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PA Health Policy Update for May 16

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

Election Update

Pennsylvania’s 2025 Primary Election will be held next Tuesday, May 20. On the ballot there are judicial candidates seeking to fill vacancies on the Commonwealth and Superior Courts, along with municipal races. Find additional election information on the Department of State’s website here.  

Governor Shapiro 

On Thursday, May 15 Governor Shapiro visited Crozer-Chester Medical Center, which is ceasing operations, in Delaware County to highlight efforts to support impacted workers, maintain emergency medical services, and “hold private equity firms accountable.” Find additional information in this press release. 

General Assembly

The state House of Representatives and Senate convened for voting session this week. The following is an overview of selected legislative activity that occurred.

  • The House of Representatives passed an amended House Bill 561, which while still prioritizing non-narcotic medication-assisted treatment (MAT) expands Act 80 to include all FDA-approved MAT. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. The bill will now be sent to the Senate for consideration. 
  • The House of Representatives passed House Bill 309, which amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license. The bill will now be sent to the Senate for consideration. 
  • The House Health Committee met on Wednesday, May 14 and favorably reported House Bill 704, which establishes the “Pennsylvania Neurodegenerative Disease Research Program.” A recording of the hearing is viewable here. 
  • The House Aging & Older Adult Services Committee held a joint hearing with the House Health Committee on Wednesday, May 14 regarding Pennsylvania’s registered nurse aide program. A recording of the hearing is viewable here. 
  • The Senate Banking & Insurance Committee met on Tuesday, May 13 and favorably reported Senate Resolution 27, which directs the Legislative Budget and Finance Committee to study the feasibility of establishing a no-fault catastrophic loss fund to provide payment for claims brought as the result of birth-related neurological injuries. A recording of the hearing is viewable here. 
  • The House Human Services Committee met on Tuesday, May 13 and favorably reported House Bill 1429, which requires a study on the feasibility of implementing chip-enabled electronic benefit cards (EBT) for the Supplemental Nutrition Assistance Program (SNAP). A recording of the hearing is viewable here. 
  • The Senate Veterans Affairs & Emergency Preparedness Committee met on Monday, May 12 and favorably reported, among other bills, Senate Bill 95, which permits EMS providers to leave naloxone with a caregiver of a patient who overdosed.

The House of Representatives and the Senate are now recessed until Monday, June 2. 

Department of Human Services

  • The Department of Human Services (DHS) has announced it will hold a listening session on May 19 from 1:00 – 2:30 p.m. entitled, “Food is Medicine: Screening and Referral.” This is part of DHS’ Keystone of Health Section 1115 demonstration waiver initiative. The listening session is intended for representatives from health care and other settings that interact with consumers that may be eligible for Food is Medicine programs. Find additional information and register here.
  • DHS has announced that the Office of Mental Health and Substance Abuse Services (OMHSAS) is conducting a survey, which will be the first step to begin the development of one proposed chapter of licensing regulations for inpatient psychiatric services in psychiatric units of general hospitals, private psychiatric hospitals, and extended acute care services located within those inpatient settings. The survey is for all stakeholders, including licensed providers, and will remain open until May 26. Find the survey here.
  • DHS has issued a Medical Assistance Bulletin with the U.S. Department of Health & Human Services’ (HHS) Centers for Disease Control and Prevention (CDC) 2025 recommended child and adolescent immunization schedule.
  • DHS has also issued a Medical Assistance Bulletin to advise dental providers enrolled in the Medical Assistance (MA) program that will accept the 2024 American Dental Association (ADA) claim form effective May 1, 2025.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of June. Find the updated calendar here.
  • DHS has announced the implementation of the 2025 Federal Poverty Income Guidelines (FPIG), which were issued by HHS and published at 90 FR 5917 on January 17, 2025. Find additional information in this Pennsylvania Bulletin notice. 

Around the State

  • Spotlight PA has written an article about private equity, its role in health care companies, and the scrutiny its drawing from critics. Spotlight also wrote an article about health systems’ opposition to initiatives aimed at implementing more stringent health care transaction oversight.  
  • The Pittsburgh Post-Gazette has published an article about Medicaid cuts being contemplated by Congress and their potential impact on providers in Fayette County. 
  • The Associated Press covered Governor Shapiro’s remarks about the potential impact of Medicaid proposals being considered by Congress. 
  • The Philadelphia Inquirer has reported about this what is anticipated to be this year’s biggest election issue, the retention of three sitting Pennsylvania Supreme Court justices. 

Stakeholder Meetings

DHS – Consumer Sub-MAAC – May 21

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 21 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – May 22

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on May 22 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Spinal Cord Research Committee – May 23

The Spinal Cord Research Advisory Committee will hold a public meeting on Friday, May 23 from 10:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-05-16T19:25:46+00:00May 16th, 2025|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 16
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PA Health Policy Update for April 18

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

Governor Shapiro 

An arsonist attacked the Governor’s Residence in Harrisburg on Sunday, April 13, which forced the Governor and his family, who were present at the time of the attack, to be evacuated. The suspect has been arrested and formally charged with attempted murder, terrorism, and other charges. Find additional details, and the Governor’s statement on political violence, in this press release. 

General Assembly

  • The state House of Representatives and Senate were recessed this week. The House of Representatives will return to Harrisburg on Tuesday, April 22. The Senate will remain recessed until Monday, May 5.
  • The House Majority Policy Committee held an informational meeting on Monday, April 14 examining the impact of the life science sector on advanced manufacturing and health care workforce development. Find additional details and a recording of the meeting here.
  • The House Majority Policy Committee also held an informational meeting on Tuesday, April 15 examining midwifery modernization and maternal health deserts in Pennsylvania. Find additional details and a recording of the meeting here.
  • The House Insurance Committee has scheduled an informational meeting on Wednesday, April 23 at 9:15 a.m. to examine infertility care in Pennsylvania. The meeting will be held in Room 523 of the Irvis Building and livestreamed here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers enrolled on the Medical Assistance (MA) program of updates to the MA program fee schedule, including the addition of new procedure codes and the end-dating of certain codes based on provider request and clinical review. These changes will take effect May 1.
  • DHS has issued a Medical Assistance Bulletin to advise federally qualified health centers (FQHCs) and rural health clinics (RHCs) of the procedure codes, modifiers, and places of service to utilize when billing for covered services provided to Medicaid beneficiaries.
  • DHS Secretary Val Arkoosh along with other health-related cabinet officials participated in the Western Pennsylvania Regional Rural Healthcare Summit to discuss opportunities and challenges communities face accessing health care services. Find more information in this press release.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through the month of May. Find the updated calendar here. 

Department of Health 

  • The Department of Health has announced that an individual from another state tested positive for measles while visiting Lancaster County after a trip to Texas, creating a potential for exposure to others. Find additional details and information about measles from DOH here.
  • The Newborn Screening and Follow-up Technical Advisory Board had voted to recommend the addition of Metachromatic leukodystrophy (MLD), a lysosomal storage disorder, to the commonwealth newborn screening panel effective January 1, 2026. Find additional information in this Pennsylvania Bulletin notice.
  • DOH has announced it will hold four public comment sessions to provide stakeholders an opportunity to comment on the development of the 2026 State Plan for the Pennsylvania Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program). Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Around the State  

Crozer Health’s ongoing challenges, as well as efforts to transition certain service lines were the subject of an article published by The Philadelphia Inquirer.  

PA has published an article about measles, the increasing cases nationally, and growing vaccine hesitancy. 

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – May 2

The Brain Injury Advisory Board will hold a public meeting on Friday, May 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 Cumberland conference room. Find additional details in this Pennsylvania Bulletin notice.

2025-04-18T17:47:31+00:00April 18th, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 18
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PA Health Policy Update for April 11

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

General Assembly

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

  • The House of Representatives passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 409, which requires health care providers to inform patients that they will be receiving their test results in their electronic health record, or that they can request to receive the results in the mail. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Monday, April 7 to examine potential updates to the Older Adult Protective Services Act (OAPSA). A recording of the meeting is viewable here.
  • The House Human Services Committee met on Tuesday, April 8 and favorably reported House Bill 561, which expands Act 80 to include all FDA-approved medication assisted treatment, and House Bill 1117, which updates language defining DDAP’s duties and responsibilities. A recording of the meeting is viewable here.
  • The House Insurance Committee met on Tuesday, April 8 and favorably reported House Bill 433, which eliminates out-of-pocket costs for diagnostic imaging related to breast cancer. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, April 9 and favorably reported, among other legislation, the following pertinent bills. A recording of the meeting is viewable here.
    • House Bill 69, which expands the existing Cancer Drug Repository program to other prescription drugs.
    • House Bill 79, which establishes uniform hospital-based financial assistance forms and requirements.
    • House Bill 1104, which caps the costs of obtaining electronic medical records.

The House of Representatives and the Senate have now recessed. The House will reconvene Tuesday, April 22 and the Senate will reconvene Monday, May 5. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to remind physicians, physician assistants (PAs), and certified registered nurse practitioners (CRNPs) enrolled in Medicaid that they are able render topical fluoride varnish (TFV) services to Medicaid beneficiaries.
  • DHS has issued a reminder to all participating Medicaid providers of the need to complete a “MA 112 Form” after the birth of a child to a mother enrolled in Medicaid in order to notify the mother’s respective county assistance office (CAO).  The “MA 112 Form” should be completed and submitted within three working days of the child’s birth.
  • DHS has published final notice of its funding allocation for FY 2024-25 for several classes of inpatient disproportionate share hospital (DSH) and supplemental payments to Medicaid-enrolled, qualifying inpatient acute care general hospitals. Find additional information in this Pennsylvania Bulletin notice. 

Around the State  

  • CBS News has published an article about the continued challenges facing Crozer Health in Delaware County. An attorney for Prospect Medical Holdings, the parent company of Crozer, indicated Crozer would start transitioning certain service lines to other providers.
  • Pennsylvania’s home care industry and its need for additional funding was the focus of an article by Politics PA this week.
  • The Pennsylvania Capital-Star has published an article about increasing measles cases in the state and some counties’ lagging vaccination rates. 

Stakeholder Meetings

DOH – WIC State Advisory Board – April 22

The WIC State Advisory Board will hold a public meeting on April 22 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice. 

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

DHS – Consumer Sub-MAAC – April 23

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 23 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – April 24

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on April 24 at 10:00 a.m. The meeting will be held virtually. Click here for additional information. 

DOH – Renal Disease Advisory Committee – April 25

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, April 25 from 10:00 a.m. to 12:00 p.m. The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

The Patient Safety Authority – April 29

The Patient Safety Authority board will hold a public meeting on Tuesday, April 29 at 10:30 a.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-11T22:36:44+00:00April 11th, 2025|Governments, Medical Assistance Bulletin, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 11
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PA Health Policy Update for January 10

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

General Assembly 

The General Assembly convened on Tuesday, January 7 to officially commence the 2025-2026 legislation session. Members of the state House of Representatives and Senate who were newly elected or re-elected were sworn in. In addition, the two chambers elected their respective presiding officers, adopted rules, and established standing committees.

At the conclusion of Tuesday’s legislative business, the House and Senate recessed until Monday, January 27. Following are their respective 2025 session calendars.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has approved the remainder of the commonwealth’s request for a five-year section 1115 demonstration – Bridges to Success: Keystones of Health for Pennsylvania. You will recall Pennsylvania received approval from CMS back in November to implement multi-year continuous eligibility for Medicaid-eligible children through age six and one year of continuous coverage for Medicaid-eligible citizens returning from a state correctional facility. The Department of Human Services (DHS) has stated it, “will work through the state budget process to determine next steps for potential implementation.” Find CMS’ approval letter to DHS here. 

Department of Human Services 

  • DHS has issued updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for Anticonvulsants submitted for prior authorization. Find additional information in this Medical Assistance Bulletin.
  • DHS has issued a Medical Assistance Bulletin to advise providers that it has updated the Admissions Notice Packet (MA 401) form due to an increase in the personal needs allowance (PNA) deduction amount. This bulletin applies to nursing facilities, intermediate care facilities, and long-term care facilities enrolled in the Medical Assistance program. 

Insurance Department

The Pennsylvania Insurance Department (PID) has announced that 259 Pennsylvanians successfully appealed denied health service claims through PID’s new Independent External Review process. Of the total health service denials submitted for review in 2024, 50.1 percent were overturned.

PID has also shared information related to its efforts to increase health insurance transparency through several reports available to the public, including its annual Transparency in Coverage Report for ACA Health Plans, which outlines data on claims, denials, and appeal information, and its inaugural ACA and Qualified Health Plans (QHP) Summary. Find additional information in this press release.

Around the State

  • WHYY has written about the Pennsylvania Insurance Department’s external review program which received 517 health service denial appeals in 2024. 259 of those denials were overturned. 
  • City & State Pennsylvania has published an article about the General Assembly’s first session day of 2025. 
  • The Pittsburgh Post-Gazette has written an article about a study released by Pennsylvania Partnerships for Children that kids largely stayed insured despite uncertainties during the Medicaid eligibly redetermination process following the conclusion of the COVID-19 public health emergency. 

Stakeholder Meetings

DOH – WIC Advisory Board – January 14

The WIC State Advisory Board will hold a meeting on January 14 from 1:00 p.m. to 2:00 p.m. The purpose of the meeting is to collaborate to gather suggestions of strategies for increasing participation and improving the WIC program to better support participants. Find details on how to participate in this Pennsylvania Bulletin notice.

DHS – Consumer Sub-MAAC – January 22

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 22 at 1:00 p.m. The meeting will be held virtually. Click here for additional information.

DHS – Medical Assistance Advisory Committee – January 23

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on January 23 at 10:00 a.m. The meeting will be held virtually. Click here for additional information.

DOH – Special Pharmaceutical Benefits Advisory Council – January 30

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, January 30 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2025-01-10T20:27:58+00:00January 10th, 2025|Federal Medicaid issues, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 10
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PA Health Policy Update for January 3

The following is an update of selected state health policy developments in Pennsylvania December 23 – January 3.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The state House of Representatives and Senate will convene on Tuesday, January 7 at 12:00 p.m. to swear in newly elected and re-elected members for the 2025-2026 legislative session. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that the department is adding doula services to the Medical Assistance (MA) program fee schedule and will pay enrolled certified perinatal doulas beginning January 1, 2025.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has issued a bulletin announcing the Peer Support Services (PSS) and PSS Provider Handbook has been updated to reflect the requirements for PSS. The revisions better clarify which requirements apply to OMHSAS licensure and which apply to MA payments. Additional updates include staff qualifications and requirements for certified peer specialists and their supervisors and telehealth requirements.
  • DHS has provided final notice of its intent to adjust the managed care assessment fixed fee. Effective January 1, 2025, the fee will be $30.47 per member per month. The aggregate fiscal impact for this change in FY 2024-2025 will be $208.6 million dollars in additional assessment revenue. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) has issued comments to the Department of Human Services (DHS) regarding the transition to the Patient-Driven Payment Model (PDMP) for non-public and county nursing facilities. Find additional information in this Pennsylvania Bulletin notice.   

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $3.8 billion in General Fund revenue in December, which was $87.2 million, or 2.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $20.2 billion, which is $97.1 million, or 0.5 percent, below estimate.

Around the State  

  • Spotlight PA has written an article about the scrutiny, and at times, lack of transparency over how counties across Pennsylvania are spending billions of dollars in opioid settlement money.
  • Writing for The Philadelphia Inquirer, Harold Brubaker has published an article about Pennsylvania’s new law limiting noncompete agreements for health care practitioners. Brubaker also wrote an article about the success and challenges of Pennsylvania-based biopharmaceutical companies in 2024. 
  • The Pittsburgh Post-Gazette has reported that Sharon Regional Medical Center announced an agreement has been made with Tenor Health Partners to take over operations at the hospital, avoiding the anticipated January 6th closure. 

Stakeholder Meetings

DOH – HIV Planning Group – January 15

The Statewide HIV Planning Group will hold a public meeting on Wednesday, January 15 and Thursday, January 16 from 9:00 a.m. to 4:30 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – January 17

The Renal Disease Advisory Committee will meet on Friday, January 17 at 10:00 a.m. to discuss new and ongoing issues relating to the treatment of chronic renal disease and the department’s programs related to care and treatment. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Preventive Health Services Block Grant Advisory Committee – January 27

The Preventative Health and Health Services Block Grant Advisory Committee will hold a public meeting on Monday, January 27 from 9:00 a.m. to 11:00 a.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Brain Injury Advisory Board – February 7

The Brain Injury Advisory Board will hold a public meeting on Friday, February 7 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2025-01-03T18:57:52+00:00January 3rd, 2025|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for January 3
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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
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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
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PA Health Policy Update for July 12

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

FY 2024-2025 Budget Update 

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

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

The following are key budget-related pieces of legislation.

General Assembly

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

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

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

Department of Human Services 

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

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

Centers for Medicare and Medicaid Services 

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

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

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

DHS – Consumer Sub-MAAC – July 24

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

DHS – Medical Assistance Advisory Committee – July 25

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

2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for July 12
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PA Health Policy Update for April 19

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

General Assembly

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

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

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

Department of Health 

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

Department of Human Services 

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

Stakeholder Events  

DHS – Consumer Sub-MAAC – April 24

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

DHS – Medical Assistance Advisory Committee – April 25

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

DOH – HIV Community Prevention Planning Committee – May 1

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

DOH – Organ Donation Advisory Committee – May 2

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

DOH – Brain Injury Advisory Board – May 3

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

2024-04-19T20:14:21+00:00April 19th, 2024|Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 19
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PA Health Policy Update for 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
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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