – 13.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

Governor Shapiro signed two executive orders this week related to gun violence prevention and affordable housing.

  • Governor Shapiro signed Executive Order 2024-02 updating an executive order issued by former Governor Tom Wolf and re-establishing the Pennsylvania Office of Gun Violence Prevention within the Pennsylvania Commission on Crime and Delinquency (PCCD). Find more details in this press release.
  • Governor Shapiro signed Executive Order 2024-03 directing the administration to create Pennsylvania’s first comprehensive housing action plan to address the state’s housing shortage, address homelessness, and expand affordable housing options. Find more details in this press release. 

General Assembly

The state Senate will convene for voting session Monday, September 16 through Wednesday, September 18. The House of Representatives will remain recessed until Monday, September 30.

The Senate Aging & Youth and Banking & Insurance Committees will meet on Wednesday, September 18 at 10:00 a.m. in Room 156 of the Main Capitol for a joint informational hearing on protecting seniors from financial exploitation. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from clinical review, provider request, and recommendations from the Advisory Committee on Immunization Practices (ACIP) and the U.S. Food and Drug Administration (FDA).  These changes are effective for dates of service on or after September 9, 2024.
  • DHS has issued a Medical Assistance Bulletin to advise providers of updates to the Medical Assistance program fee schedule for certain family planning and family planning-related services. The updates are effective for dates of service on or after July 1, 2024.
  • DHS has announced updates to the Medical Assistance program fee schedule for ophthalmology services. The updates are effective for dates of service on or after September 15, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced its intent to allocate $258 million for FY 2024-2025 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published final notice of its intent to increase funding for a class of supplemental payments for qualifying acute care general hospitals for FY 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional details in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health (DOH) has announced it will host a webinar next Monday, September 16 at 10:00am to discuss the details of new respiratory illness data submission that is required by CMS beginning in October. This event is meant for compliance staff, emergency management staff, IT professionals, and hospital leadership. DOH will explain its plans to continue using PA HIMS (currently Juvare’s EMResource) and automatic upload processes to meet these requirements. Click here to register to attend.

The Shapiro administration has announced that all school districts, intermediate units, career and technical centers, and brick-and-mortar charter schools will receive funding to provide free period products to students. Funding will be proportional to the total number of students enrolled in a school and based on a rate of $1.75 per student. Schools may use the funding for period product purchases made between July 1, 2024, and June 30, 2025. Find additional information here. 

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs (DDAP) has announced the availability of more than $26 million in funding to expand drop-in center services for individuals with substance use disorders (SUD) across Pennsylvania. DDAP will award approximately 14 grants of up to $1,875,000 each. Eligible applicants, including existing community organizations, Single County Authorities, and DDAP-licensed treatment providers, can find the grant application here. Find more details in this press release.

DDAP joined individuals in recovery, advocacy organizations, and providers this week to kick off National Recovery Month in Pennsylvania. Throughout September, DDAP will be holding several other recovery-focused events. Find those events and additional recovery resources offered by DDAP here. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has conducted a review of existing regulations at the request of legislative standing committees, including the House Health and Aging & Older Adult Services Committees. The review covered rulemakings from 10 different agencies, including 40 prior rulemakings, 103 additional Chapters of regulations, and two subchapters. IRRC’s final report, including its recommendations, can be found here. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – September 18

The Medical Marijuana Advisory Board has provided notice that it will meet on Wednesday, September 18 and Wednesday, November 13 from 10:30 a.m. to 12:30 p.m. The meetings will be held in the Capitol Media Center with an option for board members to participate virtually. These meetings will be broadcast live for the public through Commonwealth Media Services. Find additional details here.

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

2024-09-13T19:50:01+00:00September 13th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 13
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PA Health Policy Update for August 30

The following is an update of selected state health policy developments in Pennsylvania from August 26 – 30.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

The Shapiro administration, including leadership from the Departments of Human Services, Health, Drug & Alcohol Programs, and the Pennsylvania Insurance Department, has announced it is beginning the process of developing a state-wide maternal health strategic plan, which will address high rates of maternal mortality and ensure pregnant women in Pennsylvania receive necessary prenatal and postpartum care. Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

  • The Department of Human Services (DHS) has provided final notice of the fee schedule rates for targeted support management and services funded through the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waivers and Department-established fees for residential ineligible services. The rates for community-based services and residential services are effective July 1, 2024. The rates for Agency With Choice Financial Management Services and Life Sharing will be effective October 1, 2024.
  • The Office of Mental Health and Substance Abuse Services (OMHSAS) has shared a comprehensive resource guide for National Suicide Prevention month. The guide offers examples of activities that organizations and/or communities can do to raise awareness of the importance of suicide prevention, including ideas for events, trainings, social media, sample local government proclamations, etc.
  • DHS has published its annual list of each inpatient acute care general hospital, rehabilitation hospital and private psychiatric hospital qualifying for a disproportionate share payment from July 1, 2023 to June 30, 2024 and each hospital’s respective disproportionate share payment percentage. Find the comprehensive list in this Pennsylvania Bulletin notice.

Department of the Auditor General

Auditor General Tim DeFoor has released a report with results from the department’s performance audit of the Physical HealthChoices Medicaid program and its contracted pharmacy benefit manager (PBM), PerformRx, LLC. The report found Pennsylvania paid $7 million more than it should have for Medicaid prescription drug benefits during 2022. The report attributes the overspending to a lack of oversight by the Department of Human Services (DHS). 

Department of State 

The Department of State has announced beginning August 26 out-of-state physicians licensed by a state or territory participating in the Interstate Medical Licensure Compact (IMLC) who obtain a corresponding “letter of qualification” will be permitted to apply to the Pennsylvania state boards of Medicine and Osteopathic Medicine for expedited licensure to practice in the Commonwealth. Find additional information in this press release. 

Around the State 

  • Spotlight PA has published an article about the growing number of vaccine exemptions in Pennsylvania schools and the concerning potential for measles outbreaks. 
  • The Auditor General’s report on the Department of Human Services (DHS) oversight of pharmacy benefit managers (PBMs) was covered in an article published by the Associated Press. 
  • Another article by Spotlight PA highlights efforts to address the rural health care workforce crisis, including a legislative proposal being championed by Rep. Kathy Rapp (R) and Rep. Dan Frankel (D) that would provide grant funding to assist with the hiring of health care practitioners at rural facilities. 

Stakeholder Events

DOH – Health Research Advisory Committee – September 12

The Health Research Advisory Committee will hold a public meeting on Thursday, September 12 from 1:00 p.m. to 2:00 p.m. The meeting will be held at the Nesquehoning Recreational Center (335 West Railroad Street, Nesquehoning, PA 18240). Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Tobacco-Free Recovery Statewide Conference – October 9

The Pennsylvania Statewide Tobacco-Free Recovery Initiative will hold its fourth annual “Tobacco-Free Recovery is Recovery” conference on Wednesday, October 9. The conference will be held virtually. Find registration information here.

DOH – PDMP Board Meeting – October 22

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board has changed the time and location of its October 22 meeting. The meeting, which will begin at 10:30 a.m., will be held in person at the Capitol Media Center (State Capitol, Room 01, East Wing, Harrisburg, PA 17126). Find additional information in this Pennsylvania Bulletin notice.

2024-08-31T02:41:10+00:00August 30th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for August 30
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PA Health Policy Update for August 23

The following is an update of selected state health policy developments in Pennsylvania from August 19 – 23.  (Some of the language used below is taken directly from state documents). 

General Assembly

  • The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively.
  • When they return, the Senate Aging and Youth and Banking and Insurance Committees announced they will meet on September 18 at 9:00 a.m. for a joint hearing on protecting seniors from financial exploitation. 

Department of Health 

  • The Department of Health (DOH) has issued a memo to hospitals outlining the department’s plan to comply with the federal government’s renewed data reporting requirements for COVID-19 and other respiratory illnesses. CMS will require weekly reporting beginning November 1 and facilities have the option for DOH to facilitate reporting on their behalf. In the memo, the Bureau of Emergency Preparedness and Response strongly encourages facilities to utilize this reporting pathway. More information, including required data elements and a data dictionary is forthcoming.
  • The DOH policy office has temporarily paused its efforts to collect input on potential amendments to the hospital licensure regulations. The department commenced a stakeholder engagement process earlier this month that was designed to solicit feedback from various stakeholders, including hospitals. DOH will reconvene stakeholder meetings in the fall or winter to inform proposed regulations to be released in Spring 2025.
  • DOH issued a health advisory (PA HAN 766) related to recent Oropouche virus activity in travelers who have visited the Amazon basin and other areas of South America. 

Department of Human Services 

  • The Department of Human Services (DHS) announced the results of the reprocurement of the Community HealthChoices program for plan years beginning in 2025 through at least 2029. Similar to today’s program, the selected applicants are identical for each of the five CHC operating zones and include Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan (AmeriHealth). The plans will begin a readiness review with DHS shortly which will include an examination of their provider network adequacy. Find the DHS announcement here.
  • DHS issued a Medical Assistance provider bulletin to advise providers of changes to the manual edit thresholds for electronic visit verification records in both personal care and home health services effective with dates of service on and after January 1, 2025.
  • The DHS Office of Mental Health and Substance Abuse Services (OMHSAS) encourages providers to participate in a survey of provider readiness to introduce additional tobacco interventions as part of the Pennsylvania Statewide Tobacco-Free Recovery Initiative (PA STFRI) funded by the CDC. The Public Health Management Corporation conducted a similar survey in 2021, and this 15-minute survey will be a useful measure of the initiative’s progress. Click here to access the survey, which will close on August 31. 

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – August 29 – CANCELLED

The statewide Human Immunodeficiency Virus (HIV) Planning Group has cancelled its public meeting on Thursday, August 29 from 9:00 a.m. to 4:30 p.m.

 

2024-08-23T20:40:15+00:00August 23rd, 2024|Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for August 23
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PA Health Policy Update for July 26

The following is an update of selected state health policy developments in Pennsylvania from July 15 – 26.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

  • Governor Shapiro has signed several bills into law, including the following health care bills.
    • House Bill 1664 (Act 58 of 2024), which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card.
    • House Bill 1633 (Act 74 of 2024), which establishes restrictions on non-compete covenants for certain health care practitioners.
    • House Bill 1853 (Act 75 of 2024), which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys.
    • House Bill 1993 (Act 77 of 2024), which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients.
    • House Bill 2200 (Act 79 of 2024), which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts.
  • Governor Shapiro joined Insurance Commissioner Michael Humphreys, members of the General Assembly, and local pharmacists in Lawrence County this week to tout the recent enactment of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs). Read more in this press release.
  • The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.  

General Assembly 

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through August 2024. Find the updated calendar here.
  • DHS has issued Provider Quick Tip #85 with eligibility and enrollment information for the Breast & Cervical Cancer Prevention & Treatment (BCCPT) program, which provides eligible individuals treatment for confirmed cases of breast and cervical cancer or precancerous conditions of the breast or cervix. 

Department of Health 

The Department of Health (DOH) has reminded providers who operate mobile clinics to complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services. 

Department of Drug & Alcohol Programs  

The Department of Drug & Alcohol Programs (DDAP) has issued a Licensing Alert to notify licensed treatment facilities and recovery houses of the new process for submitting licensing regulation exceptions and facility requests to DDAP. 

Around the State 

  • The Citizen’s Voice has published an article about Pennsylvania’s Cancer Drug Repository Program and barriers to its utilization.
  • The Patriot-News has written an article about President Joe Biden’s decision to withdraw from the U.S. presidential race and what it means for Governor Shapiro.
  • Governor Shapiro’s signing of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs), and its potential impact on local pharmacies and patients was featured in an article published by the Times Leader.
  • The Pittsburgh Business Times has published an article about the challenges confronting rural health care and efforts to find solutions.
2024-07-26T20:18:58+00:00July 26th, 2024|Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for July 26
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PA Health Policy Update for July 12

The following is an update of selected state health policy developments in Pennsylvania from July 8 – 12.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

The state House of Representatives and Senate convened in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.
  • The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration. 

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024. 

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee. 

Centers for Medicare and Medicaid Services 

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics.  In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas.  For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking. 

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for July 12
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PA Health Policy Update for July 5

The following is an update of selected state health policy developments in Pennsylvania from July 1 – 5.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

The Commonwealth of Pennsylvania is five days into the new Fiscal Year (FY) and still doesn’t have an enacted budget, but legislative leaders remain optimistic that an agreement will be reached in the near term. The state House of Representatives and Senate, who recessed briefly for the Fourth of July, are currently scheduled to return on Saturday, July 6 to continue work on the FY 2024-2025 budget and its related bills. 

Governor Shapiro 

Governor Shapiro signed House Bill 1754 into law on Monday. Now known as Act 39 of 2024, this legislation requires public and private insurers to cover biomarker testing. Find additional information in this press release.

On Wednesday Governor Shapiro signed Senate Bill 739 into law. Now known as Act 42 of 2024, this piece of legislation provides for coverage of telemedicine services. Find additional information in this press release.  

General Assembly

The state House of Representatives and Senate held voting session Monday, July 1 through Wednesday, July 3. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate confirmed Dr. Debra Bogen as Secretary of the Department of Health by a vote of 42 – 8 on Monday, July 1. Dr. Bogen has been serving as Acting Secretary since the beginning of the Shapiro administration. Find additional information in this press release.
  • The Senate passed House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent back to the House for concurrence.
  • The Senate passed Senate Bill 1080, which allows licensed practical nurses to make death pronouncements in the hospice setting. The bill was received in the House and referred to the Health Committee.
  • The House of Representatives passed House Bill 2429, which establishes an inmate reentry program operated by the Department of Human Services to provide substance use disorder treatment and case management services prior an inmate’s release from a correctional institution. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2175, which creates a permanent Office of Child Advocate. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. The bill will now be sent to the Senate for consideration. 

The House and Senate are currently scheduled to return to Harrisburg for voting session Saturday, July 6.  

Department of Human Services 

  • The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) for nursing facilities. Find the list and additional information in this Pennsylvania Bulletin notice.
  • DHS has published two notices in the Pennsylvania Bulletin related to the implementation and reauthorization of the Philadelphia hospital assessment, including the establishment of a new class of supplemental payments and the discontinuation of certain DSH and supplemental payments.
  • DHS has published updates to the Medical Assistance (MA) program fee schedule for ophthalmology services, effective for dates of service on and after August 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued a number of Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health 

The Department of Health (DOH) has requested providers who operate mobile clinics complete a brief survey, which can be found here. The results of the survey will help DOH better understand the breadth of mobile services provided across the state, identify interest in collaboration among mobile service providers to share best practices and identify unmet needs/resources, and to identify opportunities to promote and support the mobile clinics, including opportunities for expansion of services. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania ended Fiscal Year (FY) 2023-2024 with $45.5 billion in General Fund collections. That total is $862.9 million, or 1.9 percent, above estimate. 

Stakeholder Events   

DOH – WIC Advisory Board – July 9

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Advisory will meet on July 9 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-07-08T20:21:52+00:00July 5th, 2024|Financial, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for July 5
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PA Health Policy Update for June 28

The following is an update of selected state health policy developments in Pennsylvania from June 24 – 28.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future. 

General Assembly

The state House of Representatives and Senate were in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity.

  • The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 194-8. The bill will now be sent to the Senate for consideration.
  • The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.
  • The Senate unanimously passed on Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently received in the House and referred to the Health Committee.
  • The House unanimously passed House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.
  • The House Children & Youth Committee met on Tuesday, June 25 and favorably reported House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.
  • The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here. 

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the proposed assessment amount, the proposed assessment methodology and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program beginning in FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.
  • DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

Department of Health 

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.  

Stakeholder Events   

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 28
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PA Health Policy Update for May 31

The following is an update of selected state health policy developments in Pennsylvania from May 27 – 31.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate will return to Harrisburg for voting session Monday, June 3 through Wednesday, June 5. Following is an overview of selected health care-related legislative activity currently scheduled.

  • The House Aging & Older Adult Services Committee will hold an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3 at 10:00 a.m. The meeting will take place in Room 140 of the Main Capitol. It will also be livestreamed here.
  • The House Insurance Committee will convene on Monday, June 3 at 10:30 a.m. to consider, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. The meeting will be held in the East Wing, Room 60. It will also be livestreamed here.
  • The House Children & Youth Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. The meeting will be held in East Wing, Room 60. It will also be livestreamed here.
  • The House Health Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider House Bill 2283, which requires operating rooms utilize surgical smoke evacuation systems. The meeting will be held in Room G-50 of the Irvis Office Building. It will also be livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule as a result of the 2024 Healthcare Common Procedures Coding System (HCPCS) updates. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 751) with information for health care providers about 2024 West Nile and other arboviral infections in Pennsylvania.

DOH has announced the publication of an updated list of academic clinical research centers (ACRC) under the Medical Marijuana program on the department’s website and established the time period during which applications for clinical registrants (CR) will be accepted by the department. Find additional information in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has announced it disapproved the Bureau of Professional and Occupational Affairs final-form regulation that lists criminal convictions directly related to each of the 29 professional and occupational licensing boards and commissions. IRRC indicated the regulation was not in the public interest due to the removal of certain offenses that may have direct bearing on the conduct, services, and practices of various occupations and professions. Find additional information in this Pennsylvania Bulletin notice. 

Stakeholder Events   

DHS – Long-Term Services and Supports Subcommittee – June 5

The Long-Term Services and Supports Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on Wednesday, June 5 at 10:00 a.m. Find additional information and details on how to participate here. 

The Patient Safety Authority – June 20

The Patient Safety Authority will hold a public meeting of the Authority’s Board on Thursday, June 20 at 10:30 a.m. The meeting will take place at the Central Penn College conference center (600 Valley Road, Summerdale, PA 17093). The meeting will also be held virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-06-03T17:47:33+00:00May 31st, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 31
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PA Health Policy Update for May 24

The following is an update of selected state health policy developments in Pennsylvania from May 20 – 24.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives returned to Harrisburg this week for voting session. Following is a selection of health care-related legislative activity that occurred.

  • The House passed Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board, on final consideration by a vote of 119-83. The bill will now be sent to the governor’s desk.
  • The House passed House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service, by a vote of 154-48. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana, by a vote of 196-6. The bill will now be sent to the Senate for consideration.
  • The House Health Committee convened on Tuesday, May 21 and favorably reported, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee met on Wednesday, May 22 for an informational hearing on the Living Independence for the Elderly (LIFE) program. A recording of the hearing is viewable here.

The state House and Senate are both recessed until Monday, June 3.

Department of Human Services 

  • The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule. DHS is adding and end-dating procedure codes as a result of the 2024 updates published by CMS to the Healthcare Common Procedure Coding System (HCPCS). These changes are effective for dates of service on and after May 28, 2024.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June 2024. Find the updated calendar here.
  • The Office of Long-Term Living (OLTL) has communicated to personal care homes and assisted living residences that unlicensed staff persons may not administer Glucagon-like peptide (GLP)-1 agonist medications, such as Ozempic (Semaglutide) and Trulicity (Dulaglutide) via subcutaneous injection unless they seek a regulatory waiver and submit it to ra-pwarlheadquarters@pa.gov. 

Department of Health 

  • The Department of Health (DOH) has announced it is extending the temporary scheduling of any material, compound, mixture or preparation which contains any quantity of Nitazene substances for an additional year. Find additional information in this Pennsylvania Bulletin notice. 
  • DOH has issued a Health Advisory (PA-HAN 749) with Influenza A/H5N1, a highly pathogenic avian influenza (HPAI) virus, guidance for health care providers.
  • DOH also issued a Health Advisory (PA-HAN 750)  alerting healthcare providers of an increase in meningococcal disease, linked to Umrah travel to the Kingdom of Saudi Arabia. 

Health Insurance Exchange Authority 

The Pennsylvania Health Insurance Exchange Authority, which is the state-affiliated entity that operates the commonwealth’s state-based health insurance marketplace, has issued a proposed regulation that would require insurers selling qualified plans through the Exchange Authority to be accredited in health equity. 

Around the State   

  • PennLive has published an article about legislative efforts to require state-regulated commercial insurers to cover blood pressure monitors when necessary during pregnancy and for up to a year after delivery. 
  • The Philadelphia Inquirer has reported about an effort to subpoena Philadelphia mayor Cherelle Parker’s administration regarding its plans to expand addiction treatment services in the city. 
  • An article published by PennLive highlights the Shapiro administration’s efforts to seek a Medicaid 1115 waiver to provider continuous Medicaid coverage for children from birth through age six.
2024-06-03T17:42:15+00:00May 24th, 2024|Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for May 24
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PA Health Policy Update for May 17

The following is an update of selected state health policy developments in Pennsylvania from May 13 – 17.  (Some of the language used below is taken directly from state documents). 

General Assembly

The House and Senate Democratic Policy Committees held a series of hearings this week on health care-related topics. Following are links to the respective hearings and the testimony offered at each one.

The House will return to voting session next week Tuesday, May 21 through Wednesday, May 22. The Senate is currently in recess until June 3. Following is a selection of health care-related legislative activity currently scheduled for next week.

  • The House Health Committee is scheduled to convene on Tuesday, May 21 at the call of the chair to consider, among other bills, House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
  • The House Aging & Older Adult Services Committee will meet on Wednesday, May 22 at 10:00 a.m. for an informational hearing on the Living Independence for the Elderly (LIFE) program. The hearing will be held in Room 515 of the Irvis Office Building and livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has announced the implementation of the 2024 Federal Poverty Income Guidelines (FPIG), which are the basis for the income eligibility limits for several categories of Medicaid. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued Provider Quick Tips #176 to inform presumptive eligibility providers that the income guidelines used to determine Medicaid eligibility for pregnant women have been updated effective January 11, 2024. 

Department of Health 

The Department of Health (DOH) has announced the launch of a new online dashboard to provide Pennsylvania residents and health care providers with information about tickborne diseases. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced it will begin a four-month series, Conversations with Scott Boyles, on June 3 as part of the monthly ASAM technical assistance webinars. If you would like to sign up to be added to the monthly webinar, please email DDAP’s ASAM resource account, ra-daasam@pa.gov. Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page. 

State Board of Medicine 

The State Board of Medicine has published notice of its final-form rulemaking related to the registration of naturopathic doctors. Find additional information in this Pennsylvania Bulletin notice.  

State Board of Osteopathic Medicine 

The State Board of Osteopathic Medicine has published notice of its intent to amend certain licensure requirements. Find additional information in this Pennsylvania Bulletin notice. 

Around the State   

  • Stephen Caruso has written an article for Spotlight PA about the status of FY 2024-2025 budget negotiations and the competing priorities of Republicans and Democrats.
  • City & State Pennsylvania has published an article detailing Senate Appropriations Committee Chairman Scott Martin’s comments at the Pennsylvania Press Club’s monthly speaker series.
  • The Pennsylvania Capital-Star has reported about Governor Shapiro’s signing of an executive order this week to attract skilled and experienced workers to state government.

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Wednesday, May 22 from 1:00 – 3:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120. 

DHS – Medical Assistance Advisory Committee – May 23

The Medical Assistance Advisory Committee (MAAC) will hold an in-person meeting on Thursday, May 23 from 10:00 a.m. to 12:00 p.m. Find the meeting’s agenda here. The meeting will be held in the Forest Room of the Keystone Building at 400 North St., Harrisburg, PA 17120.

DHS – Dual Diagnosis Conference – May 22-23

The Department of Human Services (DHS), Office of Developmental Programs and Office of Mental Health and Substance Abuse Services, invites stakeholders to participate in the state-wide Dual Diagnosis Conference, which will be held virtually May 22-23. Find a preliminary agenda here and registration details here.

2024-05-18T00:20:37+00:00May 17th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 17
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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