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PA Health Policy Update for Friday, May 27

The following is an update of selected state health policy developments in Pennsylvania for the week of May 23-27, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The Senate unanimously passed House Bill 889, which authorizes the State Board of Nursing to approve graduates of international nursing education programs to sit for the RN licensure examination provided that such international programs are determined to be equivalent to that which is required in Pennsylvania. The bill will now be sent to the governor.
The Senate passed Senate Bill 848 by a vote of 35-12. This legislation creates a Chief Nursing Officer position in the Department of Health. The bill will now be sent to the House for consideration.
The House unanimously passed House Bill 1644, which directs the Department of Human Services to develop an escalation process to place Medicaid patients with behavioral health or long-term-care needs in an appropriate care setting. The bill now will be sent to the Senate for consideration.
The House unanimously passed House Bill 2530, which ends the practice of prudent pay in the Department of Human Services’ Office of Developmental Programs. The bill will now be sent to the Senate for consideration.
The House Insurance Committee favorably reported House Bill 2585, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting a bid.
The Senate Banking & Insurance Committee favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
The Legislative Budget and Finance Committee released a report on the Pennsylvania CARE Act (Act 20 of 2016) and its impact on patient outcomes. Find the report’s highlights here and the full report here.

Independent Fiscal Office

The Independent Fiscal Office (IFO) has revised its revenue estimate for the current fiscal year, increasing it to $47.7 billion, a $5.8 billion increase over its initial estimate. According to the IFO, revenue in most categories, including corporate net income tax, sales tax, and personal income tax, exceeded projections. The IFO also cautioned that the state will likely see reduced revenue collections in future years. Find the IFO’s full report here and a PowerPoint presentation of its initial FY 2023 revenue estimate here.

Office of the Attorney General

The Office of the Attorney General released a report on the significant increase in fentanyl importation and use across the commonwealth. The report highlights the Bureau of Narcotics Investigations’ seizure of more fentanyl in the first three months of 2022 than it seized in all of 2021. The report recommends weighing the costs and benefits of legalizing fentanyl test strips to combat the increase in overdoses and continuing to make access to substance use disorder treatment a priority. Find the full report viewed here.

Department of Human Services

The federal Centers for Medicare & Medicaid Services (CMS) has introduced a new “Renew Your Medicaid or CHIP Coverage” web page to help current Medicaid and CHIP participants prepare for the review of their eligibility for those programs that will begin when the formal COVID-19 public health emergency ends.
The Department of Human Services (DHS) has announced its intent to allocate $70 million in state and federal funds in FY 2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in Pennsylvania’s Medical Assistance program and provide financial relief to hospitals during COVID-19 pandemic. Acute-care general, medical rehabilitation, and drug and alcohol rehabilitation hospitals enrolled in Medical Assistance are eligible for these payments. Learn more about the qualifying criteria and payments from this Pennsylvania Bulletin notice.
DHS has posted the minutes of the April 28 meeting of its Medical Assistance Advisory Committee. Find those minutes here.
DHS has circulated the following materials from the May 26 meeting of its Medical Assistance Advisory Committee:

Department of Health

The Department of Health (DOH) has issued an alert updating previously released information about monkeypox in the U.S. and elsewhere and offering information for clinicians and the public, including links to additional resources. Find the alert here.
DOH has notified skilled nursing facilities that they will no longer be permitted to hire temporary nurse aides after June 6, 2022 due to the expiration of a CMS waiver related to the COVID-19 pandemic. That waiver enabled nursing facilities to hire nursing assistants who had not yet passed the skills and written portions of the state nurse aide examination. In addition, nurse aides hired under the waiver must pass the skills and written portions of the state nurse aide examination by October 6 or they cannot continue to work in that capacity. Go here to read the letter explaining this change.
DOH has published its final set of proposed amendments to the state’s long-term-care facility regulations. Learn more about the changes that have been proposed and the process DHS intends to use to move from proposed to final regulations from this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the ninth consecutive week, rising seven percent, from a seven-day average of 3971 new daily cases on May 18 to 4238 new daily cases on May 25.
The seven-day average of COVID-19-related deaths tripled, from 12 to 36.
The growing number of COVID-19 cases in the state led to an 11 percent increase in COVID-19-related hospitalizations in the past week.
The number of these patients on ventilators, on the other hand, declined 19 percent over the past week while the number in hospital intensive care units rose 12 percent.
Sixty-four of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, leaving three counties experiencing “only” a substantial rate of community transmission.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published a new report on the number of cancer-related surgeries performed in Pennsylvania during the state’s 2021 fiscal year. Go here to learn about the report and find a link to the report itself.

Stakeholder Events

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00. There will be an opportunity to submit questions and offer comments. Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00. The purpose of this virtual meeting is to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss upcoming changes. Go here to register to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes. The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1. For further information about the webinar, sharing best practices, and participating virtually, go here.

jsteinbock2022-05-27T20:41:50+00:00May 27th, 2022|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of May 2-6

The following is an update of selected state health policy developments in Pennsylvania for the week of May 2-6, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The Center for Rural Pennsylvania, a legislative agency of the state’s General Assembly, has issued a report on access to mental health services in rural Pennsylvania that identifies barriers and challenges to obtaining mental health care in rural areas and offers proposals for addressing them, including expanding and funding telehealth services. Learn more from the report “Access to Mental Health Services in Rural Pennsylvania.”

The House Democratic Policy Committee held an informational hearing this week examining the opioid epidemic. Find the hearing’s agenda and testimony here.

Revenue Collection Update

Pennsylvania’s General Fund revenue collections in April totaled $6.5 billion, which is $1.8 billion, or 38.7 percent, above estimate. Fiscal year-to-date General Fund revenue collections are $4.5 billion, or 12.4 percent, above estimate. Governor Wolf issued a press release noting that April’s revenue collection was the most ever collected by the state in a single month.

Department of Human Services

The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2022 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals. Specifically, DHS intends to allocate $9.510 million in total funds for DSH payments to qualifying acute-care general hospitals that provide a high volume of services to the Medicaid population to promote continued access to inpatient and ancillary outpatient services and to support academic medical programs that provide integrated, patient-centered medical services; to allocate $5.917 million in total funds for DSH payments to qualifying acute-care general hospitals to promote the availability of professional medical services to Medicaid populations in less urbanized areas by supporting medical education and academic medical programs; and to allocate $40.163 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high percentage of Medicaid patients under 18 years of age. Learn more from this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin to clarify its guidelines for the delivery of services via telemedicine through the Medical Assistance program’s fee-for-service delivery system. The bulletin applies to all providers enrolled in the Medical Assistance program. Providers rendering such services under the managed care delivery system should address coverage and payment questions for the delivery of services via telemedicine to the appropriate managed care organization. Find the bulletin here.
DHS has shared presentations offered at the April 28 meeting of the Medical Assistance Advisory Committee (MAAC) by:
DHS has posted a draft file note of the April 14 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

Department of Health

The Department of Health has issued a health alert updating its vaccine recommendations for hepatitis A and B.

The Department of Health has issued a health alert about failure to disinfect assisted blood glucose monitors between uses posing a risk for blood-borne pathogen transmission. The alert describes the problem, offers suggestions for how to prevent it, and points providers to resources for further information. Find the alert here.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the sixth consecutive week. The state’s seven-day average of new cases rose eight percent, from 1734 on April 28 to 1834 on May 5.
The seven-day average of COVID-19-related deaths rose from nine on April 28 to 13 on May 5.
The growing number of COVID-19 cases in the state has led to a corresponding increase in COVID-19-related hospitalizations, with Pennsylvania experiencing a 22 percent increase in COVID-19-related hospitalizations for the second consecutive week.
While the number of these patients on ventilators rose 20 percent over the past week and the number in hospital ICUs rose 33 percent, the actual number of such patients remains modest in comparison to times earlier in the pandemic when the daily case counts were comparable.
During the past week 35 Pennsylvania counties, up from 22 last week, experienced high rates of community transmission of COVID-19; two counties, one fewer than last week, experienced a low rate of transmission; 21 counties, down from 22 last week, experienced a substantial rate of community transmission; and the remaining nine counties experienced a moderate rate.

Department of State

The Department of State has announced that the professional licensing waivers it issued under the COVID-19 disaster declaration will begin expiring in phases starting on May 23, with all waivers scheduled to expire by June 30. Go here for a list of the department’s waivers and their expiration dates.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00. To register to participate, go here.

Department of Human Services – Medical Assistance Advisory Committee Managed Care Delivery System Subcommittee – May 12

The managed care delivery system subcommittee of the Medical Assistance Advisory Committee will meet virtually on Thursday, May 12 at 10:00. For an agenda for the meeting and information about how to participate, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 12

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special population webinar on avoiding hospitalizations from nursing facilities on Thursday, May 12 at 2:00. Recommended nursing home participants are admissions coordinators, directors of nursing, and social services staff. For more information about the webinar and how to register, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes. The webinar will be held on Thursday, May 19 at 2:00. For further information about the webinar and to register to participate, go here.

DHS – Office of Medical Assistance Programs – Gun Violence Roundtable – date in May to be determined

DHS’s Office of Medical Assistance Programs will convene a roundtable in May to discuss gun violence as a public health issue and to explore public health strategies that can be used by Medicaid managed care organizations to prevent and respond to gun violence. A save-the-date will be sent out in the next week or so and the managed care organizations will be given a list of questions to come prepared to discuss. An opportunity to present on current and planned initiatives, as well as challenges and limitations, will be offered to each managed care organization.

jsteinbock2022-05-06T20:29:10+00:00May 6th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off

PA Health Policy Update for the Week of April 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of April 18-22, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed House Bill 245, which reduces the graduate medical training required for international medical graduates from three years to two years; removes the limit on the number of affiliated facilities at which a doctor with an institutional license may practice or teach; and expands and clarifies the scope of practice of temporarily licensed physicians.

General Assembly

The state House will be in session next Monday (4/25), Tuesday (4/26), and Wednesday (4/27). The Senate is in recess.
The House Professional Licensure Committee will meet on Monday, April 25 at 10:00 a.m. to consider House Bill 1956, which creates a license for certified anesthesiologist assistants.
The House Health Committee will convene on Tuesday, April 26 at 9:30 a.m. to consider the following bills.
- House Bill 398, which requires a non-custodial parent of a child to enroll their child in their own health insurance plan before seeking Medicaid coverage.
- House Bill 2441, which gives legislative agencies access to records information for research purposes under the Vital Statistics Law.
- Senate Bill 317, which provides for the authority to prescribe antibiotics to treat sexually transmitted infections without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy in the Management of Sexually Transmitted Diseases guidance issued by the CDC.
- Senate Bill 818, which seeks to align procedures permitted in licensed ambulatory surgery centers with those of the federal Centers for Medicare & Medicaid Services (CMS).

Department of Human Services

Act 2 of 2022 appropriated $225 million to support the health care workforce needs of hospitals and behavioral health providers. The law directed that the funding be used strictly for recruitment and retention payments to direct care staff. Entities receiving payments under Act 2 must submit a report to the Department of Human Services (DHS) documenting staff retention payments by September 30, 2022 and a report on staff recruitment spending by December 31, 2022. DHS has posted an FAQ describing how Act 2 works and has added to that FAQ a template for submitting the required reports. Find the FAQ and the report template here.
DHS has updated its calendar for delivering Remittance Advice and corresponding checks to extend into early June.
DHS has issued a Medical Assistance Bulletin to announce the addition of new procedure codes to the Medical Assistance program fee schedule for the provision of personal care services that are provided through home health agencies to Medicaid beneficiaries under 21 years of age. Find that bulletin here.
DHS has posted a notice to Medical Assistance fee-for-service providers reminding them of the recommended documentation needed to support the review of authorization requests for private duty/shift nursing and home health aide service hours provided to children under the age of 21. Find that notice here.
DHS has shared the minutes of the February 23 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.
DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include March 2022 data.

Department of Health

Keara Klinepeter has resigned as Pennsylvania’s Acting Health Secretary. She will be replaced by the state’s Physician General, Dr. Denise Johnson. Learn more from this Wolf administration news release.
The Secretary of Health issued a letter to the hospital community clarifying that the intention of the recently issued innovative hospital guidance was to preserve access to care in rural communities in a financially sustainable way. Find a copy of that letter here.
The Department of Health has updated its guidance to providers caring for adults and children with multisystem inflammatory syndrome.
The Department of Health has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Blair, Centre, and Clinton counties and at Edinboro University in Erie. Learn more about the locations and hours of operation in this department news release.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the fourth consecutive week. The state’s seven-day average of new cases rose 26 percent, from 1067 cases on April 14 to 1343 on April 21.
The seven-day average of COVID-19-related deaths, which has long been declining, rose during the past week from 10 on April 13 to 16 to April 21.
The rising number of COVID-19 cases in Pennsylvania has led to increases in some but not all measures of COVID-19-related hospital care. In the past week the number of Pennsylvanians hospitalized with the virus rose 13 percent and has now risen 21 percent since the beginning of the month. The number of COVID-19 patients in hospital ICUs rose 15 percent in the past week but remains modest. The number of such patients being treated on ventilators, on the other hand, declined 22 percent and remains very low.
During the past week nine Pennsylvania counties, up from five last week, experienced high rates of community transmission of COVID-19; three counties, down from five last week, experienced a low rate of transmission; 20 counties, up from 15 last week, experienced a substantial rate of community transmission; and the remaining 35 counties experienced a moderate rate.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a fourth quarter 2021 report on the effect of COVID-19 on hospitals and health care facilities in Pennsylvania. In the report, PHC4 aggregates data on fourth quarter of 2021 COVID-19 expenses and lost revenue as reported by hospitals and health systems to show the impact of the public health emergency on those institutions. The data in the report reflects financial performance for fewer than half of the hospitals in the state and does not include emergency funding the providers received from the federal or state government. Learn more from this PHC4 news release and the agency’s “COVID-19 Disaster Emergency Report.”

Stakeholder Events

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

The Department of Human Services’ Office of Long-Term Living, Office of Mental Health and Substance Abuse Services (OMHSAS), the HealthChoices behavioral health managed care organizations, and the Community HealthChoices managed care organizations will host a joint webinar on the importance of providing behavioral health services in nursing facilities and making sure nursing facilities know how to gain access to these services. The webinar will be held two more times and the material presented will be the same at each session. The webinars will be recorded. The session on Tuesday, April 26 will be held at 2:00; go here for more information and to register to participate. The session on Tuesday, May 3 also will be held at 2:00; go here for more information and to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

Special Pharmaceutical Benefits Program Advisory Council – April 28

The Department of Human Services’ Special Pharmaceutical Benefits Program Advisory Council will meet by teleconference on Thursday, April 28 at 10:00. Join the meeting at 866-588-4789 and use conference ID code 211 418 005#.

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m. For information about how to participate see this Pennsylvania Bulletin notice.

jsteinbock2022-04-22T18:48:43+00:00April 22nd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of April 11-15

The following is an update of selected state health policy developments in Pennsylvania for the week of April 11-15, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for session in Harrisburg this week.
The House concurred with the Senate’s amendment to House Bill 245 and sent it to the governor’s desk. House Bill 245 reduces the clinical residency requirement from three years to two years for an applicant who has graduated from an international medical college to receive licensure in Pennsylvania.
The House passed on third and final consideration House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses, and House Bill 2419, which expands access to outpatient psychiatric care via telemedicine. These bills will now be sent to the Senate for consideration.
The Senate passed on third and final consideration Senate Bill 1172, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services. The bill was received in the House and referred to the Health Committee.
The House Health Committee held an informational meeting on Tuesday, April 12 regarding “Opioids in the Commonwealth: Lessons learned and next steps.” A recording of the meeting may be viewed here.
The House Veterans Affairs and Emergency Preparedness Committee favorably reported House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.
The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 12 to examine long-term-care facility workforce challenges. A recording of the meeting may be viewed here.
The Senate Health & Human Services Committee met on Tuesday, April 12 and favorably reported the following bills.
- Senate Bill 749, which seeks to provide clarity for employees and employers regarding current ambiguity in the state’s medical marijuana law concerning the use of medical marijuana in the workplace.
- Senate Bill 1121, which requires the Department of Human Services (DHS) to verify wage records from employers and the Department of Revenue for Medicaid and SNAP beneficiaries.
- Senate Bill 1124, which requires DHS to check death certificates at the Bureau of Vital Statistics against Medicaid and SNAP beneficiaries.
- Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.

A recording of the hearing may be viewed here.

Department of Human Services

The Department of Human Services (DHS) has posted a file note summarizing the March 10 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

DHS has announced the addition of two procedure codes to the Medical Assistance fee schedule for the provision of personal care services by home health agencies to beneficiaries under 21 years of age, effective with dates of service on and after May 1, 2022. Find those procedure codes in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has updated its guidance for reporting on point-of-care COVID-19 test results to bring Pennsylvania into compliance with revised federal requirements. See the new guidance here.
DOH has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Centre, and Clinton counties and at Edinboro University in Erie. Learn more about the locations and hours of operation in this department news release.
DOH has posted new online resources for providers and the public to learn about and support

Pennsylvanians who may be experiencing symptoms of Alzheimer’s disease and related disorders. The new information comes in response to a law passed by the legislature earlier this year and signed by Governor Wolf requiring the administration to provide such information. Go here to find the resources for providers and here to view resources for the public.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the third consecutive week. The state’s seven-day average of new cases rose nearly 24 percent, from 797 cases on April 5 to 986 on April 13.
On the other hand, the number of new COVID-19-related deaths continues to decline, from a seven-day average of 17 on April 5 to just 10 on April 13.
The rising number of COVID-19 cases in Pennsylvania has not led to increases in hospital care for COVID-19 patients: during the past week the number of residents in hospital ICUs because of the virus and being treated with ventilators has remained steady while the number admitted to hospitals has risen only seven percent since the beginning of the month.
During the past week five Pennsylvania counties – up from two last week – experienced high rates of transmission of COVID-19 (Potter, Bradford, Susquehanna, Columbia, and Pike); five counties – the same number as last week – experienced a low rate of community transmission (Bedford, Fulton, Juniata, Elk, and Sullivan); and 15 counties experienced a substantial rate of community transmission while another 42 experienced a moderate rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued a news release describing its recent talks with state Attorney General Shapiro and other officials about how Pennsylvania might use its share of the national opioid settlement – as much as $1.07 billion – to address substance use challenges in the state. Learn more here.

Insurance Department

The Insurance Department has published a policy statement that will permit insurers to ask applicants to voluntarily provide race and ethnicity data on insurance applications in an effort to promote equity initiatives. The new statement of policy ends enforcement of a prohibition on such data collection published in 1969. Learn more about this policy change in this department news release and see the policy statement in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30. The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

Special Pharmaceutical Benefits Program Advisory Council – April 28

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m. For information about how to participate see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board – May 6

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, May 6 at 10:00 at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive in Harrisburg, in the Dauphin Conference Room. To learn more about the meeting, and for information about how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00. To register to participate, go here.

jsteinbock2022-04-15T20:31:51+00:00April 15th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of March 28-April 1

The following is an update of selected state health policy developments in Pennsylvania for the week of March 28-April 1, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed into law Senate Bill 1019, which temporarily extends certain suspensions of regulations and statutes that were issued by agencies under the COVID-19 disaster declaration through June 30, 2022.

General Assembly

The House Health Committee convened on Tuesday, March 29 and favorably reported House Bill 2357, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products, and House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.
The House Insurance Committee met on Tuesday and favorably reported House Bill 2419, which expands access to outpatient psychiatric care via telemedicine.
The state Senate will be in session next Monday (4/4), Tuesday (4/5), and Wednesday (4/6). The House will be in recess next week.

Revenue Collection Update

The Independent Fiscal Office has released its March 2022 Revenue Update. General Fund collections for March were $579.2 million or 11.6 percent above estimate. Year-to-date General Fund revenue is $3.04 billion or 9.8 percent more than projected.

Department of Human Services

The Department of Human Services (DHS) has informed providers that effective Friday, April 1 at 12:00 a.m. the current Medical Assistance Provider Forms webpage will no longer be accessible. Instead, providers may order and receive Medical Assistance provider forms here. Find updated instructions here. DHS also offered the following explanation to stakeholders:

Over the next few months, the Department of Human Services (DHS) is transitioning web-based forms to a new enterprise solution. While we strive to provide a seamless transition, we understand there may be issues along the way. If you have any bookmarked links, they may no longer work. If you are trying to access an old link that no longer works, please go to https://www.dhs.pa.gov/docs/Publications/Pages/Express-Forms-Transition.aspx for a list of affected forms.

We understand that there may be confusion and issues that arise during this transition, and we appreciate your patience. If you identify a problem following the transition, please reach out to DHS’s Digital Communications Team at RA-PWDHSSOCIALMEDIA@pa.gov and we will assist you as we are able.

DHS has issued a Medical Assistance Bulletin advising providers that the Medical Assistance program is extending postpartum coverage from 60 days to 12 months beginning on April 1 and that this applies to all providers enrolled in the Medical Assistance program. Find the bulletin here.
As part of the response to the COVID-19 emergency, numerous state regulatory requirements were suspended by the legislature and DHS to facilitate an effective, timely response to the pandemic. Over time, some of those suspended requirements have been restored. DHS has updated its collection of regulatory requirements to reflect which suspensions remain in effect and which have been lifted. Find that compendium here.
DHS has posted a notice informing providers that the Provider Electronic Solutions software they may have used to submit HIPAA-ready transactions to the PROMISe system will not be supported after June 15 and urging them to use the PROMISe Provider Portal to submit claims, validate eligibility, conduct claim inquiries, and view their weekly remittance advice. Find that notice here.
DHS has posted a notice reminding Medical Assistance billing entities that federal law requires physicians and other practitioners who order, refer, or prescribe items or services for Medicaid beneficiaries to be enrolled in the Medical Assistance program and suggesting that billing entities remind unenrolled billing providers about this requirement. Find the notice here.
DHS has posted a notice reminding providers that the two percent Medicare sequestration imposed in 2013 and suspended in 2020 in response to the COVID-19 pandemic will be restored partially on April 1 and fully after July 1. Find that notice here.
DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include January 2022 data.
DHS has posted presentations delivered at the March 24 meeting of its Medical Assistance Advisory Committee (MAAC). See the presentations from:
The federal Centers for Medicare & Medicaid Services (CMS) has released an informational bulletin informing state Medicaid agencies that CMS is exercising enforcement discretion during the COVID-19 public health emergency regarding state submissions of updated Medicaid access monitoring review plans. CMS is delaying enforcement of the updated plans that are due by October 1, 2022 until October 1, 2024. Find the CMS informational bulletin here.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed slightly over the past week. On Wednesday, March 23 the state’s seven-day average of new cases was 574 cases a day; on March 31 it was 585 cases a day.
The number of new COVID-19-related deaths, on the other hand, fell by more than half over the past week, with the March 24 seven-day average of 37 deaths falling to 18 on March 31.
For the third consecutive week, no Pennsylvania counties are experiencing a high rate of community transmission. For the second consecutive week, just eight counties experienced a substantial rate of community transmission. Three counties – down from four last week – are experiencing a low rate of community transmission. The rest of the state – 56 counties – is experiencing a moderate rate of community transmission of COVID-19.
The number of Pennsylvanians receiving hospital care for COVID-19 fell significantly during March: the number hospitalized declined from 1356 on March 1 to 481 on March 31; the number being treated on a ventilator from 163 on March 1 to 54 on March 31; and the number in hospital ICUs from 252 on March 1 to 75 on March 31.

Department of Drug and Alcohol Programs

The departments of Drug and Alcohol Programs (DDAP) and Community and Economic Development have announced the availability of more than $1 million in grant funding for recovery houses to provide safe housing for individuals in recovery from a substance use disorder. The grants are designed to help existing recovery house facilities with physical upgrades to comply with all federal, state, and local laws and ordinances, including the Americans with Disabilities Act of 1990. Grants of up to $50,000 for a 12-month period beginning July 1, 2022 will be awarded to between 22 and 25 eligible applicants for health and safety upgrades including demolition, debris removal, rehabilitation improvements, environmental remediation costs, and construction and inspections to comply with DDAP’s regulations. Learn more from this Department of Drug and Alcohol Programs news release and go here for additional information about the grant program and the application process. There is no application deadline; applications will be accepted until all of the available money is spent.

In September of 2021, Governor Wolf signed into law Act 73, which extended three of DDAP’s temporary regulatory suspensions through March 31, 2022 in response to the COVID-19 pandemic. This week Governor Wolf signed Senate Bill 1019, which further extends DDAP’s regulatory suspensions that are “related to federal exemptions granted under the federal public health emergency declaration” until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” Three DDAP regulatory suspensions and a relevant Department of State regulation are included in this chart and also remain suspended. In November of 2021, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) announced that methadone take-home flexibilities will be extended for one year after the eventual expiration of the federal COVID-19 public health emergency. DDAP has submitted its written concurrence with this exemption. SAMHSA also has indicated that it is considering mechanisms to make this flexibility permanent. Narcotic treatment programs do not need to do anything additional at this time to continue taking advantage of this flexibility. Similarly, the U.S. Drug Enforcement Administration (DEA) also has announced that it is working to make its tele-prescribing regulations permanent.

Stakeholder Events

Department of Health – Health Research Advisory Committee – April 4

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, April 4 at 10:00 a.m. to review the committee’s work, confirm its 2022 priorities, plan future health research priorities, and address emerging issues. To learn more about the meeting and how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports subcommittee – April 5

The Medical Assistance Advisory Committee’s managed long-term services and supports committee will meet virtually on Tuesday, April 5 at 10:00 a.m. Public comments will be taken after each presentation. Questions can be entered into the meeting’s chat box during the presentations and will be asked at the end of each presentation. There will be an additional period at the end of the meeting for additional public comments. Go here to register to participate.

Pennsylvania Long-Term Care Learning Network – Strategies to Reduce Hospitalizations and Emergency Room Visits – April 7

The Pennsylvania Long-Term Care Learning Network, part of DHS’s Quality Strategy for Nursing
Facilities, is holding a virtual webinar “Strategies to Reduce Hospitalizations and Emergency Room Visits” on Thursday, April 7 at 2:00 p.m. Go here to register to participate.

Department of Aging – Pharmaceutical Assistance Advisory Board Virtual Meeting – April 13

The Department of Aging’s Pharmaceutical Assistance Advisory Board will meet virtually on Wednesday, April 13 at 8:30 a.m. For information about how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30 a.m. The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

jsteinbock2022-04-01T20:56:41+00:00April 1st, 2022|Coronavirus, COVID-19, Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of March 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of March 7-11, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The Department of Human Services appeared before the Senate and the House appropriations committees this week. A recording of the House budget hearing can be viewed here and a recording of the Senate hearing can be viewed here.
The Department of Health also appeared before the Senate Appropriations Committee for its FY 2023 budget hearing. A recording of the hearing can be viewed here.
The Department of Drug and Alcohol Programs will appear before the Senate Appropriations Committee next Wednesday, March 16 at 2:00 p.m.

Department of Health

In light of the Pennsylvania Department of Environmental Protection’s confirmation of higher-than-expected rates of Powassan virus in ticks located in multiple Pennsylvania counties during the 2021 surveillance season, the Department of Health has issued a health advisory to give providers background information on POW virus disease, including transmission, clinical signs and symptoms, diagnosis, and prevention.

Department of Human Services

The Department of Human Services has issued a Medical Assistance Bulletin to inform providers enrolled in the Medical Assistance program that the state is expanding the beneficiary age for which Medical Assistance payment will be made for the administration of the Flucelvax Quadrivalent vaccine to include beneficiaries ages six months and older effective October 14, 2021.

The Department of Human Services has posted presentations delivered during the February 24 Medical Assistance Advisory Committee meeting by its:

COVID-19: By the Numbers

Daily COVID-19 case counts continue to fall. A week ago the state’s seven-day average of new cases was 1299 cases a day; yesterday (March 10) it was 954 cases a day.
The number of new COVID-19-related deaths is following the same downward trend: Pennsylvania’s seven-day average of deaths was 65 deaths a day a week ago but was 40 deaths a day yesterday (March 10).
The decline in the number of Pennsylvania counties experiencing a substantial rate of community transmission of COVID-19 – the highest rate – continues. Last week, 38 counties were in the highest rate of community transmission of COVID-19 cases; this week, only seven are. Last week, 26 counties were experiencing a substantial rate of community transmission; this week, 37 are. Last week, only three counties were experiencing only a moderate rate of community transmission; this week, 23 are.
March 9 was the first day fewer than 1000 Pennsylvanians were hospitalized with COVID-19 since August 12; March 11 was the first day fewer than 100 were on ventilators because of the virus since August 5; and March 7 was the first day fewer than 200 were in hospital ICUs because of COVID-19 since August 5.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released the new report “COVID-19 Hospitalizations ‒ March 2020 to June 2021.” The paper looks at patients who were hospitalized with COVID-19 and discharged from Pennsylvania acute-care hospitals from March 2020 through June 2021. It examines hospitalization rates and in-hospital mortality by month and for the entire period. Go here for links to the news release announcing the report, key findings, county rates, patient characteristics and outcomes, and the report itself.

Stakeholder Events

Department of Health – Advisory Health Board – March 16

The Department of Health’s Advisory Health Board will meet virtually on Wednesday, March 16 at 2:00 p.m. to discuss programmatic and departmental activities. For information about how to participate, see this Pennsylvania Bulletin notice.

Patient Safety Authority – March 17

The Patient Safety Authority will hold a virtual public meeting on Thursday, March 17 at 1:00 p.m. Learn how to join the meeting from this Pennsylvania Bulletin notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – March 30

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will hold a virtual public meeting on Wednesday, March 30, 2022 at 10:00 a.m. The agenda will include discussions about board member terms; updates from the Bureau of Family Health and the RUSP workgroup; a discussion on pyruvate dehydrogenase; and updates from the Ethics, Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Learn how to join the meeting in this Pennsylvania Bulletin notice.

jsteinbock2022-03-11T22:00:40+00:00March 11th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania proposed FY 2023 budget|Comments Off

PA Health Policy Update for the Week of February 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of February 7-11, 2022. (Some of the language used below is taken directly from state documents.)

Proposed State FY 2023 Budget

This week Governor Wolf proposed his state budget for FY 2023. Pennsylvania will go into FY 2023 with a budget surplus of approximately $3 billion and more than $2 billion in unspent federal American Rescue Plan Act (ARPA) funds. Health care highlights include a $91 million increase in Medicaid rates for skilled nursing facilities; a $37 million increase in funding for county mental health services; and $325 million in ARPA fund spending for long-term care recruitment and retention, health care workforce development, behavioral health workforce expansion, and loan forgiveness for critical care workers (highlighted here).

The proposed state funding for the Department of Human Services is nearly $4 billion more than the current fiscal year’s total, though much of that reflects increased spending attributable to the loss of enhanced federal matching funds. Proposed spending increases include:

rate increases for HealthChoices, Community HealthChoices, and CHIP managed care plans
increased Supplemental Nutrition Assistance Program benefits
increased supplemental payments to personal care homes
increased county mental health funding
reducing the waiting list for intellectual disability services
expanding court-appointed child special advocates
expanding access to evidence-based home visiting programs (for parents of young children).

The budget also assumes a slight decrease in Medicaid spending attributable to the expectation that once the COVID-19 public health emergency officially ends states will be required to redetermine eligibility for the program – they are not permitted to do this during the emergency in exchange for additional federal assistance – and that Pennsylvania’s Medicaid enrollment will then be reduced. The budget assumes a smaller increase in CHIP spending for the same reason.

For further information, find Wolf administration budget documents here and a summary of the proposed Department of Human Services budget here.

Governor Wolf

Governor Wolf signed House Bill 1082 into law on Wednesday following its unanimous passage by the House and Senate. Act 9 of 2022 directs the Department of Health to establish and maintain an “Early Detection and Diagnosis of Alzheimer’s Disease or a Related Disorder” toolkit that includes best practices and cognitive assessment tools, including the use of appropriate diagnostics, to assist the primary care workforce with the detection, diagnosis, treatment, and care planning for individuals with Alzheimer’s disease. It also makes a technical change in the definition of “High Medical Assistance hospital” in Act 2 (House Bill 253) to align it with the legislation’s original intent.

Governor Wolf signed Senate Bill 739 following its unanimous passage in the House and Senate. Act 10 of 2022 appropriates $25 million in American Rescue Plan Act funding to support Pennsylvania’s emergency management services (EMS) companies. A press release issued by the governor’s office can be viewed here.

General Assembly

The state House and Senate convened for voting session this week. The following is a selection of health-related bills that received consideration.
- House Bill 1440 passed on third and final consideration by a vote of 132 to 67. This bill provides for the regulation and licensure of medical imaging and radiation therapy professionals. It will now be sent to the Senate.
- House Bill 19, which creates professional licensure for behavior analysts, passed on third and final consideration by a vote of 134-66. The bill was received in the Senate and referred to the Consumer Protection and Professional Licensure Committee.

The House Health Committee convened on Monday, February 7 and favorably reported House Bill 1741, which allows for the prescribing and dispensing of off-label drugs to treat COVID-19, and House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.
The Senate Health & Human Services Committee met on Wednesday, February 9 and favorably reported Senate Bill 1057, which enables pharmacists to be reimbursed for administering COVID-19 antigen tests.
The House Appropriations Committee will begin budget hearings next Tuesday, February 15. The Senate Appropriations Committee will begin budget hearings the following week, on February 22. The hearing schedules can be viewed here.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers that Chartwell Pennsylvania will be the preferred specialty pharmacy in the Medicaid fee-for-service specialty pharmacy drug program effective July 1 and explaining to providers how to access drugs included in that program. The bulletin applies to pharmacies and prescribers enrolled in Medicaid that serve participants in the fee-for-service delivery system. Find the bulletin here.
DHS has updated the Medicaid program fee schedule to include a CPT code for dispensing the oral antiviral therapeutics Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) and molnupiravir capsules for treatment of COVID-19. Learn more, including the new CPT code, in this Pennsylvania Bulletin notice, which also includes information about submitting comments in response to this action. Such comments are due within 30 days.
DHS has released the minutes of the January 27 meeting of the Medical Assistance Advisory Committee meeting. Find them here.

Department of Health

The Department of Health (DOH) has updated its infection prevention and control recommendations for health care settings during the COVID-19 pandemic. The update reflects a recent revision in the CDC’s guidance. Find the state update here.

DOH has updated its information about state-sponsored COVID-19 testing sites in Berks, Blair, Centre, Clinton, Clearfield, Fayette, Monroe, Somerset, and Venango counties and its map of additional testing sites around the state. Learn more in this DOH news release.

COVID-19: By the Numbers

Daily COVID-19 case counts remain very high but fell significantly again over the past week. Pennsylvania’s seven-day average yesterday (February 10) was 5163 cases day; a week ago (February 3) its seven-day average was 8512 cases a day.
To date, Pennsylvania has experienced more than 2.7 million cases of confirmed or probable COVID-19.
The number of new COVID-19-related deaths also remains very high but declined slightly over the past week. Pennsylvania’s seven-day average yesterday (February 10) was 119 deaths a day; a week ago (February 3) its seven-day average was 135 deaths a day.
To date, more than 42,000 Pennsylvanians have died from COVID-19.
The Department of Health reports that the percentage of available adult ICU beds rose from 18.9 percent to 23.6 percent during the past week but the percentage of available pediatric ICU beds fell slightly, from 14.4 percent to 14 percent, over the same period of time.
The Department of Health also reports that that in approximately 17.3 percent of all staffed adult ICU beds are COVID-19 patients this week, down from 22.1 percent last week, and that 27.6 percent of all ventilators in the state are currently in use, down from 30.6 percent last week.
All 67 Pennsylvania counties continue to experience a high rate of COVID-19 transmission.
The decline in the number of new COVID-19 cases is reflected in a 36 percent decline over since February 1 in the number of Pennsylvanians hospitalized with the virus. The number of people on ventilators also has fallen 36 21 percent since the first of the month and the number in ICUs has fallen 37 percent.

Stakeholder Events

Human Immunodeficiency Virus Community Prevention Planning Committee – February 16 and 17

The Statewide HIV Planning Group will hold virtual public meetings on Wednesday, February 16 and Thursday, February 17, 2022 from 9:00 a.m. to 4:30 p.m. Learn more about the meetings and how to participate from this Pennsylvania Bulletin notice.

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

The Medical Assistance Advisory Committee’s managed long-term services and support (MLTSS) subcommittee will meet virtually on Tuesday, March 1 at 10:00 a.m. Go here to register to participate.

jsteinbock2022-02-11T21:54:18+00:00February 11th, 2022|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off

PA Health Policy Update for the Week of October 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of October 18-22, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed an executive order calling on the state’s Department of Labor & Industry to “study the feasibility of implementing Occupational Safety and Health Administration (OSHA) standards” in state offices and requiring that for profit entities that do business with the state pay “…a minimum wage that meets or exceeds” the state’s minimum wage and offer paid sick leave to their employees. Go here to see that executive order and here to see a Wolf administration news release about it.

General Assembly

The House of Representatives’ Democratic Policy Committee held a hearing this week titled “Navigating Healthcare Consolidation.” Co-hosted by chairman Ryan Bizarro and northeast delegation chair Rep. Maureen Madden, the hearing focused on the market dynamics that contribute to health care consolidation and the effect consolidation has on communities, patients, and employees. Representatives from the hospital community, organized labor, and patient advocacy groups testified. A press release issued following the hearing may be viewed here and testimony offered at the hearing may be viewed here.
The House and Senate will be in session next Monday (10/25), Tuesday (10/26), and Wednesday (10/27). As of October 22, the following health care-related committee meetings have been scheduled for next week:
- The House Aging & Older Adult Services Committee will meet on Tuesday, October 26 to consider, among other bills, House Bill 1356, which amends the Human Services Code to increase the reimbursement rate for guardians of older adults.
- The House Human Services Committee will meet on Tuesday, October 26 to consider House Bill 1561 and House Bill 1563. These bills, which amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, seek to align them with HIPAA and give providers, facilities, and insurers the ability to more easily share patient mental health and substance use disorder treatment information. The committee also will consider House Bill 1308, which enables local communities and agencies in Pennsylvania to establish overdose fatality review teams. Finally, the committee will consider House Bill 1995, which clarifies the Department of Drug and Alcohol Programs’ ability to promulgate rules and regulations and makes them subject to the regulatory review process, including publication, notice, and comment.

Department of Human Services

The Department of Human Services (DHS) has added November dates to its calendar of when it will be issuing Remittance Advices (RAs) and corresponding checks. Find the updated calendar here.
DHS has updated its information about provider enrollment and revalidation changes during the COVID-19 emergency.
DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin advising providers of updates of certain error status codes for personal care services subject to electronic visit verification, effective for claims received on or after October 22, 2021. The bulletin also gives providers an updated Provider Assistance Center contact e-mail address for their use. Go here to find this Medical Assistance Bulletin.
DHS’s Office of Mental Health and Substance Abuse Services has informed providers that certain regulatory requirements for on-site inspections have been reinstated as of October 18, 2021. This includes visitation requirements, the right to enter and inspect, and the requirement to undergo an annual inspection.
DHS’s Office of Medical Assistance Programs has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) of the procedure for submitting claims to DHS for a take-home supply of naloxone distributed to Medical Assistance beneficiaries. Find that bulletin here.
The federal Centers for Medicare & Medicaid Services (CMS) has issued guidance on coordinating care provided by out-of-state providers for children with medically complex conditions, including a description of best practices and other implementation considerations related to coordination of care from out-of-state providers for children with medically complex conditions. Go here to see CMS’s guidance memo to state Medicaid programs.

Department of Health

The Department of Health has published an update on point-of-care COVID-19 antigen tests and the interpretation of test results. The updated guidance replaces previous department guidance.

COVID-19: By the Numbers

The daily number of new COVID-19 cases declined slightly this week.

The number of new COVID-19-related deaths remains high but did not rise during the past week.

Every county in Pennsylvania continues to experience a high level of COVID-19 transmission.

The number of Pennsylvanians hospitalized because of COVID-19, on ventilators because of the disease, and being treated in hospital ICUs has remained relatively steady since the beginning of the month.
71.1 percent of Pennsylvanians 18 years of age and older are now fully vaccinated – more than 6.4 million people. 3000 Philadelphians and 58,000 other Pennsylvanians were recorded as completing a vaccine regimen in the past week.

Pennsylvania Rural Health Model

The federal Center for Medicare and Medicaid Innovation has posted its first evaluation of its Pennsylvania Rural Health Model, a federally approved program that seeks “…to improve population health outcomes, increase access to high-quality care, and improve the financial viability of acute care hospitals in rural Pennsylvania. Designed to reduce the risk of rural hospital closures, the Model seeks to stabilize participating hospitals’ finances by providing a predictable revenue stream through global budgets.” Go here and scroll down for information about the model and links to additional resources.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – October 27

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 27 at 1:00 p.m. Go here to register to participate.

Medical Assistance Advisory Committee – October 28

The Medical Assistance Advisory Committee will meet on Thursday, October 28 at 10:00 a.m. Go here to register to participate virtually.

Special Pharmaceutical Benefits Program Advisory Council – October 28

The next meeting of the Special Pharmaceutical Benefits Program Advisory Council will be held virtually on Thursday, October 28, 2021 at 10:00 a.m. To participate:

By Microsoft Teams meeting on computer or mobile app: Click here to join the meeting
Call-in – audio only – +1 412-648-8888,,943503419# United States, Pittsburgh or (866) 588-4789,,943503419# United States (Toll-free) – Phone Conference ID: 943 503 419#

Health Care Cost Containment Council – November 4

The Health Care Cost Containment Council will meet via teleconference on Thursday, November 4 at 10:00 a.m. The public is invited to participate. See this Pennsylvania Bulletin notice about how to join the meeting.

Organ Donation Advisory Committee Meeting – November 4

The Organ Donation Advisory Committee will hold a virtual meeting on Thursday, November 4 at 10:00 a.m. See this Pennsylvania Bulletin notice for information about how to join the meeting.

Traumatic Brain Injury Advisory Board – November 5

The Traumatic Brain Injury Advisory Board will hold a virtual meeting on Friday, November 5 at 10:00 a.m. See this Pennsylvania Bulletin notice for information about how to join the meeting.

Pharmaceutical Assistance Advisory Board – November 15

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, November 15, 2021 at 8:30 a.m. To participate virtually or by phone, go here for further information.

jsteinbock2021-10-22T21:03:04+00:00October 22nd, 2021|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of June 21-25

The following is an update of selected state health policy developments in Pennsylvania for the week of June 21-25, 2021. (Some of the language used below is taken directly from state documents.)

State-Wide Mask Mandate

The Department of Health announced that it is lifting its order requiring universal face coverings at 12:01 a.m. on Monday, June 28.   See the announcement here. The department continues to urge Pennsylvanians to follow CDC guidance for wearing a mask where required by law, rule, and regulations, including health care, local business, and workplace guidance.  For the protection of themselves and others, individuals who have not yet been vaccinated or are partially vaccinated are still encouraged to wear a mask when in public.

Legislative Update

The following are health care bills that have received third and final consideration in the state House and/or Senate as of Thursday, June 24. Both chambers will hold voting session on Friday and Saturday and we anticipate there will be additional health care-related measures passed. We will provide an update following the end of session on any pertinent bills.

Senate Bill 115 – establishes the Nurse Licensure Compact Act, which upon enactment makes the Commonwealth a party to the Nurse Licensure Compact with all other states that have joined the compact. The bill was passed by the House 146-55 and sent to the Governor’s desk.
Senate Bill 425 – amends the Medical Care Availability and Reduction of Error (MCARE) Act to permit a physician to fulfill their duty to obtain a patient’s or the patient’s authorized representative’s consent by a qualified practitioner prior to conducting surgery or administering radiation or chemotherapy blood transfusions, or medications and devices. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 484 – adds the chair of the State Veterans’ Commission or a designee to the Pennsylvania Long-term Care Council. The bill was unanimously passed by the House on June 24^th and sent to the Governor’s desk.
Senate Bill 618 – prohibits the use of vaccine passports by government entities. It also prohibits institutions of higher education from requiring proof of vaccination against COVID-19 to use a service, enter a building, or undertake an activity, including attending class in person. In addition, the bill further restricts the Secretary of Health’s ability to implement certain disease control measures for individuals who have not been exposed, potentially or otherwise, to a contagious disease. The bill was signed in the state House and Senate on June 24^th and sent to the governor. The governor has indicated he will veto

Department of Human Services

DHS and its Office of Medical Assistance Programs have posted a Medical Assistance Bulletin on the state’s Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program periodicity schedule reminding all providers they must revalidate the Medical Assistance enrollment of each service location every five years. Find the notice here.
DHS has added two COVID-19 antigen laboratory test codes to the Medical Assistance Program Fee Schedule, effective with dates of service on and after November 2, 2020.
DHS has proposed rescinding a regulation that prohibits a provider from leasing space within its office to another provider; see the proposed change in this Pennsylvania Bulletin notice. The agency will accept public comment on this proposal and it will become effective when final formal regulations are published in the Pennsylvania Bulletin.
DHS and its Office of Medical Assistance Programs have updated their guidance on providing direct services via telemedicine in the School-Based ACCESS Program during the COVID-19 emergency.
DHS has posted updates of six of its “provider quick tips.”
DHS has updated its list of providers participating in its Healthy Beginnings Plus program. See the list here.
DHS announced its proposed rates for non-public and county nursing facilities for FY 2022 in this Pennsylvania Bulletin notice. These figures will be posted on the DHS web site here.
DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.
DHS and its Office of Child Development and Early Learning have posted an FAQ on guidance for tuberculin skin testing and COVID-19 vaccinations.

Department of Health

Effective at midnight on June 23, 2021, the Department of Health terminated its order requiring skilled nursing facilities to complete a vaccine needs assessment survey since those facilities are now reporting to the federal government.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline significantly. The 174 new COVID-19 cases reported on Wednesday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths continues to decline significantly as well.
For the week from June 11 through June 17 the state’s overall COVID-19 test positivity rate was 1.4 percent, down from 1.9 percent last week and 2.9 percent the week before.
Sixty-four counties had a positivity rate lower than five percent, up from 62 last week, and no counties had a positivity rate greater than 20 percent for the eighth consecutive week.
Thirty-seven counties are currently experiencing low levels of community transmission of COVID-19, up from 22 last week; the remaining 30 Pennsylvania counties are experiencing moderate levels of community transmission and no counties are experiencing a high level of community transmission.
Since June 1 the number of Pennsylvanians hospitalized with COVID-19 has fallen 62 percent; the number on a ventilator has fallen 54 percent; and the number in hospital intensive care units has fallen 70 percent.
5.3 million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past month and only about 150,000 new vaccinations were reported in the past week. Another 760,000 people have been vaccinated in Philadelphia. According to the state, 59.4 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 62.2 percent of the entire population has now received at least the first dose of a vaccine.

Around the State

Two Pennsylvania children’s hospitals ranked among the best ten such hospitals in the U.S. in the latest rankings published by U.S. News & World Report: Children’s Hospital of Philadelphia ranked second and UPMC Children’s Hospital of Pittsburgh ranked ninth.

Two Pennsylvania-based health insurers, Highmark and Independence Blue Cross, are among five Blues plans joining forces in a new venture called Evio, a for-profit venture that will seek to make prescription drugs more affordable and improve health care outcomes. Learn more here.

Stakeholder Events

Maternal Mortality Review Committee

June 28 at 8:00

This meeting will be held via conference call. The purpose of the meeting is to discuss new and ongoing procedural issues relating to the review process for the committee. To join the call, dial +1 (267) 332-8737 and when prompted, enter the following conference code: 522 321 931#.

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

The purpose of this meeting is to discuss upcoming changes in the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss the upcoming changes. Interested parties can join the meeting in the following ways:

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Managed Long-Term Services and Supports Subcommittee Meeting

July 7 at 10:00 a.m.

This meeting will be held via webinar. Public comments will be taken after each presentation and questions can be entered in the chat box. Interested parties can participate in the following ways:

Webinar registration – go here

Dial in: 1-914-614-3221, access code 716-025-613

Remote captioning and streaming link – go here

Newborn Screening and Follow-Up Technical Advisory Board

July 15 at 10:00

The virtual public meeting will be conducted as a teleconference Skype meeting. The dial-in number is (267) 332-8737 and the conference access ID is 63145728#.

Special Pharmaceutical Benefits Program

July 29, 2021 at 10:00

This is a telephone meeting.

Join on your computer or mobile app

Click here to join the meeting

Or call in (audio only)

+1 412-648-8888,,785376728# United States, Pittsburgh

(866) 588-4789,,785376728# United States (Toll-free)

Phone Conference ID: 785 376 728#

Stakeholder Event Report

Medical Assistance Advisory Committee Meeting – June 24

Deputy DHS Secretary Sally Kozak announced that DHS will perform readiness reviews of the managed care organizations selected to participate in the latest HealthChoices program procurement. The procurement remains the subject of litigation so DHS will stop short of negotiating with the managed care organizations until there is a final decision in that case.

Stakeholder Events Materials

DHS has posted four presentations offered at the June 24 meeting of the Medical Assistance Advisory Committee. Those presentations were delivered by its:

Office of Mental Health and Substance Abuse Services (crisis services)
Office of Mental Health and Substance Abuse Services (medication-assisted treatment during the public health emergency)
Office of Medical Assistance Programs
Office of Long-Term Living

jsteinbock2021-06-26T13:46:01+00:00June 26th, 2021|Coronavirus, COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2022 budget, Pennsylvania state budget issues|Comments Off

Pennsylvania Health Policy Update for the Week of June 7-11

The following is an update of selected state health policy developments in Pennsylvania for the week of June 7-11, 2021. (Some of the language used below is taken directly from state documents.)

Governor Wolf

The Wolf administration has outlined guidelines for unvaccinated children under the age of 12 and for their families to stay safe from COVID-19. Those recommendations include parents of young children getting vaccinated themselves; children between the ages of two and 12 wearing masks in public settings, at events and gatherings, and any time they are indoors and around people from outside their own household; engaging in social distancing; and engaging in low-risk endeavors such as outdoor activities and small gatherings. Learn more from this Wolf administration news release.

The Wolf administration and the United Way of Pennsylvania have launched the Local Innovations in Vaccine Equity in Pennsylvania project (LIVE PA) to administer $4 million in mini-grants to local organizations seeking to reduce vaccine hesitancy and ensure equitable vaccine distribution throughout the state. LIVE PA is a collaboration between the Wolf administration’s Office of Advocacy and Reform and the departments of Health and Human Services, working with the United Way of Pennsylvania, to fund local, grassroots non-profit organizations to partner with certified vaccine providers to help the populations they serve overcome barriers to vaccination. The pilot phase of LIVE PA will target the zip codes and census tracts with the highest levels of health disparities, poverty, and vaccine inequity in Pennsylvania. Learn more from this Wolf administration news release.

Pennsylvania’s COVID-19 Disaster Declaration

The General Assembly invoked its new constitutional power on Thursday and voted to terminate the governor’s COVID-19 disaster declaration. House Resolution 106, which passed by a mostly party-line vote in both chambers, ends Governor Wolf’s recently renewed COVID-19 disaster declaration effective immediately. House Resolution 106 does not have to be signed by the governor.

The General Assembly also approved House Bill 854 to sustain all of the waivers and regulatory flexibilities that were still in effect under the declaration. Governor Wolf signed this bill on Friday. House Bill 854 extends the waivers and flexibilities until September 30, 2021 but agencies and authorities have the discretion to terminate their respective waivers earlier. If they choose to do so they must notify General Assembly leadership and the standing committees that have oversight authority. Some agencies have already begun terminating certain waivers. DHS published a Medical Assistance Bulletin in late April announcing its intention to reinstate prior authorization requirements that were in place pre-pandemic beginning on July 1.

Legislative Update

The following are health care bills that received third and final consideration in the state House and/or Senate during the week of June 7. We are tracking other health care bills as they move through the legislative process as well.

House Bill 854, which was amended to extend all of the waivers and regulatory flexibilities tied to the COVID-19 disaster declaration until September 30, 2021, as described above, also requires executive agencies to preserve all records relating to the orders of a declaration of disaster emergency issued by the governor relating to COVID-19. Governor Wolf signed the bill on Friday, June 11.
House Bill 118 requires a health care facility that possesses fetal remains to provide for the final disposition of those remains to be buried, in accordance with Pennsylvania Code, or cremated. The House passed the bill 118-83 and sent it to the Senate for consideration.
House Bill 253 establishes a task force to examine the opioid epidemic’s impact on infants and children. The House unanimously passed the bill on Monday and sent it to the Senate for consideration.
House Bill 1012 provides for a $130 per diem payment for ventilator or tracheostomy care provided by qualified skilled nursing facilities that meet certain criteria based on the volume and proportion of Medicaid patients to whom they provide these services. The House unanimously passed the bill on Tuesday and sent it the Senate for consideration.
House Bill 1024 makes numerous revisions to the state’s Medical Marijuana Act, including caregiver, dispensing, and criminal background check provisions. The House passed the bill 164-38 on Monday and sent it to the Senate for consideration.
House Bill 1033 permits health care practitioners to order diagnostic tests and prescribe, administer, or dispense antibiotic therapy for the duration the health care practitioner determines appropriate for patients with a clinical diagnosis of Lyme disease or a related tick-borne illness. The bill also imposes certain insurance coverage requirements. The House passed the bill 136-66 on Monday and sent it to the Senate for consideration.
House Bill 1500 prohibits an abortion if it is sought solely due to the sex of the fetus or if the fetus receives a prenatal diagnosis of Down syndrome. The House passed the bill 120-83 on Wednesday and sent it to the Senate for consideration.
Senate Bill 618 prohibits the state, as well as counties, municipalities, school districts, and colleges that are subsidized with state funds, from requiring proof of vaccination or vaccine passports. The bill also prohibits the Secretary of the Department of Health from requiring face masks, travel restrictions, social distancing, sheltering in place, and closures of privately owned businesses and also prohibits institutions of higher education that receive state subsidies from requiring their students, faculty, and staff to be vaccinated. Following final passage in the Senate the bill was sent to the House and referred to its Health Committee. It is scheduled to be considered “off the floor” on June 14.

Department of Health

The Department of Health has issued an update on its work to permit temporary nurse aides to become permanent nurse aides following the end of the public health emergency. The department has stopped accepting and processing temporary nurse aide applications while it reviews federal guidance on the training required to secure permanent status.

COVID-19: By the Numbers

The daily number of new COVID-19 cases continues to decline and has been in three digits for 14 days in a row. With 297 new COVID-19 cases reported, Monday marked the lowest new daily case count since March 25, 2020, when 276 new cases were announced.
The number of COVID-19 deaths is now declining significantly.
For the week from May 28 through June 4 the state’s overall COVID-19 test positivity rate was 2.9 percent, down from 3.8 percent last week and 4.5 percent the week before.
Fifty-five counties had a positivity rate lower than five percent, up from 28 last week, and no counties had a positivity rate greater than 20 percent for the sixth consecutive week.
Thirteen counties are currently experiencing low levels of community transmission of COVID-19, up from ten last week; 53 counties are experiencing moderate levels of community transmission; and only one county (McKean) is currently experiencing a substantial level of community transmission, the same number as last week.
In just 11 days since June 1, the number of Pennsylvanians hospitalized with COVID-19 has fallen 40 percent; the number on a ventilator has fallen 27 percent; and the number in hospital intensive care units has fallen 32 percent.
Five million Pennsylvanians have been fully vaccinated against COVID-19, according to the state’s COVID-19 dashboard. Growth in this number has slowed significantly over the past two weeks. Another 656,000 have been vaccinated in Philadelphia. According to the state, 56.6 percent of Pennsylvanians 18 years of age and older are now fully vaccinated and 60.1 percent of the entire population has now received at least the first dose of a vaccine.

Department of Human Services

DHS has released the latest issue of its Positive Approaches Journal, which aims to provide the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities to live an everyday life. Go here for information about the latest edition and a link to the publication itself.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs announced that Pennsylvania is one of four new states partnering with Shatterproof, a national non-profit organization dedicated to ending addiction, to develop and implement the Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS). During a 12-month implementation period the Department of Drug and Alcohol Programs will work with Shatterproof to customize and align ATLAS with ongoing initiatives in Pennsylvania. This project is part of the department’s 2020-2022 strategic plan goal to strengthen treatment systems by ensuring that care is delivered using evidence-based best practices. See the announcement and learn more about the expected program here.

Around the State

While the outdoor mask mandate is now history, some Philadelphians are having trouble letting go. WHYY shares their story.
They will have more changes to get used to as well: as of Friday, the Philadelphia Inquirer reports, Philadelphia’s mask mandates have been lifted.
Faced with declining numbers of residents willing to get COVID-19 vaccines, Philadelphia is joining the big money incentives movement, planning three drawings that will give away two top prizes of $50,000 and other four-figure sums as well, according to the Philadelphia Inquirer.
Lycoming County’s plan to develop a county health care center to provide preventive services to county employees took its latest step when the county awarded a contract for design and engineering services for the planned facility. The Williamsport Sun-Gazette offers the details.
Monongahela Valley Hospital will become part of Penn Highlands Healthcare later this year, according to the Pittsburgh Post-Gazette.
Erie County is taking its COVID-19 vaccination program on the road with a mobile clinic that will visit events, celebrations, workplaces, and more. GoErie explains how and why.
The federal Centers for Disease Control and Prevention has awarded Pennsylvania $36 million to address health disparities in rural and minority communities. PennLive has the story.
After two years on the market, Valley Forge Medical Center, an 88-bed addiction treatment center in Montgomery County, has been sold to Avenues Recovery Center, the Philadelphia Business Journal reports.
With 83 percent of its residents ages 12 and older at least partially vaccinated against COVID-19 and 92 percent of those 18 and older at least partially vaccinated, Chester County is easing some of its mask requirements, according to the Daily Local News.

Stakeholder Events

Medical Assistance Advisory Committee’s Consumer Subcommittee Meeting

June 23 at 1:00 p.m.

Medical Assistance Advisory Committee Meeting

June 24 at 10:00 a.m.

DHS Office of Long-Term Living – Financial Management Services Meeting

June 28 at 11:00 a.m.

From the meeting link:

https://pa-hhs.webex.com/pa-hhs/j.php?MTID=m15e2e495a802f00df6fa38c9e645237d

By meeting number:

Meeting number (access code): 132 280 2499

From a mobile device (attendees only):

1-408-418-9388,,1322802499## United States Toll

1-202-860-2110,,1322802499## United States Toll (Washington D.C.)

By phone:

+1-408-418-9388 United States Toll

+1-202-860-2110 United States Toll (Washington D.C.)

Meeting password: Stakeholder

From a video system or application

Dial 1322802499@pa-hhs.webex.com

You can also dial 173.243.2.68 and enter your meeting number

Stakeholder Events Documents

The Medical Assistance Advisory Committee met on May 27, 2021. The following documents from that meeting are now available:

jsteinbock2021-06-11T20:19:16+00:00June 11th, 2021|Coronavirus, COVID-19, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

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