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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.

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

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

PA Health Policy Update for June 7

The following is an update of selected state health policy developments in Pennsylvania from June 3 – 7.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

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

  • The Senate passed Senate Bill 1102, which increases the availability of long-term care training courses for nurse aides and expands eligibility for individuals to take the nurse aide competency exam, by a vote of 42 – 8. The bill was subsequently sent to the House and referred to the Health Committee.
  • The Senate passed Senate Bill 1104, which allow high school juniors and seniors to earn up to two credits toward their graduation requirement for employment in a congregate health care setting, by a vote of 29 – 21. It was subsequently sent to the House and referred to the Education Committee.
  • The Senate passed Senate Bill 1165, which makes certain statutory changes that will enable the state to join, among others, the medical and nursing interstate licensure compacts, by a vote of 46 – 4. The bill will now be sent to the House for consideration.
  • The House passed House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange, by a vote of 106 – 96. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program, by a vote of 123-79. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 851, which establishes the menstrual hygiene products grant program under the Public School Code, by a vote of 117-85. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services, by a vote of 181 – 21. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3. A recording of the meeting is viewable here.
  • The House Insurance Committee convened on Monday, June 3 and favorably reported, 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. A recording of the meeting is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, June 4 and favorably reported Senate Bill 840, which creates an Alzheimer’s Disease and Related Disorders Division in the Department of Aging, and 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. A recording of the meeting in viewable here.
  • The Senate Health & Human Services Committee convened on Tuesday, June 4 and favorably reported Senate Bill 1000, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients. A recording of the meeting is viewable here.
  • The House Children & Youth Committee met on Wednesday, June 5 and favorably reported, 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. A recording of the meeting is viewable here.
  • The House Health Committee convened Wednesday, June 5 and favorably reported House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session again next Monday, June 10 through Wednesday, June 13.

Department of Human Services 

The Department of Human Services (DHS) has published a Medical Assistance Bulletin to advise providers of the updates to the Medical Assistance (MA) program dental fee schedule.

DHS has issued Provider Quick Tip #207 with information about fee schedule updates to Act 62, the Autism Insurance Act, procedure codes. 

Department of Health

  • DOH, in partnership with the Bradbury-Sullivan LGBT Community Center and Public Health Management Corporation (PHMC), has announced the start of the Pennsylvania LGBTQ Health Needs Assessment Survey, which is a biannual survey conducted to evaluate health needs, health disparities, and barriers to care impacting LGBTQ+ Pennsylvanians. 

Department of Aging 

The Department of Aging has announced the release of Aging Our Way PA, which is the state’s 10-year strategic plan that will help transform service delivery and serve as a roadmap for older adult services in Pennsylvania, ensuring services meet the needs of older adults as they address everyday issues such as healthcare, transportation, housing, long-term care and social connections. 

Department of State 

Several of the state’s professional licensure boards have adopted a statement of policy regarding conversion therapy. Following are the respective boards’ conversion therapy statements of policy.

 Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

 

2024-06-07T20:44:00+00:00June 7th, 2024|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for June 7

PA Health Policy Update for May 10

The following is an update of selected state health policy developments in Pennsylvania from May 6 – 10.  (Some of the language used below is taken directly from state documents). 

General Assembly

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

  • The Senate passed Senate Bill 739 by a vote of 47-1. Senate Bill 739, which was amended before final passage, provides for coverage of telemedicine services. The bill will now be sent to the House for consideration.
  • The Senate unanimously passed Senate Bill 920, which establishes a statewide sexual assault evidence tracking system. The bill will now be sent to the House for consideration.
  • The House passed House Bill 1632, which amends the Workers’ Compensation Act to recognize post-traumatic stress injuries as eligible for workers’ compensation claims, by a vote of 154-46. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries, by a vote of 164-37. The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board. The bill will now be sent to the Senate for consideration.
  • The House Insurance Committee met on Monday, May 6 and favorably reported, among others, the following bills.
    • House Bill 1021, which prohibits insurers from discriminating against individuals because they have an opioid reversal agent in their prescription profile.
    • House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services.
    • House Bill 2138, which requires insurance coverage for blood pressure monitors for home use as a pregnancy-related service.
    • House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange.

A recording of the meeting is viewable here.

  • The House Labor & Industry Committee met on Tuesday, May 7 and favorably reported House Bill 2247, which requires the establishment of workplace violence prevention committees in health care facilities. Immediately following the voting meeting, the committee held an informational meeting on the nursing workforce crisis. A recording of both meetings is viewable here.

The state House of Representatives and Senate are now recessed. The House will return to session Monday, May 20 and the Senate will return Monday, June 3.

Department of Human Services 

The Department of Human Services (DHS) has announced its intent to increase the funding for a class of supplemental payments to qualifying hospitals for Fiscal Year (FY) 2023-2024 that treat a high volume of opioid use disorder patients in their emergency rooms. Find additional information in this Pennsylvania Bulletin notice. 

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on April 25.

Department of Health 

The Department of Health (DOH) has announced it will hold a public hearing on its proposed Preventive Health and Health Services Block Grant application for Federal Fiscal Year 2024. The hearing will take place on May 28 from 10:00 – 11:00 a.m. Find additional details on how to attend and comment in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has issued comments on the State Board of Pharmacy’s proposed pharmacy technician registration regulations. Find additional information and IRRC’s comments in this Pennsylvania Bulletin notice 

Around the State 

  • The Pennsylvania Capital-Star has reported about legislation that would cover post-traumatic stress injuries for first responders under the state’s Workers’ Compensation Act.
  • Governor Shapiro has indicated he will sign legislation criminalizing the misuse of xylazine, which is contributing to a growing number of overdose deaths, according to a Philadelphia Inquirer article. 
  • PennLive has published an article about House Democrats’ efforts to pass legislation that would enact a key part of Governor Shapiro’s budget proposal to provide assistance to individuals purchasing insurance of the commonwealth’s state-based insurance exchange, Pennie.

Stakeholder Events 

PA Chamber – Healthcare Summit – May 22

The Pennsylvania Chamber of Business and Industry is holding its inaugural health care summit on Wednesday, May 22. The event will feature conversations about leading health care topics, including innovations in pharmaceuticals, workforce development, the medical malpractice landscape, and the role of AI in health care. To view additional details and register click here 

DOH – Preventive Health and Health Services Block Grant Committee – May 28

The Preventive Health and Health Services Block Grant Advisory Committee will hold a public meeting on Tuesday, May 28 from 2:00 – 4:00 p.m. The purpose of the meeting is to present the Federal Fiscal Year 2024 workplan and budget information. The meeting will be held virtually and in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

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.

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.

PA Health Policy Update for August 11

The following is an update of selected state health policy developments in Pennsylvania from August 7 – 11.  (Some of the language used below is taken directly from state documents.) 

General Assembly

The House Professional Licensure Committee held a public hearing Monday, August 7 on HB 1000, which seeks to provide prescription authority to psychologists who complete specialized training. A recording of the hearing can be viewed here. 

Department of Human Services

The Department of Human Services (DHS) has issued Provider Quick Tip #263 with updated information regarding the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS), Office of Long-Term Living (OLTL), and long-term care 180-day exception requests requiring documentation.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has reminded stakeholders that its application is still open for qualified entities to request funding to invest in technology and training for behavioral health telehealth providers. Organizations with 51 or more employees are ineligible. The application deadline is December 31, 2023. Learn more about this funding opportunity here. 

Department of Health 

The Department of Health (DOH) and the Department of Drug and Alcohol Programs (DDAP) have requested that organizations who plan to request fentanyl and xylazine test strips complete “pre-order” information here. DOH, DDAP, and the Commission on Crime and Delinquency are working to establish a new program that can provide organizations with a supply of test strips at no cost. Organizations that make a request through the pre-order form will be contacted when orders can be filled.

DOH has issued a Health Advisory (PAHAN – 714) notifying clinicians of recently identified variant influenza viruses (A H1N2v and A H3v) in the U.S. The advisory also contains diagnosis and reporting guidance for clinicians.  

Department of Aging

The Department of Aging has announced the state’s 52 Area Agencies on Aging (AAAs) will be hosting in-person listening sessions in all 67 counties to gather input on Pennsylvania’s Master Plan for Older Adults – a 10-year strategic plan designed to transform infrastructure and coordination of services for older Pennsylvanians.

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (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.

2023-08-11T18:45:22+00:00August 11th, 2023|long-term care, Medicaid Eligibility Redetermination , Pennsylvania Medicaid|Comments Off on PA Health Policy Update for August 11

PA Health Policy Update for July 7

The following is an update of selected state health policy developments in Pennsylvania from July 3 – 7.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update 

The Fiscal Year (FY) 2023-2024 budget remains in flux. Earlier this week the House of Representatives voted to concur with the Senate-passed General Appropriations bill (House Bill 611) by a vote of 117-86. The vote occurred after Governor Shapiro issued a statement announcing his intent to line-item veto the full $100 million intended for the Pennsylvania Award for Student Success (or PASS) voucher program – an initiative adamantly opposed by House Democrats and among the chief points of contention leading to the budget impasse. House Bill 611 was subsequently signed in the House and is awaiting signature in the Senate before it can be sent to the governor.

It is unclear when the Senate will return to Harrisburg or when a final agreement between the various parties will be reached. Senate Republican leadership released a statement criticizing Governor Shapiro and indicating they will “continue to await legislative action by the House on the remaining budgetary components.” 

Governor Shapiro

Governor Shapiro held a press conference touting House Bill 611’s $45.5 billion spending plan and its critical investments in mental health, education, and law enforcement. The governor implored the Senate to return to Harrisburg and sign the bill so it can be sent to his desk. Governor Shapiro also urged the Senate Republicans and House Democrats to meaningfully engage and enact enabling legislation (Fiscal Code, etc.) that would allow the budget to be fully implemented.

Governor Shapiro signed SB 262 into law on Thursday July, 6, which is now known as Act 5 of 2023. Act 5 amends the Maternal Mortality Review Act to require the Maternal Mortality Review Committee to annually publish severe maternal mortality data. 

General AssemblyHouse Chamber of the State House

The House returned to Harrisburg this week for voting session and adjourned to the call of the chair, noting that they do not anticipate returning for voting session in the immediate future. The following are selected health-related proceedings.

  • The House Human Services Committee held a voting meeting July 5 to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The bill was reported as committed. A recording of the meeting can be viewed here.
  • The House passed HB 1515 to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments and HB 1218 which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bills now go to the Senate for consideration.
  • The House Aging and Older Adult Services Committee previously scheduled a voting meeting Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting was not held.

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (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. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin announcing its intent to reimburse health care providers for services rendered to Medicaid beneficiaries experiencing homelessness. Eligible services include but are not limited to, “primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder, and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.” DHS has updated the MA Program Fee Schedule accordingly. Find additional information in the department’s press release announcing the policy change.

  • DHS has announced it will require prior authorization of all prescriptions for Amyloid-Targeted Monoclonal Antibodies and certain drugs not included on the Statewide Preferred Drug List (PDL). These prior authorization requirements will apply to prescriptions dispensed on or after July 10, 2023.
  • DHS has provided final notice of its funding allocation for FY 2022-2023 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to general acute care hospitals. The department is not otherwise changing the qualifying criteria or payment methodology for these payments.
  • DHS has announced the end-dating of three procedure codes related to COVID-19 specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #267 with additional information regarding the department’s delayed implementation of Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals. 

Revenue Collection Update 

The Department of Revenue announced the commonwealth ended FY 2022-2023 with $44.9 billion in General Fund revenue collections, which is $1.3 billion, or 3.1 percent, above estimate.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has published the public comments it received regarding DHS’ adult protective services proposed rulemaking. The comments may be viewed in this Pennsylvania Bulletin notice. 

Stakeholder Events

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 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 – Renal Disease Advisory Committee – July 21

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 21 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DOH – HIV Community Prevention Planning Committee – July 26

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will meet on Wednesday, July 26 and Thursday, July 27 from 9:00 a.m. to 4:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Organ Donation Advisory Committee – August 3

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 3 from 10:00 a.m. to 1:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for June 9

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

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (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. 

General AssemblyHouse Chamber of the State House

The state House and Senate returned to Harrisburg for voting session Monday, June 5. The following are selected health-related proceedings.

  • The House Human Services Committee held a joint hearing with the House Veteran Affairs and Emergency Preparedness Committee Monday, June 5 on the next generation of emergency and mental health response. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held a voting meeting Monday, June 5 and considered the following bills and resolution:
    • HB 1184, which extends the Act 92 COLA moratorium until December 2025. The bill was reported as committed.
    • HB 1300, which adds a member of the Pennsylvania Long-Term Care Ombudsman’s Office to the Pennsylvania Long-Term Care Council. The bill was reported as amended.
    • HR 77, recognizing the month of June 2023 as “Alzheimer’s and Brain Awareness Month” in Pennsylvania. The resolution was reported as committed.

A recording of the meeting can be viewed here.

  • The House Health Committee held a voting meeting Tuesday, June 6 to consider HB 106, the Patient Safety Act, which sets nursing staffing ratios and HB 754, which provides a standard notice to each nursing home resident and their designated representatives at the time of their admission into a nursing home facility that they have the option of having legal representation to assist with the application for Medicaid benefits. HB 106 was reported as amended along party lines and HB 754 was reported as committed. A recording of the meeting can be viewed here.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 6 and considered the following bills and resolution.
    • SB 514, which requires a blood screening for lead exposure of all children by the age of two. The bill was reported as committed.
    • SB 520, which addresses Medicaid coverage for Assisted Living Residences. The bill was reported as amended.
    • SR 120, which directs the Legislative Budget and Finance Committee to conduct a study on the financial impact to EMS providers due to non-reimbursement from Medicaid for “treat and release” services. The bill was reported as amended.

A recording of the meeting can be viewed here.

  • The Senate Health and Human Services Committee held a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. A recording of the hearing can be viewed here.
  • The House Human Services Committee held a voting meeting Wednesday, June 7 to consider HB 1305, to establish funding for Pennsylvania’s 988 Suicide and Crisis Lifeline. A recording of the meeting can be viewed here. 

The Senate now stands in recess until Monday, June 19. The House will return to Harrisburg Monday, June 12 for voting session. The following are selected health-related proceedings.

  • The House Insurance Committee will hold a voting meeting Monday, June 12 at 11:00am to consider HB 1050, requiring health insurers to cover preventive health care services without cost-sharing. The meeting will be held in Room 60 East Wing and will be live streamed here. The Insurance Committee will reconvene on Wednesday, June 14 to consider HB 1140, expanding access to contraceptives. The meeting will be held in Room B31 of the Main Capitol. 

Department of Health

  • The Acting Secretary of Health wrote to hospitals this week to explain that the Department of Health (DOH) order requiring hospitals to make daily reports of specific data regarding supplies and equipment, dated March 24, 2020, will be terminated effective June 9, 2023. CMS requirements for reporting will remain. View the secretary’s letter here.
  • DOH has issued updated guidance for health care settings on how to identify and report COVID-19 outbreaks originating within the facility.
  • DOH has issued a Health Advisory (2023 – PAHAN – 703) with currently available information regarding the status of the ongoing fungal meningitis outbreak and highlights interim recommendations for diagnosis and treatment.
  • DOH has issued a Health Advisory (2023 – PAHAN – 702) regarding poor air quality conditions resulting from wildfires in Canada and current weather conditions.
  • DOH has issued a Health Advisory (2023 – PAHAN – 699) regarding Pennsylvania’s 2023 West Nile Virus (WNV) season and notifying providers that the first WNV-positive mosquito pools of were identified in Delaware, Fayette, and York counties.

Department of Human Services

The Department of Human Services (DHS) announced this week it has “completely eliminated [the] backlog of Medicaid provider enrollment and revalidation applications.” Additional information may be found in this press release.

DHS has released the minutes of the Medical Assistance Advisory Committee (MAAC) meeting held on May 25, 2023. 

Stakeholder Events

Department of Aging – Pharmaceutical Assistance Advisory Board – June 15

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Thursday, June 15, 2023, from 9 a.m. to 10:30 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here. 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

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