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PA Health Policy Update for February 16

The following is an update of selected state health policy developments in Pennsylvania from February 12 – 16.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

  • The Senate Republican Policy Committee held an informational meeting on Wednesday, February 14 examining challenges in rural health care. A recording of the meeting, as well as copies of the testimony offered to the committee, are viewable here.
  • The House Democratic Policy Committee held an informational meeting on Wednesday, February 14 to discuss the future of artificial intelligence, including how it may impact the field of medicine. A recording of the hearing in its entirety is viewable here, while testimony can be viewed here.
  • Next week the state House of Representatives and Senate Appropriations Committees will begin their hearings to examine Governor Shapiro’s proposed FY 2024-2025 spending plan. The Department of Aging is the only health-related agency that will have a budget hearing next week – it will be held on Thursday, February 22 at 10:00 a.m. Find the House Appropriations Committee’s complete schedule here and the Senate Appropriations Committee’s complete schedule here.
  • The House Republican Policy Committee will hold an informational meeting on Thursday, February 22 at 1:00 p.m. regarding, “A State Lost in Addiction: Pennsylvania’s Path to Recovery.” The meeting will take place at The Crane Room Grille (3009 Wilmington Rd.) in New Castle, PA. 

Department of Human Services 

  • Last week DHS announced that pharmacists may enroll in the Medical Assistance (MA) program to provide services to MA beneficiaries effective March 1, 2024. The following guidance has subsequently been issued by DHS related to pharmacists’ enrollment in the MA program.
  • DHS has issued a Medical Assistance Bulletin indicating the procedure codes that can be billed for pharmacists services. DHS also published notice of intent to add procedure codes for pharmacists to the MA program fee schedule in the Pennsylvania Bulletin, which is viewable here.
  • Additional information related to the enrollment requirements and application process, pharmacists should refer to the DHS website here.
  • DHS has issued a remittance advice alert notifying providers of a claims recovery that was done to recoup monies paid in error due to the department’s eligibility records indicating recipients being deceased prior to the dates of service being billed.

Department of Health 

The Department of Health (DOH) has issued a revised template for nursing facilities to use in calculating their nursing staffing ratios. Click here to download the updated spreadsheet tool. 

DOH has published a Pennsylvania Bulletin notice, as required, with a list of hospitals that have provided notice to the department that they may not provide emergency contraception or sexual assault emergency services due to various factors.  

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published comments in response to the proposed regulations submitted by DHS that would make changes to comply with CMS’ final rule – ”Medicaid Program; Covered Outpatient Drugs.” The proposed regulation also makes technical changes to add diabetic supplies, opioid overdose agents, and immunizations to the list of services excluded from copayments. In addition, it recognizes the prescriptive and dispensing authority of certified nurse practitioners (CRNP) and midwives. Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DHS – Consumer Sub-MAAC – February 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 21 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – February 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 22 at 10:00 a.m. Register to participate here.

DOH – Preventive Health & Health Services Block Grant Advisory Board – February 27

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, February 27 from 3:00 p.m. to 4:00 p.m. The purpose of the meeting is to discuss the status of the funding for the block grant. Find additional details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – March 28

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, March 28 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted both in person and as a virtual teleconference. Find additional information in this Pennsylvania Bulletin notice.

Long-Term Care Council – 2024 Meeting Dates

The Long-Term Care Council has published its 2024 bi-monthly meeting dates. Council meetings are open to the public and held virtually unless otherwise specified. Find additional information in this Pennsylvania Bulletin notice.

2024-02-16T20:34:54+00:00February 16th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 16
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PA Health Policy Update for February 9

The following is an update of selected state health policy developments in Pennsylvania from February 5 – 9.  (Some of the language used below is taken directly from state documents).

Governor Shapiro

Governor Shapiro delivered his second annual budget address to a joint session of the General Assembly this week. In total, Governor Shapiro’s proposed FY 2024-2025 budget spends $48.3 billion, a $3.7 billion or 8.4 percent increase over the current fiscal year. The budget does not propose any broad-based tax increases, but it uses new revenue sources and the commonwealth’s budget surplus.

The themes outlined in Governor Shapiro’s budget address and the budget proposal’s supporting documents largely reflect a continuation of the policy priorities championed by his administration throughout its first year, including education, public safety, government reform, and economic competitiveness. Following are selected health care highlights in the budget proposal.

  • Invests $100 million in mental health funding for K-12 schools, which builds upon one-time federal funds to ensure schools have the resources to provide mental health services to students and staff.
  • Increases funding for community-based mental health services by an additional $20 million this year and calls for additional funds in successive years (up to $60 million).
  • Invests $50 million of state funding into the state’s reinsurance program to create an additional subsidy wrap for low- and middle-income Pennsylvanians that are on the cusp of being able to afford health insurance.
  • Governor Shapiro highlighted the need to reform pharmacy benefit manager (PBM) operations and called on the General Assembly to enact legislation to that effect.
  • Although the budget proposal doesn’t include specific funding for rural health, Governor Shapiro noted the need to address rural hospital closures and indicated his administration would develop a plan soon.
  • Dedicates $4 million for medical debt relief for low-income Pennsylvanians and calls for health care providers to implement transparent practices to limit medical debt.
  • Includes $1.9 million toward the creation of the Alzheimer’s Disease and Related Disorders Division at the Department of Aging.

Find additional budget documents released by the Office of the Budget below.

General Assembly 

The state House of Representatives and Senate convened in Harrisburg this week. Following is an overview of selected health care-related legislative activity.

  • The Senate passed House Bill 1564, which provides for the creation of an associate license for marriage and family therapists and an associate license for professional counselors, on third and final consideration. The bill will now be sent back to the House for concurrence.
  • The House Health Subcommittee on Health Care held an informational meeting on Monday, February 5 on adult-use cannabis. Find a recording of the meeting here.
  • The Senate Veterans Affairs & Emergency Preparedness Committee favorably reported, among other bills, Senate Bill 1054, which adds EMS providers as required reporters to the Overdose Information Network (ODIN) system.
  • The House Health Committee met for a voting meeting on Tuesday, February 6 and favorably reported the following bills.
  • House Bill 1853, which requires the Department of Health to meet with licensed nursing facilities under their jurisdiction to discuss and share information on survey results, patterns, trends, best practices, etc.
  • House Bill 1931, which establishes a registry of medical directors in nursing facilities, personal care homes, and assisted living residences.
  • House Bill 1956, which makes certain amendments to the Patient Test Results Act.
  • The House Human Services Committee held an informational meeting on Wednesday, February 7 examining Centers of Excellence for Opioid Use Disorder. Find a recording of the meeting here. 

Department of Human Services 

The Department of Human Services (DHS) has announced the addition and end-dating of certain procedure codes to and from the Medical Assistance (MA) program fee schedule for pharmacist services. These changes are effective for dates of service on and after March 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

DHS has issued a Medical Assistance Bulletin with updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for opioid use disorder treatments submitted for prior authorization. 

Department of Health 

The Department of Health (DOH) Bureau of Epidemiology’s COVID-19 Infection Control and Outbreak Response team has updated the COVID-19 LTC Toolkit. 

Medicaid Continuous Coverage Unwinding

  • DHS reported that it has contacted any individuals that have had their Medicaid coverage restored due to issues with the commonwealth’s ex parte redetermination process about how to use their retroactive coverage to have providers resubmit bills and reimburse any out-of-pocket costs that were paid in error during this time.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

 Stakeholder Events 

DHS – Consumer Sub-MAAC – February 21The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 21 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – February 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on February 22 at 10:00 a.m. Register to participate here.

2024-02-09T20:45:39+00:00February 9th, 2024|Governments, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 9
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PA Health Policy Update for February 2

The following is an update of selected state health policy developments in Pennsylvania from January 29 – February 2.  (Some of the language used below is taken directly from state documents).

Governor Shapiro 

Governor Shapiro will deliver his second budget address on Tuesday, February 6 at 12:30 p.m. in the Capitol rotunda. In advance Tuesday’s address, the administration has announced a number of initiatives that will be incorporated into the FY 2024-2025, including an increase in public transit funding, recommendations to improve higher education in the commonwealth, and an increase for Emergency Medical Services (EMS) funding.

The Shapiro administration also announced the launch of Pennsylvania’s first state-wide economic development strategy in more than 20 years. The plan highlights five key industries, including agriculture, energy, life sciences, manufacturing, and robotics and technology. Find the comprehensive economic development plan here.

General AssemblyHouse Chamber of the State House 

The state House of Representatives and Senate will convene next week for Governor Shapiro’s budget address. The Senate will also be in voting session Monday, February 5 and Wednesday, February 7. Following is a selection of health-related legislative activity next week.

  • The House Health Subcommittee on Health Care will convene on Monday, February 5 at 10:00 a.m. for an informational meeting on adult-use cannabis. The meeting will be held in Room 140 of the main Capitol.
  • The Senate Veterans Affairs & Emergency Preparedness Committee will hold a voting meeting on Monday, February 5 to consider, among other bills, Senate Bill 1054, which adds EMS providers as required reporters to the Overdose Information Network (ODIN) system.
  • The House Health Committee will meet for a voting meeting on Tuesday, February 6 at 11:00 a.m. in Room 515 of the Irvis Office Building to consider the following bills:
  • House Bill 1853, which requires the Department of Health to meet with licensed nursing facilities under their jurisdiction to discuss and share information on survey results, patterns, trends, best practices, etc.
  • House Bill 1931, which establishes a registry of medical directors in nursing facilities, personal care homes, and assisted living residences.
  • House Bill 1956, which makes certain amendments to the Patient Test Results Act.
  • The House Human Services Committee will convene on Wednesday, February 7 at 9:30 a.m. for an informational meeting on Centers of Excellence for Opioid Use Disorder. The meeting will be held in Room 515 of the Irvis Office Building. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise licensed pharmacists that they may enroll in the Medical Assistance (MA) Program to provide services to MA beneficiaries.

DHS has published notice of its intent to continue making Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2023-2024. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has issued a revised template for nursing facilities to use in calculating their nursing staffing ratios. Click here to download the updated spreadsheet tool.

DOH has announced it is working to secure funding to purchase supplies on behalf of harm reduction organizations, including sharps containers, wound care kits, sterile water, and saline. If an organization is interested in receiving these harm reduction supplies at no cost, please complete this survey by February 9.

Supreme Court 

The Pennsylvania Supreme Court has ruled that a lower court must hear a challenge to the constitutionality of a long-standing state law limiting the use of Medicaid funding for abortions. The lower court previously dismissed the case on procedural grounds. Find the court’s full opinion here.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.9 billion in General Fund revenue in January, which was $74.6 million, or 1.9 percent, more than anticipated, Revenue Secretary Pat Browne reported today. Fiscal year-to-date General Fund collections total $23.8 billion, which is $6.6 million above estimate. 

Medicaid Continuous Coverage Unwinding

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.
2024-02-02T22:51:18+00:00February 2nd, 2024|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for February 2
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PA Health Policy Update for January 26

The following is an update of selected state health policy developments in Pennsylvania from January 22 – 26.  (Some of the language used below is taken directly from state documents).

Department of Human Services 

  • The Department of Human Services (DHS) has announced the launch of PA Navigate, an online tool designed to connect Pennsylvanians with community-based organizations, county and state agencies, and health care providers, for referrals to community resources that help them meet basic needs like food, shelter, transportation, etc.
  • DHS has provided final notice of the assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment program from FY 2023-2024. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the grantees who will administer the new Women’s Service Program, a grant intended to provide access to women’s health care, especially for pregnant and parenting women.
  • DHS has issued a Medical Assistance Bulletin to distribute the Medical Assistance (MA) program vaccine desk reference, which is applicable to all  providers enrolled in the MA program that may administer vaccines to MA beneficiaries in the fee-for-service or managed care delivery systems.

Department of Health 

  • The Department of Health (DOH), Office of Health Equity has announced its 2024 Health Equity Summitt will take occur April 4 – 5 in Harrisburg. The goal of the annual event is to bring key stakeholders from diverse backgrounds together to discuss health equity and address differences in health outcomes across communities. Find additional information on the summit’s website here.
  • DOH has announced it will hold a series of public meetings for providers and families to share input on the potential priorities that will guide the commonwealth’s Title V Maternal and Child health Services Block Grant. Find additional information in this Pennsylvania Bulletin notice. 

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has announced that $18 million is available through the substance use disorder (SUD) student loan repayment program to assist practitioners within the SUD treatment, prevention, case management and recovery support services workforce. The SUD loan repayment program is designed to help DDAP-licensed drug and alcohol treatment facilities as well as staff providing Single County Authority (SCA)-funded prevention, case management, and recovery support services in the Commonwealth. Applications must be submitted by March 1.

DDAP has also announced the availability of nearly $300,000 in grant funding for physical upgrades in recovery houses that provide safe housing for individuals in recovery from SUD. Grants of up to $50,000 each will be awarded to approximately five eligible applicants for health and safety upgrades including demolition, debris removal, rehabilitation improvements, environmental remediation costs, and construction and inspections to comply with DDAP’s regulations. The application period will remain open until the availability of funding is exhausted.

Board of Pharmacy 

The State Board of Pharmacy has published current income levels necessary to participate in the Cancer Drug Repository program. Find additional information in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

Board of Nursing – January 29

The Board of Nursing will hold a public meeting on Monday, January 29 beginning at 9:00 a.m. The meeting will be held in person and virtually. Find additional details on how to participate here. 

DOH – HIV Community Prevention Planning Committee – January 31

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, January 31 from 9:00 a.m. to 5:00 p.m. and on Thursday, February 1 from 9:00 a.m. to 4:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – February 1

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 1 from 10:00 a.m. to 1:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – February 2

The Brain Injury Advisory, formerly the Traumatic Brain Injury Advisory Board, will hold a public meeting on Friday, February 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 (6340 Flank Drive, Harrisburg, PA 17112) in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2024-01-26T21:42:21+00:00January 26th, 2024|health equity, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 26
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PA Health Policy Update for January 19

The following is an update of selected state health policy developments in Pennsylvania from January 15 – 19.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The Shapiro administration has issued a press release touting Act 32 of 2023, formerly Senate Bill 500 sponsored by Senator Michelle Brooks, which went into effect this week. Act 32 of 2023 increases access to pasteurized donor human milk by expanding the number of health conditions eligible for Medicaid-covered donor human milk. 

General Assembly 

The state House of Representatives and Senate are in recess until Tuesday, February 6 when they will convene for Governor Shapiro’s annual budget address.

The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise enrolled Medical Assistance program providers who prescribe and supply pasteurized donor human milk (PDHM) of changes in coverage conditions for PDHM and requirements for enrollment as a human milk bank. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 734) in follow-up to PAHAN 730 regarding high levels of chromium, in addition to lead, in cinnamon

samples and recalled applesauce pouch products, including WanaBana, Schnucks, and Weis

brands. DOH has advised patients and providers that a general clinical work-up

for anemia would be appropriate, since this is the health effect associated with the duration of exposure, if patients or clinicians are concerned or suspect chromium overexposure. 

Medicaid Continuous Coverage Unwinding

  • DHS has announced the launch of a survey to collect feedback from Medicaid enrollees about their experience completing their annual renewal. The survey is being conducted in partnership with the University of Pittsburgh’s Medicaid Research Center, and feedback collected will be used to inform renewal outreach strategies moving forward. Participants will be contacted via text message.
  • DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here. 

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – January 31

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold public meetings on Wednesday, January 31 from 9:00 a.m. to 5:00 p.m. and on Thursday, February 1 from 9:00 a.m. to 4:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – February 1

The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 1 from 10:00 a.m. to 1:30 p.m. The meetings will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – February 2

The Brain Injury Advisory, formerly the Traumatic Brain Injury Advisory Board, will hold a public meeting on Friday, February 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 (6340 Flank Drive, Harrisburg, PA 17112) in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

2024-01-19T21:15:32+00:00January 19th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for January 19
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PA Health Policy Update for January 12

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

General Assembly 

  • The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that, effective February 1, 2024, doulas may enroll in the Medical Assistance (MA) Program, which will enable MA managed care organizations (MCOs) to enter into network agreements with doulas. The bulletin also contains information on provider enrollment.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through February 2024. Find the updated calendar here. 

Department of Health

DOH has requested input from stakeholders on what the state’s priorities should be for its Title V Maternal and Child Health Services Block Grant, which is intended to improve the health and wellbeing of mothers, infants, children, and youth, including children and youth with special health care needs, and their families. Interested stakeholders can find additional information and details on how to submit feedback here. 

Board of Nursing 

The State Board of Nursing, along with DHS and DOH, has issued a joint statement of policy to clarify nursing standards and qualifications in the commonwealth for licensed practical nurses (LPNs) and registered nurses (RNs) as it relates to the Nurse Licensure Compact (NLC). Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the establishment of a state-administered independent appeal process that allows Pennsylvanians to submit for an independent external review if they believe their insurer wrongly denied a claim for covering medical service, treatment, or other items. This is part of Act 146 of 2022, which reformed the state’s prior authorization and step therapy procedures. 

PID has also announced that Pennie’s open enrollment period for 2024 health care coverage will be extended until January 19. Pennie is Pennsylvania’s official health insurance marketplace. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced the Drug-Free Communities Program, which provides community coalitions with grant funding for substance use prevention efforts, will release its FY 2024 notice of funding opportunities on www.grants.gov in February 2024.   

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new report – COVID-19, The Impact on Health Care in Pennsylvania – examining how the coronavirus pandemic affected Pennsylvania and its health care system. Find additional information in this press release issued by PHC4. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here. 

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-01-12T23:48:27+00:00January 12th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 12
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PA Health Policy Update for January 5

The following is an update of selected state health policy developments in Pennsylvania from December 21 – January 5.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The commonwealth’s Behavioral Health Council held its first meeting the week of December 18. Created by Executive Order 2023-20 in October, the council is tasked with developing and recommending a state-wide action plan to address deficiencies in access, affordability, or delivery of behavioral health services. Find additional information about the council’s first meeting and a list of council members in this press release. 

General Assembly 

  • The state House of Representatives and Senate briefly convened for session on Tuesday, January 2. Both chambers are now in recess until Tuesday, February 6 when they will convene for Governor Shapiro’s annual budget address.
  • Senator Kim Ward (R-Westmoreland) was reelected by her colleagues on Tuesday to serve as President Pro Tempore of the Senate.
  • The House and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that the department is providing coverage and payment for interprofessional consultation services in the Medical Assistance (MA) Program, beginning January 1, 2024.
  • DHS has also issued a Medical Assistance Bulletin to inform providers about the department’s coverage policy for routine patient care costs associated with qualifying clinical trials and the updated requirements.
  • DHS has published a Pennsylvania Bulleton notice announcing its intent to submit a state plan amendment to the Centers for Medicare & Medicaid Services to implement Act 15 of 2023, which increases ground ambulance rates for the MA fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate funds in FY 2023-2024 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to MA enrolled, qualifying acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has published its approved and required medications list for emergency medical service agencies and emergency medical service providers. Find additional information in this Pennsylvania Bulletin notice.
  • DOH has published a Pennsylvania Bulletin notice with the scope of practice for emergency medical responders, emergency medical technicians, advanced emergency medical technicians, paramedics, prehospital registered nurses, prehospital physician extenders, and prehospital physicians.

Department of Drug & Alcohol Programs 

The Department of Drug and Alcohol Programs’ (DDAP) new training management system (TMS) is now live and DDAP has migrated all training records from the old TMS and TrainPA. Find more information and access the new TMS here. 

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.7 billion in General Fund revenue in December, which was $69.6 million, or 1.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $19.8 billion, which is $70.7 million, or 0.4 percent, below estimate. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

DOH – Renal Disease Advisory Committee – January 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, January 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’s programs related to care and treatment. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Medical Marijuana Advisory Board Meetings – 2024    

The Medical Marijuana Advisory Board has provided notice of its 2024 board meeting schedule. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice.

 

2024-01-05T20:38:40+00:00January 5th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for January 5
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PA Health Policy Update for December 22

The following is an update of selected state health policy developments in Pennsylvania from December 18 – 21.  (Some of the language used below is taken directly from state documents). There will be no update the week of December 25. The next update will be Friday, January 5, 2024. 

Governor Shapiro 

The Shapiro administration has issued a press release highlighting its first-year public health accomplishments, including the expansion of maternal health services, support for emergency medical services, and more.  

General Assembly 

The state House of Representatives and Senate are in recess until 2024. The Senate is scheduled to return to voting session on January 16 and the House is scheduled to return to voting session March 18. Find the House’s current 2024 session schedule here and the Senate’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued two Medical Assistance (MA) bulletins regarding the submission of claims, including those claims outside the 180-day timeframe, for MA beneficiaries whose MA coverage has been reinstated.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through January 2024. Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin relating to prior authorization of pharmacy services for hypoglycemics, incretin mimetics/enhancers.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania – is open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, or during multiple advisory and stakeholder meetings. Those details can be found here. 

Department of Health 

  • The Department of Health (DOH) has posted a solicitation for proposals that seek to foster and encourage innovative research for treatment and rehabilitative techniques for the functional improvement of people with spinal cord injuries. Find the solicitation on eMarketplace here.
  • DOH has issued a Health Advisory (PAHAN – 731) to alert health care providers of low vaccination rates against influenza, COVID-19, and respiratory syncytial virus (RSV). DOH also advised health care providers that they should recommend and provide antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high-risk of progression to severe disease.
  • DOH has also issued a Health Advisory (PAHAN – 732) to notify health care providers of an increase in pertussis across Pennsylvania, primarily among high school students and their close contacts. Providers should have an increased suspicion of pertussis if patients have certain symptoms. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

2023-12-22T16:56:08+00:00December 22nd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for December 22
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PA Health Policy Update for December 15

The following is an update of selected state health policy developments in Pennsylvania from December 11 – 15.  (Some of the language used below is taken directly from state documents.)

FY 2023-2024 Budget 

The General Assembly and Governor Shapiro enacted the remaining pieces of the FY 2023-2024 budget this week, including the Fiscal Code – House Bill 1300. The enactment of the Fiscal Code will enable approximately $1.1 billion that has been delayed since July to begin to be distributed. This includes $50 million for hospital financial relief, tobacco settlement funds, etc.  Find a summary of the various provisions in the Fiscal Code here. 

Governor Shapiro 

Governor Shapiro signed several bills into law this week. Following is a selection of health care-related laws enacted.

  • Senate Bill 414 (Act 59 of 2023) authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.
  • Senate Bill 683 (Act 43 of 2023) requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
  • Senate Bill 941 (Act 66 of 2023) enables certain flexibilities for addiction treatment providers.
  • House Bill 1131 (Act 50 of 2023) removes the requirement for counties to operate state health centers in counties establishing their own local health departments. 

General Assembly 

The state House of Representatives and Senate convened for their final voting session of 2023 this week. In addition to the bills noted above that were enacted by the General Assembly and the governor, following is an overview of selected health care-related legislative activity from this week.

  • The House of Representatives passed House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania, by a vote of 163-40. The bill will now be sent to the Seante for consideration.
  • The House of Representatives amended House Bill 181, known as the Family Medical Leave Act, on second consideration. The bill was subsequently referred to Appropriations and re-reported as amended. The bill still needs to be passed on third and final consideration before heading to the Senate.
  • The House Health Subcommittee on Health Care met on Wednesday, December 13 for an informational meeting on the “cannabis regulatory landscape.” Find a recording of the proceeding here. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of interprofessional consultation services to the Medical Assistance (MA) program fee schedule. These changes are effective for dates of services on and after January 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania – is open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.
  • DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Medical Assistance (MA) program fee schedule related to the administration of COVID-19 vaccines.

Department of Health

  • The Department of Health (DOH) has sent a message to long-term care facilities regarding the methodology for calculating staffing ratios for licensed practical nurses (LPNs) and nurse aides. The new methodology will go into effect January 1, 2024.
  • DOH has published an addendum to its solicitation for substance use disorder navigation services to increase emergency department capacity. Find the addendum and additional information regarding the solicitation here.
  • DOH has asked health care providers to report individuals with blood lead levels of 3.5 μg/dL or higher detected through venous, capillary or unspecified testing within three months after consuming a WanaBana, Schnucks, or Weis brand cinnamon applesauce or apple purée product containing cinnamon by securely emailing the following information to RA-DHBOE-RESPONSE@pa.gov or by fax: 717-772-6975. Find additional information in this Health Advisory issued by DOH. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its 2022 Hospital Performance Report. The report includes risk-adjusted, hospital-specific mortality and readmission ratings as well as volume of cases and average charges for patients discharged from Pennsylvania’s acute care hospitals between October 1, 2021, through September 30, 2022 

State Board of Medicine 

The State Board of Medicine has published proposed rulemaking submitted by the Board of Medicine effectuating Act 79 of 2021, which among other things, enables physician assistant written agreements to be effective upon being filed rather than approved. Find additional information in this Pennsylvania Bulletin notice. 

Department of Labor & Industry 

The Department of Labor & Industry has determined the maximum compensation payable under the Workers Compensation Act shall be $1,325 per week for injuries occurring on or after January 1, 2024. Find additional information in this Pennsylvania Bulleton notice. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2023-12-18T16:30:15+00:00December 16th, 2023|long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for December 15
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PA Health Policy Update for December 8

The following is an update of selected state health policy developments in Pennsylvania from December 4 – 8.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro 

In October, the Shapiro administration established the Pennsylvania Behavioral Health Council through Executive Order 2023-20. As the administration and Council begin their work, they have asked interested stakeholders to complete a brief survey to share their insights. The survey will remain open until December 14, 2023. 

General Assembly 

The state House of Representatives and Senate will convene for session next week. Following are selected health care-related legislative proceedings currently scheduled.

  • The House Health Committee will meet on Monday, December 11 at the call of the chair to consider Senate Bill 683, which requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
  • The House Health Subcommittee on Health Care will convene on Wednesday, December 13 at 9:00 a.m. in Room G-50 of the Irvis Office Building for an information meeting on the “cannabis regulatory landscape.”
  • The House Human Services Committee will convene on Monday, December 11 at 10:00 a.m. in Room 60 of the East Wing to consider Senate Bill 941, which enables certain flexibilities for addiction treatment providers. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the opening of a public comment period on its proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania. The public comment period will take place from December 2, 2023 through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.
  • DHS has announced the addition of a procedure code to the Medical Assistance (MA) program fee schedule for the administration of an influenza vaccine. The effective date and MA fee are indicated in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of the following procedure codes to the MA program fee schedule for the administration of bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines manufactured by Pfizer, Inc. and Moderna, Inc. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced it will require prior authorization of all prescriptions for continuous glucose monitoring (CGM) products that are designated as preferred on the Statewide PDL. These prior authorization requirements apply to prescriptions dispensed on or after January 8, 2024.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 728) notifying health care providers of an increase in mycoplasma pneumoniae activity internationally and in some U.S. jurisdictions.

DOH has published guidelines and fees that a health care provider or facility may charge in response to a request for production of medical charts or records. The guidelines and fees, which can be found in this Pennsylvania Bulletin notice, are effective January 1, 2024. 

Revenue Collection Update 

The Department of Revenue announced Pennsylvania collected $3.1 billion in General Fund revenue in November, which was $46.4 million, or 1.5 percent, more than anticipated. Fiscal year-to-date General Fund collections total $16.1 billion, which is $1.1 million below estimate. 

Medicaid Continuous Coverage Unwinding

DHS is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

DHS has published the following resources to help providers educate patients about Medicaid renewals and what to do if they are no longer eligible for Medicaid.

Stakeholder Events 

DHS – 1115 Waiver Public Forums – December 11, 12, and 15

DHS will hold a series of public forums for the public to ask questions and submit comments related to the Bridges to Success: Keystones of Health for Pennsylvania. Following is the schedule of forums.

  • Monday, December 11 at 12:00 p.m. Register to participate here.
  • Tuesday, December 12 at 6:00 p.m. Register to participate here.
  • Friday, December 15 at 9:00 a.m. Register to participate here. 

Board of Nursing – December 11

The State Board of Nursing will hold its monthly meeting on Monday, December 11. Find the agenda and details on how to participate in the meeting here.

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – ABC-MAP Board – 2024 Meeting Dates

The Pennsylvania Achieving Better Care by Monitoring All Prescriptions (ABC-MAP) Board has published its 2024 meeting calendar. Find the meeting dates and details on how to participate in this Pennsylvania Bulletin notice.

 

2023-12-11T14:42:46+00:00December 8th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for December 8
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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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