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PA Health Policy Update for July 26

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

Governor Shapiro

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

General Assembly 

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

Department of Human Services

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

Department of Health 

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

Department of Drug & Alcohol Programs  

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

Around the State 

  • The Citizen’s Voice has published an article about Pennsylvania’s Cancer Drug Repository Program and barriers to its utilization.
  • The Patriot-News has written an article about President Joe Biden’s decision to withdraw from the U.S. presidential race and what it means for Governor Shapiro.
  • Governor Shapiro’s signing of House Bill 1993, which establishes increased oversight of pharmacy benefit managers (PBMs), and its potential impact on local pharmacies and patients was featured in an article published by the Times Leader.
  • The Pittsburgh Business Times has published an article about the challenges confronting rural health care and efforts to find solutions.
2024-07-26T20:18:58+00:00July 26th, 2024|Medical Assistance Advisory Committee, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for July 26
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PA Health Policy Update for May 17

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

General Assembly

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

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

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

Department of Human Services 

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

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

Department of Health 

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

Department of Drug & Alcohol Programs

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

State Board of Medicine 

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

State Board of Osteopathic Medicine 

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

Around the State   

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

Stakeholder Events

DHS – Consumer Sub-MAAC – May 22

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

DHS – Medical Assistance Advisory Committee – May 23

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

DHS – Dual Diagnosis Conference – May 22-23

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

2024-05-18T00:20:37+00:00May 17th, 2024|Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 17
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PA Health Policy Update for April 19

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

General Assembly

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

  • The House passed House Bill 1633, which prohibits non-compete agreements for health care practitioners and establishes certain notification requirements, by a vote of 150-50. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee met on Monday, April 15 and favorably reported 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. A recording of the meeting is viewable here.
  • The House Children and Youth Committee met on Tuesday, April 16 and favorably reported House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 321, which establishes an implementation deadline for the Department of Human Services’ enterprise case management system. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. A recording of the meeting is viewable here.
  • The House Democratic Policy Committee held a roundtable discussion on Tuesday, April 16 examining maternal health deserts. Find the agenda and testimony presented to the committee here.
  • The Senate Democratic Policy Committee held an informational meeting on Monday, April 15 examining pharmacy deserts. Find a recording of meeting and testimony presented to the committee here.

The state House of Representatives and the Senate are in recess until Monday, April 29. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 745) with information regarding recent increases in reported congenital syphilis. The department is recommending that pregnant individuals be offered a test for Syphilis at the first prenatal visit, at the third trimester of pregnancy, and at delivery. 

Department of Human Services 

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin with the 2024 recommended child and adolescent immunization schedule.
  • DHS has published a Medical Assistance Bulletin to advise providers that the department will begin paying for ground ambulance mileage for each loaded mile in addition to increasing the fees for certain ambulance services on the Medical Assistance (MA) program fee schedule, effective with dates of service on or after January 1, 2024.
  • DHS has published the minutes of the March 28, 2024 Medical Assistance Advisory Committee (MAAC) meeting.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through May 2024. Find the updated calendar here. 

Stakeholder Events  

DHS – Consumer Sub-MAAC – April 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 1:00 p.m. Find the agenda here and register to participate here. 

DHS – Medical Assistance Advisory Committee – April 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 25 at 10:00 a.m. Find the agenda here and register to participate here. 

DOH – HIV Community Prevention Planning Committee – May 1

The Human Immunodeficiency Virus (HIV) Prevention Planning Committee will hold a public meeting on Wednesday and Thursday, May 1-2, 2024. The meeting will be held in person and virtually. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Organ Donation Advisory Committee – May 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, May 2 from 10:15 a.m. to 1:15 p.m. The meeting will be held virtually and in person. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – May 3

The Brain Injury Advisory Board will hold a public meeting on Friday, May 3, 2024 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional details in this Pennsylvania Bulletin notice.

2024-04-19T20:14:21+00:00April 19th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 19
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PA Health Policy Update for March 15

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

Governor Shapiro 

The Shapiro administration has published its semi-annual agenda of regulations under development or consideration across the various state agencies under the governor’s jurisdiction, including the Departments of Health and Human Services. Find the comprehensive regulatory agenda in this Pennsylvania Bulletin notice.  

General Assembly

The state House of Representatives and Senate will convene for a voting session next week. Following is a selection of health care policy-related legislative activity currently scheduled.

  • The House Professional Licensure Committee will hold an informational hearing on Monday, March 18 at 10:00 a.m. to discuss House Bill 1354, which enables boards and commissions within the Department of State’s Bureau of Professional and Occupational Affairs to issue advisory opinions to licensees. The meeting will be held in Room 515 of the Irvis Office building. It will also be livestreamed here.
  • The House Health Subcommittee on Health Care and Judiciary Subcommittee on Crime and Corrections will hold an informational meeting on Wednesday, March 20 at 9:00 a.m. regarding the criminal justice implications of adult-use cannabis legalization. The meeting will take place in Room G50 of the Irvis Office building. It will also be livestreamed here.
  • The House Children & Youth Committee will hold an informational meeting on the Office of the Child Advocate. The meeting will be held on Wednesday, March 20 at 10:00 a.m. in Room 60 of the East Wing. It will also be livestreamed here. 

Department of Health

The Department of Health (DOH) has issued a health advisory regarding elevated levels of lead in certain ground cinnamon products from discount retail stores. Prolonged exposure to these products may be unsafe. Find additional information here.

DOH also issued a Health Advisory (PA-HAN 740) to make clinicians aware of updated recommendations for prenatal hepatitis B and hepatitis C testing. These infectious conditions can lead to profound consequences for pregnant individuals and their infants. Hepatitis B and C testing and linkage to care in pregnancy is critical to the prevention and control of viral hepatitis in Pennsylvania. 

Department of Human Services 

The Department of Human Services (DHS) has announced the extension of an alternative payment methodology for services provided by Federally Qualified Health Centers (FQHCs), including FQHC look-alikes in Philadelphia, that serve a high volume of Medicaid beneficiaries. The alternative payment methodology will be extended through March 31, 2029. Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department

The Insurance Department has announced it will hold a public informational hearing regarding Highmark Health’s request to modify the department’s 2013 order and terms approving the merger of Allegheny Health Network and Highmark Health. Find additional information, including details on how to participate in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

  • DHS has reported that it has contacted individuals that 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 – March 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 27 at 1:00 p.m. Register to participate here.

DHS – Medical Assistance Advisory Committee – March 28

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on March 28 at 10:00 a.m. Register to participate here.

2024-03-15T21:29:51+00:00March 15th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for March 15
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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 September 22

The following is an update of selected state health policy developments in Pennsylvania from September 18 – 22.  (Some of the language used below is taken directly from state documents.) 

General AssemblyHarrisburg, PA capital building 

  • The state Senate convened for voting session this week. The following bills were passed on third and final consideration.
    • House Bill 1209 and House Bill 1407 make various changes to ensure Pennsylvania remains in compliance with the tobacco Master Settlement Agreement and isn’t exposed to litigation that would jeopardize tobacco settlement funding. Both bills will now be sent to Governor Shapiro for his signature.
    • Senate Bill 712 allows clinical laboratories certified by the federal government to directly or indirectly advertise or solicit business for diagnostic laboratory testing under certain terms and conditions. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
    • Senate Bill 773 makes various changes to the Medical Marijuana Act. Following passage, the bill was received in the House of Representatives and referred to the Health Committee.
  • The House Health Committee held a public hearing on Wednesday, September 20 on House Bill 1657, which amends the Clean Indoor Air Act. A recording of the hearing may be viewed here.
  • Democrat Lindsay Powell won a special election Tuesday, September 19 to fill the vacancy created by the resignation of Representative Sara Innamorato (D – Allegheny), who’s running for Allegheny County Executive. Powell’s victory will preserve the Democrat’s one-seat majority in the House of Representatives.
  • The state House of Representatives will convene next Monday, September 26 and Tuesday, September 27 for voting session. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to electronic visit verification requirements for pediatric home health aide services in the fee-for-service and managed care delivery systems.
  • DHS has announced its intent to allocate $258 million for FY 2023-2024 inpatient disproportionate share hospital (DSH) payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.

Department of Health 

The U.S. Centers for Disease Control and Prevention (CDC) reported this week that a team of epidemiologists from the Pennsylvania Department of Health (DOH) was the first to identify the transmission of Legionella from an organ directly to a transplant patient. This finding will help protect transplant recipients from serious lung infections. The published research can be viewed in the CDC’s Morbidity and Mortality Weekly Report.

DOH has released a Health Advisory (PAHAN – 719) with recommendations regarding the updated (2023-2024) Monovalent mRNA COVID-19 vaccines. 

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.

Stakeholder Events 

DHS – Consumer Subcommittee of the MAAC – September 27

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a meeting on Wednesday, September 27 at 1:00 p.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here.

DHS – Medical Assistance Advisory Committee (MAAC) – September 28

The MAAC will hold a meeting on Thursday, September 28 at 10:00 a.m. The agenda may be viewed here. The meeting will be held in person at the Keystone Building in the Forrest Room (400 North St., Harrisburg, PA). To participate virtually, register here. 

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

2023-09-22T18:52:13+00:00September 22nd, 2023|Medicaid Eligibility Redetermination , Medicaid supplemental payments, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for September 22
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PA Health Policy Update for July 28

The following is an update of selected state health policy developments in Pennsylvania from July 24 – 28.  (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.

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.

General Assembly

The Center for Rural Pennsylvania will hold a public hearing Thursday, August 3 at 9:00 a.m. on rural hospital and healthcare sustainability to explore difficulties facing rural hospitals and health systems. The hearing will be held at the University of Pittsburgh at Bradford and will be livestreamed here. More information on the hearing and a tentative agenda can be found here. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers enrolled in the Medical Assistance (MA) Program that an updated version of the sterilization consent form (MA 31) is available for use.

DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on July 27.

Department of Health

  • The Department of Health’s (DOH) Healthcare Incident Management System (HIMS) has transitioned from the Corvena to the Juvare software platform. Hospitals, rehabilitation, psychiatric, and long-term care providers are strongly encouraged to attend training on the new platform. Learn more about HIMS here and register for an upcoming training webinar here.
  • DOH has announced it will be transitioning the LTC RISE program to its next phase – LTC RISE 2.0. The next iteration of the program aims to make regional best practices statewide. It will also scale back on COVID-19 crisis response activities; however, those capabilities will be preserved in the event of an increase in COVID-19 outbreaks. Learn more about LTC RISE 2.0 here.
  • DOH has issued a Health Advisory (2023 – PAHAN – 710) alerting health care providers that, effective July 10, 2023, the state Medicaid program no longer requires prior authorization for preferred hepatitis C agents on the DHS Statewide Preferred Drug List (PDL). This change applies to MA beneficiaries receiving benefits in both fee-for-service and managed care delivery systems. 

Department of Drug and Alcohol Programs 

The Department of Drug and Alcohol Programs (DDAP) has released a Policy Bulletin (No. 23-02) describing modifications to the DDAP Gambling Treatment Manual. 

Insurance Department 

The Pennsylvania Insurance Department (PID) is exploring the possibility of updating the Commonwealth’s Essential Health Benefits benchmark (EHB-benchmark) plan. As a part of that process, the department is seeking public input about which benefits to potentially include in an updated EHB-benchmark plan. Comments are due by September 1, 2023. Find additional information in this Pennsylvania Bulletin notice.

2023-07-28T19:51:21+00:00July 28th, 2023|COVID-19, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Pennsylvania Medicaid COVID-19|Comments Off on PA Health Policy Update for July 28
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PA Health Policy Update for July 14

The following is an update of selected state health policy developments in Pennsylvania from July 10 – 14.  (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. 

FY 2023-2024 Budget Update 

It remains unclear when a final agreement will be reached on the FY2023-2024 budget; however, it appears unlikely an agreement will be reached in the immediate future. This week, Senate Majority Leader Joe Pittman sent a letter to House Majority Leader Matt Bradford outlining the Senate’s position on the current budget impasse. 

General Assembly

The House of Representatives adjourned from voting session Friday, July 7 until Tuesday, September 26 or unless sooner recalled by the Speaker.

Both chambers released their fall voting session schedules and indicated that they would return to Harrisburg sooner if a budget agreement is reached. Find the House’s schedule here and the Senate’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has provided final notice of its FY 2022-2023 funding allocation for several classes of disproportionate share hospital (DSH) and supplemental payments to qualifying acute care general hospitals. The department is not changing the qualifying criteria or payment methodology for these payments. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has published the minutes of the June 22, 2023 Medical Assistance Advisory Committee (MAAC) meeting. 
  • DHS has published a notice of recission in the Pennsylvania Bulletin for its statement of policy clarifying the term “within a provider’s office” due to the promulgation of the Interrelationship of Providers final-form rulemaking. The final rule deleted language previously prohibiting co-located providers from enrolling in the Medical Assistance (MA) program.
  • DHS has issued a correction to its previously published annual list of exceptional Durable Medical Equipment, which included an incorrect email address. Find the revised Pennsylvania Bulletin notice here.

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. 

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.

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.

DHS – Managed Long-Term Services and Supports Subcommittee – August 2

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will take place on Wednesday, August 2 from 10:00 a.m. to 1:00 p.m. in-person and via webinar. The meeting location is the Department of Education Building’s Honors Suite, 1st floor, 333 Market Street, Harrisburg. Register here to attend.

2023-07-14T20:00:14+00:00July 14th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for July 14
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PA Health Policy Update for June 30

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

FY 2023-2024 Budget Update 

As of 4:00 p.m. Friday, June 30 Governor Shapiro and the General Assembly have not enacted a final Fiscal Year (FY) 2023-2024 spending plan despite being hours away from the state’s constitutionally mandated deadline. The Senate is preparing to vote on a $45.5 billion spending plan, but the Democratic leaders of the House haven’t signaled support for the measure. Negotiations are ongoing. 

Shapiro Administration

Dr. Val Arkoosh officially became Secretary of the Department of Human Services (DHS) in accordance with the Pennsylvania Constitution this week. Find additional information in this press release issued by the DHS.

Governor Shapiro officially recalled the nomination of Dr. Debra Bogen to serve as Secretary of Health. The recall followed a confirmation hearing held by the Senate Health & Human Services Committee. A recording of the confirmation hearing for Dr. Bogen, as well as Dr. Arkoosh, can be viewed here. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings. Please note the House and Senate remain in session as of 4:00 p.m. Friday, June 30. As a result, this is not an exhaustive list of legislative proceedings.

  • The House passed HB 106, “The Patient Safety Act,” on third and final consideration Wednesday, June 28 by a vote of 119 – 84. The bill, which would implement specific nurse-to-patient ratios, was amended on second consideration to decrease the penalties for violations and create a grant program – funded by the penalties paid by hospitals – for nursing recruitment and retention for rural and high Medical Assistance hospitals. The amendment also delays the ability of the Department of Health to impose penalties on rural and high Medical Assistance hospitals for two years and extended the effective date for the remainder of hospitals to one year, instead of six months. The bill now goes to the Senate for consideration.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 27 to consider HB 479, which requires both the Medical Assistance Capitation and Fee-for-Service programs to pay for all loaded ambulance miles at $4 per loaded mile beginning on January 1, 2025. A recording of the meeting can be viewed here.
  • The Senate Banking and Insurance Committee held a voting meeting Tuesday, June 27 to consider SB 739, which defines telemedicine, offers guidelines outlining who can provide telemedicine services, and addresses insurance company reimbursement for these services. The bill was reported as amended. A recording of the meeting can be viewed here.
  • The House Human Services Committee met this week to consider the following bills:
    • HB 1515, to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments. The bill was reported as committed.
    • 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 bill was reported as amended.

A recording of the meeting can be found here.

  • The House Human Services Committee is expected to reconvene for a voting meeting Friday, June 30 at the call of the chair 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 meeting will be held in Room 60 East Wing and livestreamed here.
  • The House Aging and Older Adult Services Committee is expected to hold a voting meeting at the call of the chair 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 will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.

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 published its annual list of exceptional Durable Medical Equipment (DME) in this Pennsylvania Bulletin notice.
  • DHS has issued several Medical Assistance Bulletins related to prior authorization guideline changes. Following are the various bulletins.
  • DHS has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program periodicity schedule and coding matrix.
  • DHS has issued a Remittance Advice Alert to regarding the department’s delay in implementing Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals.

Department of Health

  • The Department of Health (DOH) has published answers to frequently asked questions about new long-term care facility regulations that come into effect on July 1, 2023.
  • DOH has provided a staffing ratio calculation tool to assist long-term care facilities planning for compliance with new regulatory requirements as of July 1. Use of the tool is not required but may be useful when calculating the required number of nursing hours as well as the staff ratios. Click here for instructions, which opens in a Word document, and here for the tool, which opens as an Excel spreadsheet.
  • DOH has issued a Health Advisory (2023 – PAHAN – 707) to share information and notify clinicians, public health authorities, and the public about locally acquired malaria cases and concern for a potential rise in imported malaria cases associated with increased international travel during the summer.
  • DOH has issued a Health Advisory (2023 – PAHAN – 706) to request that clinicians continue to test for influenza in patients with respiratory illness throughout the summer due to the severity of recent human infections with avian influenza A(H5N1). 

Stakeholder Events 

PHC4 – Council Meeting – July 6

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet on Thursday, July 6 at 10:00 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

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. 

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.

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.

2023-06-30T20:28:31+00:00June 30th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for June 30
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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