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PA Health Policy Update for October 18

The following is an update of selected state health policy developments in Pennsylvania October 14 – 18.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro

Governor Shapiro has signed the following bills into law this week.

  • House Bill 155, now known as Act 96 of 2024, removes the requirement that direct care workers be interviewed in-person for a position.
  • House Bill 2084, now known as Act 101 of 2024, establishes a license for prescription drug virtual manufacturers.
  • House Bill 2127, now known as Act 102 of 2024, allows hospitals, birthing centers, physicians, and midwives or nurse-midwives to provide patients with a fact sheet regarding postpartum depression and counseling resources.
  • Senate Bill 668, now known as Act 109 of 2024, permits certified nurse aides to become certified medication aides in long-term care facilities, assisted living residences, and personal care homes.
  • Senate Bill 840, now known as Act 111 of 2024, creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. 

General Assembly

  • The state House of Representatives and Senate are scheduled to return to Harrisburg on Monday, October 21 for session. This is the last scheduled session week prior to the November 5 General Election. 
  • The House Children & Youth Committee will meet on Tuesday, October 22 at 10:00 a.m. in Room 515 of the Irvis Office Building to consider House Bill 1600, which expands oversight of juvenile justice facilities, and House Bill 2461, which establishes an Ebony Alert system.
  • The House Children & Youth Committee will also meet on Wednesday, October 23 at 10:00 a.m. in Room 515 of the Irvis Office Building for an informational meeting the CCAP Complex Case Task Force report and the DHS Blueprint report. 
  • The Senate Aging & Youth and Banking & Insurance Committees will hold a joint hearing on Wednesday, October 23 at 9:00 a.m. on protecting senior citizens, with a focus on House Bill 2064 and possible revisions to the Older Adult Protective Services Act. The meeting will be held in Hearing Room 1 of the North Office Building. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) that DHS will continue the alternative payment methodology and pay the Medical Assistance (MA) program fee schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit.
  • DHS has shared the agenda for the next Medical Assistance Advisory Committee (MAAC) meeting on Thursday, October 24. Find additional details on how to participate in Stakeholder Events below.

Department of Health 

The Department of Health (DOH) has reminded long-term care providers that its annual questionnaire of long-term care facilities must be completed and submitted to the department electronically by Friday, October 25, 2024. Any questions regarding the questionnaire may be directed to RA-dohbhssurveys@pa.gov.

Around the State  

Spotlight PA published an article about the increasing number of long-term care facility closures in the commonwealth. 

Pennsylvania pharmacists are receiving less money for drugs dispensed to Medicaid patients, the Pennsylvania Capital-Star reports. 

Stakeholder Events 

DHS – Consumer Sub-MAAC – October 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 23 at 1:00 p.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information.

DHS – Medical Assistance Advisory Committee – October 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on October 24 at 10:00 a.m. The meeting will be held in the Forest Room of the Keystone Building (400 North Street, Harrisburg, PA 17120). Click here for additional information. 

DOH – Special Pharmaceutical Benefits Program (SPBP) Advisory Council – October 24

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a hybrid public meeting on Thursday, October 24, 2024, from 10 a.m. to 3 p.m. Find more information in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – November 1

The Brain Injury Advisory Board (Board) will hold a public meeting on Friday, November 1, 2024, from 10 a.m. to 3 p.m. Find additional information in this Pennsylvania Bulletin notice.

2024-10-21T20:36:11+00:00October 18th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for October 18

PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.
  • DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20

PA Health Policy Update for July 12

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

FY 2024-2025 Budget Update 

Late Thursday evening the General Assembly passed Senate Bill 1001 – the General Appropriations Act – to fund Pennsylvania’s FY 2024-2025 budget. Governor Shapiro promptly signed Senate Bill 1001, as well as the various enabling pieces of legislation necessary to implement the budget, which marked the completion of the FY 2024-2025 budget process, more than 10 days after the commonwealth’s constitutionally mandated deadline.

In total, the FY 2024-2025 budget spends $47.6 billion, which represents a $2.7 billion, or 6.6 percent, increase over the prior fiscal year. It is nearly $700 million less than Governor Shapiro’s initial budget proposal. The FY 2024-2025 budget increases spending for K-12 and higher education. It also makes targeted investments in health and human services. The budget doesn’t include any tax increases or the Governor’s proposal to legalize cannabis. The final budget does include Governor Shapiro’s economic development proposal to create the Pennsylvania Strategic Investments to Enhance Sites (PA SITES) program and authorize up to $500 million in new funding to invest in site development, preparation, and readiness for businesses to locate or expand in Pennsylvania.

The following are key budget-related pieces of legislation.

General Assembly

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

  • The Senate passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 48-1. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The Senate passed House Bill 1633, which establishes restrictions on non-compete covenants for certain health care practitioners, on third and final passage. The House of Representatives subsequently voted to concur with the Senate’s amendments and sent the bill to Governor Shapiro for his signature.
  • The House of Representatives voted to concur with the Senate’s amendments to House Bill 1664, which prohibits insurers from restricting their method of payment to participating health care providers so that the only payment method is by credit card. The bill will now be sent to Governor Shapiro for his signature.
  • The Senate passed House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys, on third and final consideration. The bill will now be sent to Governor Shapiro for his signature.
  • The House of Representatives passed House Bill 2339, which establishes hospital price transparency reporting and disclosure requirements. The bill also stipulates penalties for noncompliance. The bill, which passed by a vote of 168-34, will now be sent to the Senate for consideration.
  • The House of Representatives also passed House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, on third and final consideration. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. The bill will now be sent to the Senate for consideration. 

The House and Senate have recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS will increase fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule, effective for dates of services on and after August 1, 2024. 

DHS has published the transcript and a recording of the July 2 meeting of the Long-Term Services and Supports Subcommittee. 

Centers for Medicare and Medicaid Services 

The Centers for Medical and Medicaid Services (CMS) has proposed amending the Medicaid clinic services regulation, which currently permits Medicaid payment for clinic services furnished outside of the four walls of a clinic only to individuals who are unhoused, to authorize federal reimbursement for services furnished outside the four walls of a freestanding clinic by IHS/Tribal clinics.  In addition, at state option, federal reimbursement also would be available for services provided by behavioral health clinics and services provided by clinics located in rural areas.  For clinics located in rural areas, CMS is not proposing a specific definition of rural but is seeking public comment on different alternative definitions for consideration in final rulemaking. 

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

The Organ Donation Advisory Committee will hold a public meeting on Thursday, August 8 from 10:30 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional information on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – July 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 24 at 1:00 p.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

DHS – Medical Assistance Advisory Committee – July 25

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on July 25 at 10:00 a.m. The meeting will be held in person. It will be located in the Forest Room of the Keystone Building – 400 North St., Harrisburg, PA 17120.

PA Health Policy Update for April 19

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

General Assembly

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

  • The House passed House Bill 1633, which prohibits non-compete agreements for health care practitioners and establishes certain notification requirements, by a vote of 150-50. The bill will now be sent to the Senate for consideration.
  • The House Professional Licensure Committee met on Monday, April 15 and favorably reported House Bill 2200, which makes certain changes to Pennsylvania statute that will enable the state to join, among others, the medical and nursing interstate licensure compacts. A recording of the meeting is viewable here.
  • The House Children and Youth Committee met on Tuesday, April 16 and favorably reported House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 321, which establishes an implementation deadline for the Department of Human Services’ enterprise case management system. A recording of the hearing is viewable here.
  • The House Health Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. A recording of the meeting is viewable here.
  • The House Judiciary Committee met on Wednesday, April 17 and favorably reported, among other bills, House Bill 2012, which establishes a state antitrust statute and expands notification requirements for health care facilities when there is a merger, acquisition, etc. A recording of the meeting is viewable here.
  • The House Democratic Policy Committee held a roundtable discussion on Tuesday, April 16 examining maternal health deserts. Find the agenda and testimony presented to the committee here.
  • The Senate Democratic Policy Committee held an informational meeting on Monday, April 15 examining pharmacy deserts. Find a recording of meeting and testimony presented to the committee here.

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

Department of Health 

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

Department of Human Services 

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

Stakeholder Events  

DHS – Consumer Sub-MAAC – April 24

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

DHS – Medical Assistance Advisory Committee – April 25

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

DOH – HIV Community Prevention Planning Committee – May 1

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

DOH – Organ Donation Advisory Committee – May 2

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

DOH – Brain Injury Advisory Board – May 3

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

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

PA Health Policy Update for April 12

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

General AssemblyHarrisburg, PA capital building

  • The state House of Representatives and Senate convened for voting session in Harrisburg this week. Following is an overview of selected health care-related legislative activity that occurred.
    • The House passed House Bill 1512, which provides for the coverage of telemedicine services, by a vote of 197-3. The bill will now be sent to the Senate for consideration.
    • The Senate unanimously passed House Bill 1795, which aligns state statute with federal requirements for source plasma donation centers. The bill was subsequently presented to the governor.
    • The House Human Services Committee met on Monday, April 8 and favorably reported House Resolution 373, which recognizes the week of April 11 through 17, 2024, as “Black Maternal Health Week” in Pennsylvania. The full House subsequently adopted the resolution. The committee also held an informational hearing on the delivery of quality home care services under Community HealthChoices. A recording of the meeting is viewable here.
    • The House Health Committee held an informational meeting on Thursday, April 11 on advancing social equity through cannabis legalization. A recording of the meeting is viewable here. 
  • The House will reconvene for voting session on Monday, April 15. The Senate is recessed until Monday, April 29.
  • The House Children and Youth Committee is scheduled to meet on Tuesday, April 16 at 10:00 a.m. to consider, among other bills, House Bill 1059, which updates the definition of sexual abuse or exploitation in the Child Protective Services law, and House Bill 2175, which codifies the Office of Child Advocate as a permanent office in the Department of Human Services. The hearing will be livestreamed here.
  • The House Health Committee is scheduled to meet on Wednesday, April 17 at 9:30 a.m. to consider, among other bills, House Bill 1608, which extends Medicaid coverage to doula services and creates a doula advisory board, and House Bill 2097, which provides Medicaid coverage of blood pressure monitors for pregnant or postpartum beneficiaries. The hearing will be livestreamed here. 

Department of Health 

  • The Department of Health (DOH) released updated guidance at the end of March for hospitals to submit attestations for new services and new or replacement equipment. The revised guidance narrows the scope of new and replacement equipment. Find the updated guidance here. 
  • DOH has issued a Health Advisory (PA-HAN 744) to alert health care providers of an increase in invasive meningococcal disease. Providers should have a heightened suspicion for invasive meningococcal disease and initiate antibiotic treatment immediately, particularly in people who are disproportionately affected by the current increase, including people ages 30-60 years, Black or African American people, and people with HIV.
  • DOH has invited stakeholders to a session with the Drug Enforcement Administration (DEA) to discuss pharmacy best practices when ordering and dispensing controlled substances, with a focus on medications for opioid use disorder. The session will be held virtually on Wednesday, April 24, 2024, from 12:30-2:00 p.m. Register here. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS provides coverage and payment for over-the-counter (OTC) oral contraceptives. 
  • The Office of Long-Term Living has made changes to the MA 376 based on recommendations from CMS and nursing facility admissions should use the updated form as of March 1. Click here for a bulletin outlining those changes and here for the updated form.
  • DHS has issued Provider Quick Tip #273 to remind providers of the policy for benefit limit exceptions (BLE) for certain dental services.
  • DHS has published a statement of policy to clarify the meaning of “purchase service agreement” relating to the contracted delegate function for the delivery of emergency involuntary commitment services. The statement of policy obsoletes Bulletin OMHSAS-21-05 regarding contracted delegate services. Find the statement of policy in this Pennsylvania Bulletin notice. 

Stakeholder Events  

DOH – WIC Program Advisory – April 16

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program) Advisory will meet on April 16, 2024, from 1 p.m. to 2 p.m. The purpose of this meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Patient Safety Authority – April 25

The Patient Safety Authority will hold a meeting of the authority’s board on Thursday, April 25 at 1:00 p.m. The meeting will be held virtually. Find details on how to participate in this Pennsylvania Bulletin notice.

DOH – Infant Hearing Screening Advisory Committee – April 25

The Infant Hearing Screening Advisory Committee established under the Infant Hearing Education, Assessment, Reporting and Referral (IHEARR) Act will hold a public meeting on Thursday, April 25 from 9:00 a.m. until 11:00 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-04-12T20:43:51+00:00April 12th, 2024|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 12

PA Health Policy Update for March 8

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

General Assembly

  • The Department of Human Services appeared before the Senate Appropriations Committee on Tuesday, March 5 for its FY 2024-2025 budget hearing. A recording of the first part of the hearing is viewable here and the second part is viewable here.
  • The Department of Human Services also appeared before the House Appropriations Committee this week to review its FY 2024-2025 budget proposal. A recording of the hearing is viewable here.
  • The Department of Health appeared before the Senate Appropriations Committee on Thursday, March 7 for its FY 2024-2025 budget hearing. A recording of the hearing is viewable here.
  • The state House of Representatives and Senate have concluded their FY 2024-2025 budget hearings. Both chambers are scheduled to return to session Monday, March 18. 

Department of Health 

  • The Department of Health (DOH) has published guidance related to Act 43 of 2023, which requires fentanyl and xylazine testing when a urine drug screening is conducted in an emergency department within an acute care hospital.
  • DOH has published a corrected list, as required, with a list of hospitals that have provided notice to the department that they may not provide emergency contraception or sexual assault emergency services due to various factors. Learn more from this Pennsylvania Bulletin notice.
  • DOH has announced that it will hold a statewide Health Equity Summit from April 4 – 5 in Harrisburg and virtually. The theme of the summit is “Joy and Justice.” Learn more from this press release.
  • DOH has issued a Health Advisory (PA HAN – 738), which contains guidance for health care facilities related to infection prevention and control for podiatric care. 

Department of Human Services

  • DHS has issued instructions advising providers participating in the Medical Assistance program on how they may continue to bill DHS directly for fee-for-service (FFS) claims while Change Healthcare’s billing and claims management systems remain unavailable due to a cyber-attack. Learn more here.
  • DHS has shared a federal funding opportunity for community programs for outreach and intervention with youth and young adults at clinical high risk for psychosis. Find additional information here.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through March 2024. Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to advise FQHCs and rural health clinics (RHCs) of certain updates to the PROMISe™ Provider Handbook. The department has updated Appendix E, which is a compilation of federal and state requirements and standards for the provision and payment of FQHC and RHC services. 

Medicaid Continuous Coverage Unwinding

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

Stakeholder Events  

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

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

DOH – HIV Community Prevention Planning Committee Meeting – March 27-28

The Statewide HIV Planning Group will hold public meetings on Wednesday, March 27 from 9:00 a.m. to 5:00 p.m. and on Thursday, March 28 from 9:00 a.m. to 4:30 p.m. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for February 16

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

General AssemblyHarrisburg, PA capital building

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

Department of Human Services 

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

Department of Health 

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

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

Independent Regulatory Review Commission

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

Medicaid Continuous Coverage Unwinding

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

Stakeholder Events

DHS – Consumer Sub-MAAC – February 21

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

DHS – Medical Assistance Advisory Committee – February 22

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

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

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

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

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

Long-Term Care Council – 2024 Meeting Dates

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

PA Health Policy Update for February 9

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

Governor Shapiro

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

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

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

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

General Assembly 

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

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

Department of Human Services 

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

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

Department of Health 

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

Medicaid Continuous Coverage Unwinding

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

 Stakeholder Events 

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

DHS – Medical Assistance Advisory Committee – February 22

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

PA Health Policy Update for January 26

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

Department of Human Services 

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

Department of Health 

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

Department of Drug & Alcohol Programs

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

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

Board of Pharmacy 

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

Medicaid Continuous Coverage Unwinding

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

Stakeholder Events

Board of Nursing – January 29

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

DOH – HIV Community Prevention Planning Committee – January 31

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

DOH – Organ Donation Advisory Committee – February 1

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

DOH – Brain Injury Advisory Board – February 2

The Brain Injury Advisory, formerly the Traumatic Brain Injury Advisory Board, will hold a public meeting on Friday, February 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network (6340 Flank Drive, Harrisburg, PA 17112) in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

PA Health Policy Update for January 19

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

Governor Shapiro 

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

General Assembly 

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

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

Department of Human Services 

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

Department of Health 

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

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

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

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

Medicaid Continuous Coverage Unwinding

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

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

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

DHS – Medical Assistance Advisory Committee – January 25

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

Patient Safety Authority – January 25

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

DOH – HIV Community Prevention Planning Committee – January 31

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

DOH – Organ Donation Advisory Committee – February 1

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

DOH – Brain Injury Advisory Board – February 2

The Brain Injury Advisory, formerly the Traumatic Brain Injury Advisory Board, will hold a public meeting on Friday, February 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network (6340 Flank Drive, Harrisburg, PA 17112) in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

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