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PA Health Policy Update for June 16

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

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) is maintaining an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code. Additional updates and resources about the Medicaid eligibility renewal process may be found here.

U.S. Health & Human Services (HHS) Secretary Xavier Becerra has sent a letter to governors urging states to adopt all options that HHS has offered to help eligible individuals and families maintain their health coverage during the redetermination process and leverage all partners to support individuals and families to complete renewal forms. 

Governor Shapiro

Governor Shapiro signed House Bill 739 (Act 2 of 2023) into law on Wednesday. Act 2 creates new cyber security-related requirements for health insurers and allows the Insurance Commissioner to adopt National Association of Insurance Commissioners (NAIC) Valuation Manual exemptions by notice in the Pennsylvania Bulletin. 

General Assembly

The state House returned to Harrisburg for voting session Monday, June 12. The following are selected health-related proceedings.

  • The House Insurance Committee held a voting meeting Monday, June 12 at 11:00am to consider HB 1050, requiring health insurers to cover preventive health care services without cost-sharing. The bill was reported as amended. A recording of the meeting can be viewed here. The Insurance Committee was expected reconvene on Wednesday, June 14 to consider HB 1140; however, the meeting was cancelled.
  • The House Health Committee held a voting meeting Wednesday, June 14 to consider the following bills:
    • HB 78, establishing the Medical Debt Relief Program. The bill was reported as amended by a vote of 18-3.
    • HB 807, providing for perimenopause and menopause education. The bill was reported as committed by a vote of 20-1.
    • HB 817, amends the Pharmacy Act to provide education on drug take back programs. The bill was reported as committed by a vote of 20-1
    • HB 818, creates the Pharmaceutical Collection Sites Educational Program within the Department of State. The bill was reported as amended by a vote of 18-2.
    • HB 1209 and HB 1407, add two enforcement mechanisms to the Tobacco Product Manufacturer Directory Act and the Tobacco Settlement Agreement Act, which resolved legal claims between the commonwealth and participating manufacturers relating to health care costs for treating smoking-related illnesses. The bills were unanimously reported as committed.
    • HB 1351, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership.
    • SB 262, amends the Maternal Mortality Review Act to would add “severe maternal morbidity” to the list of reportable events within the Pennsylvania Department of Health. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here. 

The Senate will return to Harrisburg Monday, June 19 and the House will return Tuesday, June 20 for voting session. The following are selected health-related proceedings.

  • The Senate Health & Human Services Committee will hold a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which require an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership.
    • SB 817, which creates a primary care workforce initiative for our Federally Qualified Health Centers (FQHCs).
  • Immediately following, the Senate Health & Human Services Committee will hold a public hearing to consider the nomination of Dr. Latika Davis-Jones for Secretary of the Department of Drug and Alcohol Programs (DDAP).

Both meetings will be held in Room 8E-A East Wing and will be live streamed here. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (2023 – PAHAN – 704) notifying providers of an anticipated increase in Legionellosis cases due to seasonality.

Department of Human Services

  • The Department of Human Services (DHS) has shared the agenda for the June 22 Medical Assistance Advisory Committee (MAAC) meeting. In advance of the meeting, DHS has also shared the public input it received regarding the Drug Utilization Review (DUR) Board prior authorization guideline briefing documents discussed at the May 25 meeting.
  • DHS has issued a Medical Assistance Bulletin informing providers the department has rescinded the statement of policy codified at § 1101.51a, which clarified the term “within a provider’s office” and updated the process for the enrollment or revalidation of providers that are in co-located arrangements. Effective January 14, 2023, providers who are in co-location arrangements no longer need to complete the attestation form during enrollment or revalidation in the MA Program.
  • The Executive Board approved a reorganization of DHS. Additional information and a revised organizational chart is available in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of a procedure code to the Medical Assistance (MA) Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc. The effective date and MA Fee for the code is indicated in this Pennsylvania Bulletin notice. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has issued Licensing Alert 04-2023 to provide clarification on how to calculate client to counselor ratios for inpatient, non-hospital treatment and rehabilitation facilities for regulatory compliance. 

Department of Aging 

The Department of Aging held its first regional town hall in southeastern Pennsylvania to seek input on Pennsylvania’s Master Plan for Older Adults, which will be a 10-year, state-led strategic plan designed to transform the infrastructure and coordination of services for older Pennsylvanians. Governor Shapiro’s executive order directing the department to develop the plan is available here. 

Stakeholder Events

DHS – Medical Assistance Advisory Committee Meeting – June 22

The Medical Assistance Advisory Committee (MAAC) will meet on June 22, 2023 at 10:00 a.m. Individuals interested in participating may register here. 

DOH – Medical Marijuana Advisory Board – June 28

The Medical Marijuana Advisory Board will meet on June 28 from 10:30 a.m. to 12:30 p.m. to discuss Medical Marijuana Program updates. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

The Pennsylvania Insurance Department (PID) has announced it is accepting public comment on its 1332 State Innovation Waiver Reinsurance Program beginning June 1 and ending June 30. PID will also hold an in-person forum for public comment on Thursday, June 28 from 1:00 p.m. to 2:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-17T00:10:13+00:00June 16th, 2023|Federal Medicaid issues, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for June 16
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PA Health Policy Update for May 5

The following is an update of selected state health policy developments in Pennsylvania from May 1 – 5.  (Some of the language used below is taken directly from state documents.) 

Medicaid Eligibility Redetermination 

The Department of Human Services (DHS) published the first section of an online dashboard with Medicaid continuous coverage unwinding data. The data on this dashboard tracks the renewal process by county and zip code.

Additional updates and resources about the Medicaid eligibility renewal process may be found here. 

Governor Shapiro

Governor Shapiro signed the first bill of his administration on Monday. Act 1, formerly Senate Bill 8, requires insurers to cover all costs associated with genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. View this press release for additional information.

The Shapiro administration announced today that all commonwealth agencies completed a comprehensive review of their respective licensing, certification, and permitting processes as directed in the governor’s January 31 executive order. The administration will now work to establish “efficient processing times” for all permits and licenses. 

General Assembly

  • The state House and Senate returned to Harrisburg on May 1 for voting session. Below is coverage of selected health-related proceedings.
    • The House Health Committee held a public hearing Tuesday, May 2 on HB 106, the Patient Safety Act, which sets nursing staffing ratios. A recording of the hearing can be viewed here.
    • Representative Jennifer O’Mara (D-Delaware), Representative Eddie Day Pashinski (D-Luzerne) and Senator Carolyn Comitta (D-Chester) held a press conference Wednesday on hospital closure reform. More information can be found here.
    • The House Republican Policy Committee held a public hearing Thursday, May 4 on hospital pricing transparency. A recording of the hearing can be viewed here.
    • The Senate voted to confirm Governor Josh Shapiro’s nominee for the Secretary of Aging, Jason Kavulich, this week. A recording of the confirmation hearing in the Senate Aging and Youth Committee can be viewed here.
    • The Senate Health and Human Services Committee held a voting meeting on Tuesday, May 2 to consider among other bills:
      • SB 100, Establishing the Lyme Disease and Related Tick-Borne Illness Diagnosis and Treatment Act. The bill was unanimously reported as committed.
      • SB 262, Amends the Maternal Mortality Review Committee Act regarding reportable events. The bill was unanimously reported as committed.
      • SB 414, Expanding access to Sexual Assault Nurse Examiners (SANE). The bill was unanimously reported as committed.
      • SB 500, Provides for Medicaid Coverage for Pasteurized Donor Human Milk. The bill was unanimously reported as committed.
      • SB 549, Requires consent for pelvic, rectal, and prostate exams. The bill was unanimously reported as amended.
      • SB 555, Reducing the loaded mileage requirements for EMS Medicaid reimbursement. The bill was unanimously reported as committed.

A recording of the meeting can be viewed here.

  • The state Senate will return to Harrisburg for voting session Monday, May 8. The state House is recessed and will return to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.
    • The House Aging and Older Adult Services Committee will hold an information meeting Wednesday, May 10 at 10:00am to receive updates from local Area Agencies on Aging and to discuss scams targeting older adults. The meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here. 

Office of the Attorney General 

Attorney General Michelle Henry issued the following Frequently Asked Questions (FAQ) document regarding medication abortion and mifepristone access in Pennsylvania. 

Department of Health 

The Department of Health’s (DOH) Division of Newborn Screening and Genetics, with support of the Newborn Screening and Follow-up Technical Advisory Board, is proposing that Guanidinoacetate Methyltransferase (GAMT) deficiency screening be added effective January 1, 2024 to the supplemental conditions mandated for screening. Additional information can be viewed in this Pennsylvania Bulletin notice. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to increase the funding and amend the payment methodology for the COVID-19 disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for FY 2022-23. Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its intent to allocate funding and amend the qualifying criteria and payment methodology allocation for DSH payments to acute-care general hospital trauma centers. These payments will amount to $18.034 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS published final notice of its funding allocation for FY 2022-23 supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance (MA) Program, and to provide financial relief to hospitals during the COVID-19 pandemic. Learn more from this Pennsylvania Bulletin notice.
  • DHS published updates to the Medical Assistance (MA) Program Fee Schedule for administration of a booster dose of the SARS-CoV-2 vaccine manufactured by Novavax. Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced the temporary extension of the Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for the administration of COVID-19 vaccines administered during a COVID-19 vaccine-only visit. The APM will be extended beyond the end of the federal PHE to September 30, 2024. Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued an updated Provider Quick Tip (#263) regarding the electronic submission process in the PROMISe Portal for Office of Medical Assistance Fee-for-Service (FFS) and Office of Long Term Living (OLTL) 180-day exception requests and other claims requiring documentation.

Revenue Collection Update

The Department of Revenue announced Pennsylvania collected $5.7 billion in General Fund revenue in April, which was $51.1 million, or 0.9 percent, more than anticipated. Fiscal year-to-date General Fund collections total $37.9 billion, which is $1.2 billion, or 3.3 percent, above estimate. 

Stakeholder Events

DOH – WIC Advisory Board – May 10

The WIC Program Advisory will meet on May 10 from 1:00 p.m. – 2:00 p.m. Additional information and details on how to participate can be viewed in this Pennsylvania Bulletin notice. 

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

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

DOH – HIV Community Prevention Planning Committee – May 18

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, May 17 and Thursday, May 18. For information on how to participate, review this Pennsylvania Bulletin notice.

DHS – Medical Assistance Consumer Subcommittee – May 24

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

DHS – Medical Assistance Advisory Committee – May 25

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

 

2023-05-05T21:19:20+00:00May 5th, 2023|Federal Medicaid issues, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 5
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PA Health Policy Update for April 21

The following is an update of selected state health policy developments in Pennsylvania from April 17 -21.  (Some of the language used below is taken directly from state documents.) 

Governor Shapiro

Governor Shapiro announced this week his administration submitted a notice of intent to temporarily add xylazine, commonly known as “tranq,” to the list of schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. This step is an effort to limit access to xylazine, which is increasingly being found in Pennsylvania’s illicit drug trade. The administration also intends to schedule nitazenes, a class of synthetic opioids, as a schedule I drug. 

General Assembly

  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 20 on The State Master Plan on Aging. A recording of the hearing can be viewed here.
  • The House Children and Youth Committee held a public hearing Thursday, April 20 on overcrowding in Pennsylvania’s Juvenile Detention Facilities. A recording of the hearing can be viewed here.
  • The state House and Senate will return to Harrisburg on Monday, April 24 for voting session. Following are selected health-related committee proceedings.
    • The Senate Consumer Protection and Professional Licensure Committee will hold a public hearing Monday, April 24 at 10:00am on professional licensing delays in health care. The hearing will be held in Hearing Room 1 of the North Office Building and will be livestreamed here.
    • The House Insurance Committee will hold a voting meeting on Monday, April 24 at 11:00 a.m. to consider among other bills, SB 8 which requires insurers to cover all costs associated for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and also requires insurers to cover all costs associated with a supplemental breast screening by MRI or Ultrasound for women at increased risk of breast cancer. The meeting will be held in Room B31 of the Main Capitol and will be livestreamed here.
    • The House Health Committee will hold an informational meeting Wednesday, April 26 at 9:00 a.m. on unregulated intoxicants and psychoactive substances. The hearing will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.
    • The House Human Services Committee will hold a voting meeting Wednesday, April 26 at 9:15 a.m. to consider the following bills.
      • HB 409, which would establish a mental health care services clearinghouse.
      • HB 754, which would provide a standard notice to each nursing home resident and their designated representatives at the time of their admission that they have the option of having legal representation to assist with the application for Medicaid benefits.

The meeting will be held in Room 523 of the Irvis Office Building and will be livestreamed here.

    • The House Professional Licensure Committee will hold an informational meeting April 26 at 10:00am on the Bureau of Professional and Occupational Affairs. The hearing will be held in Room 140 of the Main Capitol and will be livestreamed here.

Department of Health

  • DOH reminded long-term care facilities that the obligation to report COVID-19 cases and deaths through the ERS will continue beyond the end of the federal PHE on May 11. These records are reportable within 24 hours of diagnosis. Only new cases should be reported and positive cases that later result in death should be amended rather than entered as a new data record.  Find details on the reporting process here.
  • DOH encouraged nursing care facilities to make every effort to help temporary nurse aides to schedule and complete the required exams to become permanent certified nurse aides as soon as possible. When the federal PHE ends on May 11, candidates will have four months to complete the required testing as long as they are enrolled in an Approved Nurse Aide Training Program and candidates may continue to work in facilities while they complete the training program. Information on preparing and scheduling tests can be found here.   

Department of Human Services

  • The Department of Human Services (DHS) released the agenda for the Medical Assistance Advisory Committee’s (MAAC) April 27 meeting. In advance of the meeting, DHS also issued a briefing document outlining proposed changes and clarifications to the 340B Drug Pricing Program.
  • DHS issued proposed regulations to strengthen and clarify the Adult Protective Services Act (Act 70). Implementation of Act 70 began in 2015 but has operated under agency guidance and contract amendments rather than formal regulation. Find additional information and the proposed regulations in this Pennsylvania Bulletin notice.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks into late May.  Find the updated calendar here. 

Insurance Department

The Insurance Department issued a request for comments on a proposal to suspend the reinsurance program for the state-based insurance exchange, PENNIE®, and potentially replace it with a possible “state subsidy wrap.” Additional information on the proposal and details on how to comment may be found in this Pennsylvania Bulletin notice. 

Office of the Attorney General 

Attorney General Michelle Henry joined a coalition of seventeen other Attorneys General submitting a letter in support of the Federal Trade Commission’s proposal to prevent businesses from having employees sign non-compete agreements as a condition of employment. Find additional information in this press release. 

Independent Regulatory Review Commission

The Independent Regulatory Review Commission (IRRC) released the agenda for its May 18 meeting. Following are certain health-related regulations IRRC will consider.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

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

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

DDAP – Xylazine: A New Drug Additive – June 12

The Department of Drug & Alcohol Programs (DDAP) will host two additional sessions of “Xylazine: A New Drug Additive,” presented by Savage Sisters Recovery, in Harrisburg on June 12, 2023. Please visit the Training Management System for details and to register.

2023-04-21T20:06:37+00:00April 21st, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Uncategorized|Comments Off on PA Health Policy Update for April 21
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PA Health Policy Update for April 14

The following is an update of selected state health policy developments in Pennsylvania from April 10 -14.  (Some of the language used below is taken directly from state documents.) 

General Assembly 

  • The House and Senate Appropriations Committees concluded their budget hearings this week.
    • On Tuesday, April 11, the Department of Human Services appeared before the House Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Wednesday, April 12, the Department of Human Services appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here and here.
    • On Thursday, April 13, the Department of Health appeared before the Senate Appropriations Committee. A recording of the hearing can be viewed here.
  • The House Health Committee held an informational hearing Wednesday, April 12 on prescription drug affordability boards. A recording of the hearing can be viewed here.
  • The House Democratic Policy Committee held a public hearing Thursday, April 13 on black maternal health. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee held an informational hearing Thursday, April 13 on PACE/PACENET, the State Long-Term Care Ombudsman and AARP. A recording of the hearing can be viewed here.
  • The House Aging and Older Adult Services Committee will hold an informational hearing Thursday, April 20 at 1:00pm on The State Master Plan on Aging. The hearing will be held in Room G-50 of the Irvis Office Building and can be livestreamed here.
  • The House Children and Youth Committee will hold a public hearing Thursday, April 20 at 10:00am on overcrowding in Pennsylvania’s Juvenile Detention Facilities. The hearing will be held in Room 515 of the Irvis Office Building and can be livestreamed here.
  • The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24.

Department of Health

The Department of Health posted new documents related to the implementation of the long-term care nursing facilities regulations that become effective July 1, 2023:

  • Guidance for long term care regulations (effective July 1, 2023)
  • LTC Licensure Regulations Provider Updates – Presentation
  • LTC Licensure Regulations Provider updates – slides

View these and other guidance documents on the dedicated webpage here.

The Department of Health issued a health advisory with information about the Pennsylvania Childhood Blood Lead Act that took effect on January 2, 2023, and requires certain blood lead assessment and testing for children and pregnant women. Find more information in the health advisory. 

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin with the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention’s (CDC) Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2023. This bulletin replaces the 2022 recommended vaccine schedule.
  • DHS issued Provider Quick Tip #41, which is an updated Medical Assistance (MA) Desk Reference with provider contacts.
  • DHS issued a Medical Assistance Bulletin to inform MA providers that DHS added Current Procedural Terminology (CPT) codes 0164A (Moderna, Inc.) and 0173A (Pfizer, Inc.) to the MA Program Fee Schedule for the administration of additional bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines.
  • DHS issued a Medical Assistance Bulletin to inform providers of updates to the Emergency Medical Condition Information Eligibility form. 

Around the State      

  • The Pennsylvania Capital Star reported on the House Appropriations Committee’s examination of Governor Shapiro’s proposed FY 2023-24 budget for DHS.
  • The Scranton Times Tribune wrote about the continued nursing shortage in Pennsylvania and its impact on the health care system.

Stakeholder Events

DHS – Drug Utilization Review (DUR) Board – April 26

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate. 

DHS – Medical Assistance Consumer Subcommittee – April 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate. 

DHS – Medical Assistance Advisory Committee – April 27

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate.

Patient Safety Authority – April 27

The Patient Safety Authority’s board will meet virtually on Thursday, April 27 at 1:00 p.m. Go here for additional information and details on how to participate.

DOH – Special Pharmaceutical Benefits Program – May 4

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, May 4, 2023, from 10 a.m. to 3 p.m. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. Go here for additional information and details on how to participate.

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

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

DHS – Dual Diagnosis Conference – May 18

The Office of Developmental Programs and Office of Mental Health and Substance Abuse Services will host a state-wide Dual Diagnosis Conference virtually on May 18, 2023. The conference will include a variety of perspectives for supporting individuals who have experienced trauma. You may register here.

Pennsylvania Long-Term Care Council – 2023 Meeting Dates

The Pennsylvania Long-Term Care Council released an update list of its remaining meetings for the 2023 calendar year. Additional details may be viewed here.

2023-04-14T20:25:48+00:00April 14th, 2023|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Uncategorized|Comments Off on PA Health Policy Update for April 14
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PA Health Policy Update for March 31

The following is an update of selected state health policy developments in Pennsylvania from March 27 to March 31.  (Some of the language used below is taken directly from state documents.) 

 General Assembly 

  • The House Health Committee met on Wednesday, March 29 and favorably reported, among other bills, House Bill 155, which removes the requirement that direct-care workers be interviewed in person for a position, and House Bill 507, which requires medical schools, teaching hospitals, and medical institutions to receive explicit patient consent for all procedures and exams performed under anesthesia by medical students or for training purposes.
  • The Departments of Health, Aging, and Drug & Alcohol Programs appeared before the House Appropriations Committee for their respective budget hearings this week. A recording of the hearings can be viewed here. 
  • The House and Senate Appropriations Committees will continue budget hearings the week of April 10. A complete schedule for the House Appropriations Committee can be viewed here, and a complete schedule for the Senate Appropriations Committee can be viewed here. 
  • The state House and Senate are currently recessed. They will return to Harrisburg on Monday, April 24 following the conclusion of budget hearings. 

Department of Health 

The Department of Health (DOH) is evaluating a future purchase and distribution of devices that can eliminate viruses, bacteria, mold and other pathogens from air and surfaces simultaneously. DOH would purchase and distribute the devices free of charge to small businesses, non-profit entities, and other facilities throughout the Commonwealth to mitigate the spread of COVID-19, flu, and other diseases. Long-term care facilities that are interested in receiving a device if this program moves forward should complete this application.  The application is being used to gauge interest in receiving a device and those who complete the application are not guaranteed to receive one.  

In response to the Norfolk Southern train derailment in East Palestine, Ohio, DOH announced the establishment of a community-based health resource network this week to connect Pennsylvania residents impacted by the derailment with local health care providers for long-term assistance.   

Department of Human Services   

The Office of Medical Assistance Programs (OMAP) issued a bulletin to advise providers of additions and updates to the Medical Assistance (MA) Program Fee Schedule and the issuance of updated physician and general hospital provider handbook pages regarding the prior authorization procedures for proton therapy services. These changes are effective for dates of services on and after April 1, 2023.  

The Office of Mental Health & Substance Abuse Services (OMHSAS) issued a memorandum to address stakeholder concerns about the impact of ending OMHSAS’ bulletin suspensions regarding signature requirements specific to consent for treatment, service verification, and treatment plans on March 31, 2023, and clarifying the use of audio-only for telehealth in the delivery of services licensed by OMHSAS.  

Board of Nursing  

The State Board of Nursing published Interpretations Regarding the Administration of Drugs-Statement of Policy in the Pennsylvania Bulletin. This statement of policy clarifies that registered nurses may administer a specific amount of conscious sedation medication during minor therapeutic and diagnostic procedures upon a written order of either a physician or a CRNP when either a physician or CRNP is present during the administration. This statement of policy is expected to eliminate confusion about CRNPs’ authority to order and supervise registered nurses’ administration of conscious sedation under certain circumstances.  

Around the State   

The Pennsylvania Capital-Star reported Pennsylvania long-term care facilities will share $14.2 million from the Centers for Disease Control & Prevention (CDC). The funds are intended to support workforce development, staff retention, and infrastructure improvements.   

The Pittsburgh Post-Gazette wrote about the Pennsylvania Department of Health’s budget hearing this week and noted the focus on the state’s response to the East Palestine, Ohio train derailment and Pennsylvania’s post-COVID public health landscape.   

A report issued by Kaufman Hall noted that hospital finances continue to struggle in the face of macroeconomic headwinds but they appear to be beginning to stabilize. Fierce Healthcare details the challenges hospitals continue to confront here.   

Stakeholder Events  

DOH – Medical Marijuana Advisory Board – April 12 

The Medical Marijuana Advisory Board will meet on April 12, 2023, from 10:30 a.m. to 12:30 p.m. Go here for additional information and details on how to participate.   

DHS – Drug Utilization Review (DUR) Board – April 26 

The DUR Board will meet Wednesday, April 26 from 9:00 a.m. to 4:00 p.m. Go here for additional information and details on how to participate.  

DHS – Medical Assistance Consumer Subcommittee – April 26 

The Consumer Subcommittee of the Medical Assistance Advisory Committee is scheduled to meet on April 26, 2023, at 1:00 pm. Go here to register to participate.  

DHS – Medical Assistance Advisory Committee – April 27 

The Medical Assistance Advisory Committee is scheduled to meet on Thursday, April 27 at 10:00 a.m.  Go here to register to participate. 

2023-04-05T18:10:50+00:00March 31st, 2023|COVID-19, Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for March 31
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PA Health Policy Update for January 20

The following is an update of selected state health policy developments in Pennsylvania from January 14-20.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

  • Josh Shapiro was sworn in as Pennsylvania’s 48th governor on Tuesday.  Much of the governor’s inaugural speech focused on preserving democracy.  He also highlighted the need for unity and emphasized bringing people together.  Find a transcript of the governor’s speech here.
  • On Wednesday Governor Shapiro issued his first executive order, which prioritizes work experience, skill, and competency for state jobs and highlights that 92 percent of the state’s jobs do not require a four-year college degree.
  • Information about the Shapiro administration’s health-related agency nominees can be found here and a complete list of the Shapiro administration appointments made to date can be found here.

General Assembly

The state Senate convened for voting session this week and the House briefly convened for non-voting session.  Both chambers are now recessed.  The Senate is scheduled to return on Monday, February 27 while the House has yet to release a session calendar.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin rescinding Medical Assistance Bulletin 01-22-78, titled “340B Drug Pricing Program – Dispensing 340B Purchased Drugs,” which was issued on December 22, 2022.  Instead, Medical Assistance Bulletin 99-13-08, titled “340B Drug Pricing Program Provider Requirements and Billing Instructions – Pharmacy Services,” remains in effect.  Go here to see the new bulletin rescinding the December 22 version.
  • DHS has extended its calendar for Remittance Advice (RA) notifications and the delivery of electronic payments and checks into early March.  Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has added CPT codes 0124A, 0154A (Pfizer) and 0134A, 0144A (Moderna) to its fee schedule for the administration of a bivalent booster dose COVID-19 vaccine.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders informing them that it has extended until March 31 its requirement that providers capture consent to treat, service verifications, and approval of treatment plans for Medicaid-funded behavioral health services delivered via telehealth.  At the end of this period providers must have an electronic capability to secure auditable electronic signatures for consent and service verification.  Learn more from OMHSAS’s message to stakeholders.
  • DHS has informed stakeholders that Jennifer (Jen) Smith has joined the department as deputy secretary for OMHSAS.  Smith previously served as Secretary of the Department of Drug and Alcohol Programs.  Learn more from DHS’s message to stakeholders.
  • DHS has posted information about an electronic submission process for Medicaid fee-for-service 180-day exception requests and other claims requiring documentation that will soon be available in the PROMISE portal.  Find that information here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its peer groups, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities.  DHS used these peer groups, peer group medians, and peer group prices to determine case-mix rates for non-public nursing facilities for FY 2023.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published its final annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Learn about those rates from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its telemedicine interpretive guidance for hospitals.  Find the updated guidance here.
  • DOH has updated its FAQ on innovative care models for hospitals.  Find the updated FAQ here.  The changes, which address critical access hospitals and small rural hospitals, are highlighted in red.
  • DOH has updated its criteria and guidance for establishing an outpatient emergency department.  The changes, which address critical access hospitals, small rural hospitals, and rural emergency hospitals, are highlighted in red.  Find the updated guidance here.
  • DOH also has updated its matrix on how facilities can qualify as an innovative hospital model.  Find the updated matrix here.   Changes again are highlighted in red.
  • DOH has issued guidance requiring prospective new owners of skilled nursing facilities to inform facility residents, representatives, and employees of the possibility of a change of ownership of the facility.  Learn more from this DOH guidance.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania declined 27 percent over the past week and the number of new daily deaths, after a 50 percent increase a week ago, returned this week to its level of recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined nearly 14 percent last week after an 11 percent decline the previous week; the number on a ventilator because of the virus rose nine percent; and the number in hospital ICUs fell six percent.
  • The CDC reports a five percent decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 18, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; eight counties are experiencing a substantial rate of community transmission; and the remaining 55 counties are experiencing high rates of community transmission.

Health Care Cost Containment Council (PHC4)

PHC4 is beginning the verification process for hospital self-pay records for fiscal year 2021.  Its self-pay data reconciliation web application on the PHC4 portal enables hospitals to reconcile their self-pay records, which eventually will be provided to DHS to be used as a part of its calculation of the extraordinary expense portion under Act 77 (the state’s 2001 tobacco settlement law).  Find PHC4’s letter to hospitals here and the portal for self-pay records here.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – January 26

The Patient Safety Authority will meet virtually on Thursday, January 26 at 1:00.  For information about how to participate in this meeting, see this Pennsylvania Bulletin notice.  Registration is required.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

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

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

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

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

2023-01-20T21:47:06+00:00January 20th, 2023|340b, COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 20
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PA Health Policy Update for Friday, November 4

The following is an update of selected state health policy developments in Pennsylvania for the week of October 31 to November 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed 66 bills into law this week and vetoed one, Senate Bill 736.  The following is a selection of health care-related bills signed into law by the governor.

  • House Bill 220, which is now Act 101 of 2022, specifies that a person does not need to test positive for drugs to begin addiction treatment.
  • House Bill 1393, which is now Act 111 of 2022, seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.
  • House Bill 2293, which is now Act 128 of 2022, requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2527, which is now Act 135 of 2022, expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.
  • House Bill 2800, which is now Act 143 of 2022, amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • Senate Bill 225, which is now Act 146 of 2022, streamlines and standardizes the process for prior authorization of medical services.  The Insurance Department has issued a news release about this new law.
  • Senate Bill 522, which is now Act 150 of 2022, requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.

General Election

The 2022 general election will be held on Tuesday, November 8.  Pennsylvanians will be voting for one U.S. Senate seat, 17 U.S. House of Representatives seats, governor, half of the 50 state Senate seats, and all 203 state House seats.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals’ response to COVID-19 to reflect the October 31 expiration of the COVID-19 state regulatory waivers and flexibilities. Find the updated guidance here.  At the same time, the Department of Human Services (DHS) has updated its list of regulations that have been suspended in response to the COVID-19 public health emergency.  Find the updated list here and scroll down to see the latest regulation suspensions that have expired; they are highlighted in red.
  • DOH has issued a health advisory about the increase in the number of cases of respiratory syncytial virus (RSV) nationally and in the state.  The alert describes the virus, outlines testing and treatment recommendations, and asks providers to report laboratory-confirmed RSV cases to DOH through Pennsylvania’s electronic reportable disease surveillance system,  PA-NEDSS.  It also urges providers to report outbreaks or clusters of severe respiratory illness, regardless of etiology, to the state and local health departments.  Find the advisory here.
  • DOH has issued a news release outlining the changes in the state’s regulations for skilled nursing facilities that have been approved by Pennsylvania’s Independent Regulatory Review Commission and now await review by the state’s Attorney General.
  • DOH has released a request for applications for its Long-Term Care Quality Investment Pilot, which will distribute approximately $11.7 million in federal funds to long-term-care facilities, including skilled nursing facilities, personal care homes, assisted living facilities, and intermediate-care facilities for the purpose of building resilience.  These funds are designed to be invested in key areas such as workforce development and retention, infection prevention control, emergency preparedness, and improvements to facility infrastructure.  To apply for this funding, facilities must participate in the state’s LTC RISE program’s quality improvement projects and cannot be located in Philadelphia.  Find the state’s request for applications here and learn about LTC RISE here.  The application deadline is December 31.

Department of Human Services

  • The Department of Human Services (DHS) announced that Pennsylvania has received approval from the federal Centers for Medicare & Medicaid Services (CMS) to extend its postpartum coverage period for mothers and birthing people eligible for Medicaid because of their pregnancy from 60 days to 12 months.  Learn more from this DHS news release.
  • DHS has extended into early January of 2023 its Remittance Advice calendar for mailing checks and electronically sending Medicaid payments.  Find the updated calendar here.
  • In response to the passage and signing of House Bill 1630 (now Act 98), which addresses, among other things, the delivery of some mental health and substance use services, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders to advise them of some of the new law’s implications and to list the sections of the Pennsylvania Code the new law repeals.  Find the OMHSAS message to stakeholders here.
  • DHS has issued a Medical Assistance Bulletin advising providers who are not a recognized provider type under the Medical Assistance program that they now may enroll in the program for the purpose of billing for cost-sharing for services provided to beneficiaries who receive both Medicare and Medicaid.  This bulletin also provides information on how to complete and submit an enrollment application.  Find the bulletin here.
  • DHS has added a procedure code to the Medical Assistance fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for:

These requirements take effect on January 9, 2023.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose 12 percent after a decline of 12 percent the week before; the number of deaths rose slightly.  The state is averaging more than 1800 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs (172) is at its highest level since early March.
  • The CDC reports a modest increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a 15 percent decrease last week.
  • As of November 4, 54 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 13 are experiencing substantial rates of community transmission; and Cameron County is experiencing a moderate rates of community transmission.

Stakeholder Events

Department of Health – State Child Death Review Team – November 9

The Department of Health’s State Child Death Review Team will hold a public meeting in Harrisburg on Wednesday, November 9 at 10:00.  The state’s Child Death Review Program provides training and technical assistance to local Child Death Review teams.  This meeting will focus on suicide deaths.  For information about the location of the meeting and the Child Death Review Team, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-11-04T20:15:28+00:00November 4th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on PA Health Policy Update for Friday, November 4
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PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21
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PA Health Policy Update for Friday, September 30

The following is an update of selected state health policy developments in Pennsylvania for the week of September 26-30, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that it has added CPT codes for administering COVID-19 pediatric boosters.  The new codes can be used immediately.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to advise providers of the addition of procedure codes to the Medical Assistance fee schedule for the provision of private duty nursing services, which are provided through home health agencies to beneficiaries under 21 years of age.  The additions take effect on October 1.  Find that bulletin here.
  • DHS’s Office of Long-Term Living has launched its American Rescue Plan Act of 2021 funding reporting portal.  The online portal will be available beginning on September 30, 2022 for Office of Long-Term Living providers to submit costs associated with American Rescue Plan funding distributed in 2021, as required by the state.  Learn more from this announcement of the portal’s launch and from DHS’s guide on to how to use the portal.
  • DHS has updated its data on physical health HealthChoices enrollment and participation in the Medical Assistance Transportation Program.  Find the update here.

Department of Health

  • The Department of Health (DOH) has issued new guidance for health care providers and their employees who have been exposed to or contracted COVID-19.  The first addresses the return to work for health care workers with confirmed or suspected cases of COVID-19 and the second describes work restrictions for health care workers who have been exposed to COVID-19.  Both are introduced to align state standards with recently revised guidance from the federal Centers for Disease Control and Prevention.
  • DOH has updated its definition of how it defines whether individuals are up to date on their COVID-19 vaccinations.  Go here to see the updated definition and learn about the department’s rationale for this change.
  • DOH has issued a health alert to notify providers, laboratories, infection control specialists, and local health departments about an unvaccinated adult with poliovirus infection and acute flaccid paralysis.  Wastewater testing in treatment facilities in Rockland County, New York, which is adjacent to Pennsylvania, and surrounding counties also identified related poliovirus, indicating that the virus is circulating in the community and others may become ill.  DOH urges providers to consider polio as a possible cause of sudden onset of limb, facial, oropharyngeal, or respiratory muscle weakness; to contact their local or state health department to discuss such cases; and to encourage any unvaccinated patients to receive polio vaccines.  Learn more from this health alert.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of 10-20 percent.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 191 admissions a day over the past week, a slight reduction from the previous week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Snyder County is currently experiencing “only” a substantial rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued Licensing Alert 02-22 to inform drug treatment programs about the process for establishing mobile narcotic treatment programs.  Find the alert here.

Insurance Department

The state Insurance Department has released Pennsylvania’s 2023 individual and small group Affordable Care Act health insurance rates.  The release also shares changes in the number of insurers offering coverage to Pennsylvanians and offers information about federal rate subsidies.  Learn about the newly released information and find a link to the rates and insurers themselves in this Insurance Department news release.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 25,613 confirmed cases of monkeypox in the U.S. as of September 29, up only slightly from 23,364 cases on September 21.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 25, 475 of those Pennsylvania monkeypox cases were in Philadelphia, up from 446 on September 18.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Stakeholder Events

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

2022-09-30T21:16:03+00:00September 30th, 2022|COVID-19, HealthChoices, long-term care, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for Friday, September 30
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PA Health Policy Update for Friday, September 16

The following is an update of selected state health policy developments in Pennsylvania for the week of September 12-16, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for voting session this week.  The following is an overview of selected health-related legislative activity.

  • The House unanimously passed House Bill 1630, which grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers in Medicaid.  The bill was received in the Senate and referred to the Health & Human Services Committee.
  • The House unanimously passed House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits.  The bill will now be sent to the Senate.
  • The House Insurance Committee favorably reported Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners’ model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
  • The House Professional Licensure Committee favorably reported House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The House Republican Policy Committee held an informational meeting on Monday to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred.  A recording of the meeting and testimony submitted to the committee may be viewed here.
  • The House Human Services Committee favorably reported House Bill 2686, as amended, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
  • The House Children & Youth Committee held an informational meeting this week to examine “Child & Adolescent Fatality Trends & Community Responses.”  A video recording of the hearing may be viewed here.

The state House and Senate will be in session next Monday (9/19), Tuesday (9/20), and Wednesday (9/21).  The following is an overview of selected health-related committee meetings next week.

  • The House Insurance Committee will convene on Tuesday, September 20 at 10:00 a.m. to consider Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
  • The Senate Health & Human Services Committee will hold an informational hearing on Tuesday, September 20 at 11:00 a.m. on the tick crisis in Pennsylvania.
  • The House and Senate Democratic Policy Committees will hold a joint hearing on Friday, September 23 to discuss Senate Bill 860 and House Bill 1848 and the need for Pennsylvania to establish a statewide rape-kit tracking system.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers of updates to the Medical Assistance program fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has extended its calendar for remittance advice (RA) electronic transfer and mailing dates into November.  Find the updated calendar here.
  • DHS has published information about improvements in how providers can update their enrollment summary in the state’s PROMISe provider internet portal.  Find the notice here.
  • DHS has revised its list of drug companies participating in the state’s Medicaid drug rebate program.  Find the updated list here.
  • In July, DHS proposed new regulations governing the delivery of psychiatric rehabilitation services, and in particular, on the use of telehealth in the delivery of those services.  Now, Pennsylvania’s Independent Regulatory Review Commission has published its analysis of the proposed regulation and shared comments submitted by stakeholders in response to the proposed changes.  Find the commission’s analysis and stakeholder comments in this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to announce that it has issued an updated School-Based ACCESS Program provider handbook.  Find that bulletin and the updated handbook here.
  • DHS has posted a notice announcing to stakeholders that it has not yet calculated Medicaid hospice rates for FY 2023 and explaining its process for completing those calculations and notifying affected parties.  Find that notice here.

Behavioral Health Commission for Adult Mental Health

The Behavioral Health Commission for Adult Mental Health created to develop recommendations for how to allocate $100 million appropriated for adult mental health purposes in the state’s FY 2023 budget held its fourth public meeting this week.  The first part of the meeting focused on workforce development issues, with participants identifying the biggest challenges in workforce development as recruitment, retention, licensing, lack of funding for loan repayment and salary increases, lack of career pathways and pipelines, and burnout.

After additional discussion, commission members decided they should organize their spending recommendations into four categories:  workforce ($37 million of the $100 million available), expanding services ($36.7 million), criminal justice ($23.3 million), and other ($3 million); they also discussed priorities within each category.  The commission’s final report and recommendations should be presented to the legislature next week but no money will be spent until the General Assembly, which will only meet a few more days this year, specifically authorizes it.  Learn more about the Behavioral Health Commission for Adult Mental Health from its section of the DHS web site.

Department of Health

The Department of Health has notified licensed providers that although the CDC now considers individuals up to date with their COVID-19 vaccinations only if they have had a dose of the new bivalent booster shot, providers should continue to consider individuals up to date if they have received either a monovalent or bivalent booster shot on the recommended schedule.   Learn more from the Department of Health’s letter to providers.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, 74.5 percent of Pennsylvanians five years of age and older are now vaccinated.
  • Sixty-five of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Delaware and Philadelphia counties are currently experiencing “only” substantial rates.

Monkeypox

The CDC has posted an updated map showing the distribution of 23,117 confirmed cases of monkeypox in the U.S. as of September 15, up from 21,504 cases on September 1.  684 of those cases were in Pennsylvania, up from 624 a week ago.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs is offering online training on substance use disorder confidentiality.  This updated training incorporates changes based on passage of Pennsylvania Act 33, the Pennsylvania Drug and Alcohol Abuse Control Act, in July.  Learn how to receive the training from this Department of Drug and Alcohol Programs notice.  Participants can earn PCB continuing education credits.

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

The Rare Disease Advisory Council will hold a stakeholder summit on Thursday, September 22.  The summit will feature panels on gene therapy, newborn screening, and the results of the council’s Patient Needs Assessment Survey.  Learn more about the stakeholder summit here.

Department of Human Services – Special Populations/Dementia Issues September 22

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how facilities can help community members understand what dementia is, how it affects people, and how individuals can make a difference in the lives of those touched by dementia.  The webinar, to be held on Thursday, September 22 at 2:00, is especially recommended for community liaisons, non-clinical teams, nurse educators, service coordinators, and volunteers.  Learn more from this webinar notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-16T21:36:30+00:00September 16th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 16
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