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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 published a COVID-19 Infection Control and Outbreak Toolkit for Long-Term Care. The resources in the toolkit are intended to expand upon infection prevention and control guidance from the Centers for Disease Control and Prevention (CDC) for long-term care facilities for COVID-19 outbreak preparation and response.

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.

PA Safety Net Admin2023-07-28T19:51:21+00:00July 28th, 2023|COVID-19, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Pennsylvania Medicaid COVID-19|Comments Off

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.

PA Safety Net Admin2023-07-14T20:00:14+00:00July 14th, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off

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.

DHS has published revisions to the Participating Drug Company List for the Federal Medicaid Drug Rebate program.

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.

PA Safety Net Admin2023-06-30T20:28:31+00:00June 30th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off

PA Health Policy Update for May 19

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

Medicaid Continuous Coverage Unwinding

The Department of Human Services (DHS) has announced it will maintain 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.

2023 Primary Election

Pennsylvania’s 2023 primary election was held on Tuesday, May 16. In addition to judicial and municipal elections, Pennsylvanians in two legislative districts voted in a special election to fill vacancies in the state House of Representatives. Democrat Heather Boyd defeated Republican Katie Ford to represent the 163 Legislative District and Republican Michael Stender defeated Democrat Trevor Finn to represent the 108 Legislative District. The outcome of these two special elections enables the Democrats to maintain their one-vote majority in the House.

General Assembly

The House Agriculture and Rural Affairs Committee held a public hearing on May 18 to discuss access to rural medicine and health care in Pennsylvania. A recording of the hearing can be viewed here.

The state House will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.

- The House Health Committee will hold a voting meeting Monday, May 22 at 10:00am to consider, among several resolutions, HB 1131 sponsored by Representative Lisa Borowski, which would remove the requirement for counties to operate state health centers in counties establishing their own local health departments. The meeting will be held in Room G-50 of the Irvis Office Building and will be live streamed here.

- The House Human Services Committee will hold a voting meeting Tuesday, May 23 at 9:00am to consider, HB 849 sponsored by Representative Mike Schlossberg, to allocate funding for the Behavioral Health Commission on Adult Mental Health’s recommendations for funding, and HB 931 sponsored by Representative Eddie Day Pashinski, to establish the Kinship Care Legal Assistance Grant Program. The meeting will be held in Room 523 of the Irvis Office Building and can be live streamed here.

The state Senate will return to Harrisburg for voting session Monday, June 5.

Department of Health

The Department of Health began to register Temporary Health Care Services Agencies (THCSA) this month, as directed by Act 128 of 2022. THCSAs are entities engaged in the business of procuring temporary employment in health care facilities for nurse aides, registered nurses, licensed practical nurses, and direct care staff. The statute requires any person that owns or operates a THCSA to register annually with the department and provide a list of each separate location. An application, instructions, and additional resources can be found on the THCSA website.

Department of Human Services

The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) May 25 meeting.

Personal care homes and assisted living residences are reminded that after May 11, they should report any COVID-19 outbreaks through the department’s Reportable Incident and Condition form for reporting. If a facility experiences a significant outbreak, it can contact the regional licensing office and ongoing assistance with infection prevention and control is available through the LTC-RISE program.

DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through June. Find the updated calendar here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) met May 18 and considered the following health-related regulations:

Temporary Graduate Perfusionist License (Approved 5-0)
- No. 3365 State Board of Medicine #16A-4954
- No. 3366 State Board of Osteopathic Medicine #16A-5332
Environmental Quality Board #7-574: Radiological Health Fees (Approved 5-0)

Stakeholder Events

DHS – Medical Assistance Consumer Subcommittee – May 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on Wednesday, May 24 at 1:00 pm. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – May 25

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, May 25 at 10:00 a.m. Go here to register to participate.

PA Safety Net Admin2023-05-19T20:25:32+00:00May 19th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for April 28

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

Medicaid Eligibility Redetermination

Medicaid unwinding has officially begun, and recipients will begin to receive their renewal packets and additional communications from the Department of Human Services 90 days prior to their individual renewal date. Individuals can view their renewal dates in COMPASS and can begin the renewal application online up to 60 days early. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

General Assembly

The state House and Senate returned to Harrisburg on April 24 for voting session. Below is coverage of selected health-related committee proceedings.

- The Senate Consumer Protection and Professional Licensure Committee held a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. A recording of the hearing can be viewed here.

- The House Insurance Committee held a voting meeting on Monday, April 24 to consider, among other bills, SB 8 which requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The bill advanced from committee and received a unanimous vote on final passage in the House. SB 8 will move to the Governor’s desk for his consideration upon signature in the Senate.

- The Senate Veteran Affairs and Emergency Preparedness Committee held a voting meeting to consider SB 81, which codifies the ability for EMS providers to leave a dose of Naloxone with an on-scene caregiver. The bill now moves to the full Senate for consideration. A recording of the meeting can be viewed here.

- The House Health Committee held an informational meeting Wednesday, April 26 on unregulated intoxicants and psychoactive substances. A recording of the hearing can be viewed here.

- The House Human Services Committee held a voting meeting Wednesday, April 26 to consider the following bills.
  - HB 409, which would establish a mental health care services clearinghouse. The bill was reported without amendment.
  - HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits. The bill was re-referred to the House Health Committee.

A recording of the meeting can be viewed here.

- The House Professional Licensure Committee held an informational meeting on the Bureau of Professional and Occupational Affairs. A recording of the meeting can be viewed here.

The state House and Senate will return to Harrisburg for voting session Monday, May 1. Following are selected health-related proceedings.

- The House Health Committee will hold a public hearing Tuesday, May 2 at 9:30am on HB 106, the Patient Safety Act, which sets nursing ratios. The hearing will be held in Room 523 of the Irvis Office Building and can be live streamed here.

- The Senate Health and Human Services Committee is holding a voting meeting on Tuesday, May 2 at 11:00 to consider among other bills:
  - SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act.
  - SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events.
  - SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE).
  - SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk.
  - SB 549, Requires consent for pelvic, rectal, and prostate exams.
  - SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement.

The meeting will be held in Room 8E of the East Wing and will be livestreamed here.

Department of Health

The Department of Health issued a Health Alert (PAHAN – 693-04-28) with updated recommendations regarding the Monovalent and Bivalent mRNA COVID-19 vaccines.

Department of Human Services

The Department of Human Services (DHS) issued a press release highlighting how the Shapiro administration has reduced the backlog for Medicaid provider enrollment from 34,682 applicants waiting more than 30 days to less than 8,500. The press release notes the backlog has been reduced by 75 percent in the administration’s first 100 days.

DHS has shared the following presentations used at the Medical Assistance Consumer Subcommittee meeting on April 26

DHS has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of April.

DHS has issued Provider Quick Tip (#263) with an update notifying providers that the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS) and the Office of Long Term Living’s 180-day exception requests and other claims requiring documentation is available in the PROMISe Portal.

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

Stakeholder Events

PHC4 –Executive Committee & Council Meeting – May 4

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting at 9:30 a.m. and a council meeting at 10:00 a.m. on May 4, 2023. Go here for additional information and details on how to register to participate.

DHS – Managed Long-Term Services and Supports Subcommittee – May 12

The Managed Long-Term Services and Supports (MLTSS) Subcommittee will hold a meeting on Friday, May 12 from 10:00 a.m. – 1:00 p.m. in the Department of Education Building’s Honors Suite, 1st floor, at 333 Market Street in Harrisburg, or via webinar. You may register for the webinar here.

PA Safety Net Admin2023-04-28T20:48:32+00:00April 28th, 2023|long-term care, Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Uncategorized|Comments Off

PA Health Policy Update for March 24

The following is an update of selected state health policy developments in Pennsylvania from March 18 to March 24. (Some of the language used below is taken directly from state documents.)

General Assembly

The House Appropriations Committee will hold a budget hearing next Tuesday, March 28 at 10:00 for the Department of Health and at 1:00 for the Department of Drug and Alcohol Programs. The hearings will be held in the House chamber and also will be live-streamed here. A complete schedule for the House Appropriations Committee can be viewed here and a complete schedule for the Senate Appropriations Committee can be found here.
The House Health Committee will convene on Wednesday, March 29 to consider, among other bills, House Bill 155, which removes the requirement that direct-care workers be interviewed in person for a position, and House Bill 507, which requires medical schools, teaching hospitals, and medical institutions to receive explicit patient consent for all procedures and exams performed under anesthesia by medical students or for training purposes.
The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings.

Department of Human Services

The Department of Human Services (DHS) has announced updates of the Medical Assistance fee schedule that will take effect on April 1. Find the affected fees in this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin to inform providers that it has added CPT code 0044A to the Medical Assistance fee schedule for the administration of the booster dose of COVID-19 vaccine manufactured by Novavax. The new code takes effect immediately. Learn more from this Medical Assistance Bulletin.
DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into early May. Find the updated calendar here.
DHS has shared information for its community partners to use when helping their current Medicaid patients complete the process of renewing their Medicaid eligibility. The information includes key dates, web addresses and phone numbers for further information, links to FAQs, and more. Go here to find these resources.
DHS’s Medical Assistance Advisory Committee met on March 23. See the presentations delivered by the following DHS offices:
DHS has issued its report on Medicaid managed care enrollment in Pennsylvania for the month of February.
DHS has updated its list of companies that participate in its Medicaid drug rebate program.

Department of Health

The Department of Health has added Mucopolysaccharidosis Type II Disorder (MPS II) screening to the supplemental conditions mandated for screening and follow-up under the state’s newborn screening program effective July 1. Learn more from this Pennsylvania Bulletin notice.
The Department of Health, which last month joined the Department of Agriculture and Department of Environmental Protection in establishing a temporary physical presence in Darlington Township, Beaver County to assist residents affected by the Norfolk Southern train derailment in East Palestine, Ohio, has announced that the three departments will maintain a weekly presence there to continue addressing the needs and concerns of local residents. Learn more about when the departments will be on site and what services they will offer from this Department of Health news release.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced an expansion of its free substance use disorder prevention and education tool “Just Five.” Learn more about the expansion of this tool and its new components from this Department of Drug and Alcohol Programs news release.

COVID-19: By the Numbers

The number of new COVID-19 cases reported in Pennsylvania fell 26 percent last week after 19 percent declines in each of the two previous weeks. The number of weekly deaths is holding steady.
In the past week the state surpassed 2.9 million confirmed cases of COVID-19; another 637,000 cases are considered “probable.”
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 fell 10 percent last week after falling 14 percent the previous week and 16 percent the week before that. The number of COVID-19 patients on ventilators rose slightly in the past week and the number in hospital ICUs fell slightly.
The CDC reports a 10 percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 after an 18 percent decline the previous week and a 13 percent decline the week before that.
For the week ending March 22, one Pennsylvania county (Sullivan) experienced a low rate of community transmission of COVID-19; 28 counties experienced a moderate rate of community transmission of COVID-19; 23 counties experienced a substantial rate of community transmission; and 15 counties experienced a high rate of community transmission.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting April 5

The Medical Assistance Advisory Committee’s managed long-term services and support subcommittee will hold a public meeting on Wednesday, April 5 at 10:00 in Harrisburg. For information about how to join the meeting in person or participate remotely, see this DHS notice.

Department of Health – Spinal Cord Research Advisory Committee Meeting – April 10

The Department of Health’s Spinal Cord Research Advisory Committee will meet in Sellersville and be available for participants virtually on Monday, April 1 at 1:00. For information about the committee, the location of the meeting, and how to join virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-03-24T20:58:02+00:00March 24th, 2023|COVID-19, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off

PA Health Policy Update for February 17

The following is an update of selected state health policy developments in Pennsylvania from February 11-17. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House of Representatives will convene for session on Tuesday, February 21 at 12:00 p.m. The state Senate is scheduled to return on Monday, February 27.

Department of Human Services

The fee-for-service subcommittee of the Department of Human Services (DHS) Medical Assistance Advisory Committee met on Wednesday, February 8. See the presentation made by Office of Medical Assistance officials during that meeting.
DHS’s Office of Long-Term Living offered a presentation during the February 14 meeting of the Medical Assistance Advisory Committee’s long-term services and supports subcommittee. Find that presentation here.
DHS has published a notice of its funding allocation for FY 2023 inpatient disproportionate share hospital (DSH) payments to qualifying inpatient acute-care general, psychiatric, and rehabilitation hospitals and qualifying psychiatric and rehabilitation units of acute-care general hospitals; outpatient supplemental payments to qualifying inpatient acute-care general hospitals; direct medical education payments to qualifying inpatient acute-care general hospitals; and certain DSH and supplemental payments to new hospitals. It is not otherwise changing the qualifying criteria or payment methodology for these payments. These payments will amount to $257.76 million in total funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published a notice of its funding allocation for DSH payments to qualifying acute-care general hospital burn centers, to qualifying acute-care general hospitals providing obstetrical and neonatal services, to critical access and qualifying rural hospitals, and to qualifying acute-care general hospitals that treat a high percentage of Medical Assistance patients under 18 years of age. Together, the payments amount to $107.655 million in total state and federal funds. Learn more from this Pennsylvania Bulletin notice.
DHS has published procedure codes and payment rates for the administration of the Pfizer and Moderna bivalent booster dose of the COVID-19 vaccines. Find the codes, the rates, and their effective dates in this Pennsylvania Bulletin notice.
DHS’s Office of Long-Term Living has informed stakeholders that the Centers for Medicare & Medicaid Services has approved renewal of the Community HealthChoices waiver, effective January 1, 2023, for five years. See the DHS message here.
DHS has published a notice announcing that it will increase fees in the Medical Assistance Program for certain ambulance transportation services in both the fee-for-service and managed care delivery systems, effective with dates of service on and after January 1, 2023. Those fees will be not less than $325 for basic life support ambulance transportation services, not less than $400 for advanced life support ambulance transportation services, and not less than $4 per loaded mile for each loaded mile beyond 20 loaded miles for ground ambulance transportation. Learn more from this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has issued a health alert to providers advising them about a possible nation-wide increase in invasive group A streptococcal (iGAS) infections in children. This increase, however, reflects only a return to pre-pandemic levels. The alert includes information about the condition and offers guidance for clinicians and laboratories. Find the alert here.
DOH has published information about its Medical Care Availability and Reduction Error (MCARE) Act surcharge for FY 2023, a per unit assessment of approximately $156.56 payable by June 1. Learn more about the surcharge and the providers to which it applies from this Pennsylvania Bulletin notice.
DOH has published information about its Nursing Home Patient Safety Trust Fund surcharge for FY 2023. That surcharge will be $13.83 per nursing facility bed. Learn more from this Pennsylvania Bulletin notice.
DOH has published a list, as required by regulation, of hospitals that have chosen to exercise their religious or moral beliefs regarding the provision of certain contraception-related emergency services and will instead refer patients to other hospitals to receive such services. Learn more from this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania and the number of new daily deaths in the past week remained at the same levels as last week.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators held steady over the past week while the number in hospital ICUs declined 25 percent.
The CDC reports a six percent decline in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19.
For the week ending February 15, five Pennsylvania counties experienced a moderate rate of community transmission of COVID-19; 16 counties experienced a substantial rate of community transmission; and the remaining 46 counties experienced a high rate of community transmission – all the same numbers as last week.

Department of Drug and Alcohol Programs

In response to the continuing challenge health care providers are having maintaining an adequate workforce, the Department of Drug and Alcohol Programs is conducting a workforce climate survey among drug and alcohol service providers to learn about which jobs and positions are in short supply or understaffed, the challenges these providers face, what they are doing to address them, and how they think the state can help them address those challenges. Find that survey here.

Independent Regulatory Review Commission

The Independent Regulatory Review Commission has issued comments in response to regulations proposed by the State Board of Nursing that address licensure by endorsement and reactivation. Find those comments in this Pennsylvania Bulletin notice.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – February 22

The consumer subcommittee of the Medical Assistance Advisory Committee will meet virtually on Wednesday, February 22 at 1:00. Learn more from the meeting’s agenda and go here to register to participate.

DHS – Medical Assistance Advisory Committee Meeting – February 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, February 23 at 10:00. For the meeting agenda go here and to register to participate go here.

DHS – Managed Long-Term Services and Supports Subcommittee Meeting – March 1

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00. For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00. For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates: March 9 and May 16, both at 8:30. This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria. The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies. The program will be held on May 16 at 8:30. Continuing education credits are available. Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice. Please note that this program is identical to one offered on March 9.

jsteinbock2023-02-17T21:42:53+00:00February 17th, 2023|COVID-19, DSH hospitals, long-term care, Medicaid supplemental payments, Meetings and notices, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for February 3

The following is an update of selected state health policy developments in Pennsylvania from January 28 to February 3. (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro has signed an executive order seeking to improve the state’s licensing, permitting, and certification processes, launching a review of how long it takes agencies to process applications and how workers and businesses apply online. This executive order seeks to establish definitive dates for when applicants for licenses, permits, and certificated will hear back from the state, and if applicants do not receive a response by that date, the agency responsible will refund their application fee. Learn more from this news release from the governor’s office and from the executive order.

General Assembly

State Representative Lynda Schlegel Culver won a special election this week to replace former state Senator John Gordner, who resigned to become counsel to Senate President Kim Ward. Senator-elect Culver will represent the 27^th district, which includes all of Columbia, Montour, Northumberland, and Snyder counties and part of Luzerne County. Once she resigns from her state House seat a special election will be scheduled to replace her.

Department of Human Services

The Department of Human Services (DHS) has notified hospitals with accredited Level I, II, III, or IV trauma centers of the required annual attestation for inclusion in the FY 2022-23 Trauma DSH Program. The deadline to submit completed attestations is February 24. Potentially eligible trauma centers that have not been notified should contact DHS at RA pwdshpymt@pa.gov. Questions regarding the attestation form and the Trauma DSH Program also should be directed to this address.
DHS has posted information for providers on how to check the status of their electronic Medical Assistance provider enrollment application and what to do if their application was returned for additional information. Find it here.
DHS has posted information for group providers on how to reactivate, revalidate, or make
changes to group members. Find it here.
DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has announced a grant program through which qualified entities may apply for funding to invest in technology and training for behavioral health telehealth providers. The state has allocated $4 million for one-time grants of up to $50,000 for providers that meet a number of criteria, including having fewer than 50 employees and at least 51 percent of their clients enrolled in Medicaid. Learn more about the program, eligibility criteria, and how to apply from this OMHSAS notice. Applications will be accepted until December 31 or until the $4 million is exhausted.
DHS has posted the presentations offered during the January 26 meeting of the Medical Assistance Advisory Committee. See presentations from the:

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania declined over the past week and the number of new daily deaths returned to the usual range for COVID-19-related deaths in recent months.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on a ventilator because of the virus, and in hospital ICUs with COVID-19 all declined slightly over the past week.
The CDC reports an 11 percent decrease in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
For the week ending February 2, one Pennsylvania county – Cameron – experienced a low rate of community transmission of COVID-19; seven counties experienced a moderate rate of community transmission; eight counties experienced a substantial rate of community transmission; and the remaining 49 counties experienced a high rate of community transmission.

Insurance Department

The Insurance Department is conducting a medical professional liability insurance study to determine whether sufficient capacity exists to increase the basic coverage limits of insurance required by the Medical Care Availability and Reduction of Error (MCARE) Act. Learn more about the issues the study will address from this Pennsylvania Bulletin notice. Stakeholder comments are due by March 4.

Stakeholder Events

Department of Health – Preventative Health and Health Services Block Grant Advisory Committee Meeting – February 13

The Department of Health’s Preventative Health Services Block Grant Advisory Committee will meet in Harrisburg on Monday, February 13 at 1:00. For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.