Pennsylvania Medical Assistance Archives - Page 3 of 7 - Safety-Net Association of Pennsylvania

PA Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the May edition of Health Law News, its monthly newsletter.
Included in this edition are articles about the Wolf administration’s newly released Medicaid managed long-term supports and services proposal; the increase in Medicaid enrollment since the state’s Medicaid expansion began on January 1; the Medical Assistance Transportation Program; and the state’s application to the federal government to establish Pennsylvania’s own health insurance marketplace.
Go here to see the latest edition of PA Health Law News.

PA Safety Net Admin2015-06-09T06:00:56+00:00June 9th, 2015|Uncategorized|Comments Off

“Super-Utilizers” Costing PA Millions, Report Shows

“Super-utilizers” – people who visit hospital emergency rooms often and are admitted to hospital beds with unusual frequency – are costing the health care system millions of dollars a year.
According to a new report from the Pennsylvania Health Care Cost Containment Council (PHC4), super-utilizers – people admitted to the hospital at least five times in a year – while just three percent of hospital patients in FY 2014, accounted for 17 percent of the state’s Medicaid expenditures for inpatient care ($216 million) and 14 percent of Medicare inpatient expenditures ($545 million). In all, 18 percent of Medicaid hospital admissions in Pennsylvania in FY 2014 were for super-utilizers.
PHC4 identified the three leading reasons for these admissions as heart failure, septicemia, and mental health disorders.
Learn more about super-utilizers and their impact on hospital admissions and health care spending in the PHC4 report, which can be found here.

PA Safety Net Admin2015-02-20T11:06:56+00:00February 20th, 2015|Uncategorized|Comments Off

SNAP Looks to the Future

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The fourth of those papers, released this week, addresses the importance of innovation in addressing the challenges safety-net hospitals face in leading the way to serving Pennsylvania’s growing Medicaid population.
The paper describes the new demands being made of hospitals by insurers, government, and others; tools through which to pursue innovation; the goals of future innovation; and the role that SNAP and safety-net hospitals must play in that innovation.
The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
The third paper, “Transitioning Medicaid: Principles for Changing Course on Medicaid Expansion,” presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Find all four SNAP papers here.

PA Safety Net Admin2015-02-12T10:43:14+00:00February 12th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Expansion Glitch Hits Drug and Alcohol Patients, Providers

A flaw in the implementation of Pennsylvania’s Medicaid expansion has left many of the state’s Medicaid beneficiaries with no coverage for the treatment of their drug and alcohol problems – and some providers without payment for some care they have delivered.
Under the Healthy Pennsylvania Medicaid expansion program, beneficiaries with extensive health problems, like drug and alcohol issues, were supposed to be directed into the state’s “Healthy Plus” Medicaid benefits package, which covers services that address such problems. Instead, many were places in private, state-approved insurance plans for Medicaid beneficiaries, which do not cover those services.
State officials are aware of the problem and say they will soon have a plan to fix it.
Learn more about this glitch in Pennsylvania’s Medicaid expansion and how state officials hope to address it in this Philadelphia Inquirer article.

PA Safety Net Admin2015-01-30T06:00:14+00:00January 30th, 2015|Healthy PA, Pennsylvania Medicaid policy|Comments Off

SNAP Principles for Changing Course on Medicaid Expansion in Pennsylvania

With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The third of those four papers presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion.
Those eight principles are:

communicate changes effectively to the provider community
ensure beneficiaries’ continuity of coverage and continuity of care
ensure the adequacy of provider networks
simplify beneficiary and provider enrollment
preserve vital supplemental payments to safety-net hospitals
continue pursuing Medical Assistance payment reforms
ensure the long-term financing of Medical Assistance in response to current and future threats to that financing
invest in innovative, population-based infrastructure and programmatic improvements

The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
The second paper, “The Challenges Pennsylvania Safety-Net Hospitals Face,” describes the special role safety-net hospitals play in serving low-income and medically vulnerable Pennsylvanians and the emerging challenges they face in fulfilling this vital role.
Find all three SNAP papers here.

PA Safety Net Admin2015-01-28T06:00:12+00:00January 28th, 2015|Healthy PA, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

The Challenges Facing Pennsylvania’s Safety-Net Hospitals

With the arrival of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff.
The second of those four papers describes the major health care and health policy challenges safety-net hospitals face. Those challenges include:

the distinct patients safety-net hospitals serve
inadequate payments for Medicaid services
the large numbers of uninsured and underinsured patients safety-net hospitals serve
threats to vital state Medicaid supplemental payments, such as Medicaid disproportionate share payments (Medicaid DSH
continuing change and reform in the health care system, including the delivery of care and how safety-net hospitals are paid for their services

The first paper, “What is SNAP?”, was an introduction to the Safety-Net Association of Pennsylvania: what safety-net hospitals are, where they are located, whom they serve, and how they differ from other acute-care hospitals in the state.
Find both SNAP papers here.

PA Safety Net Admin2015-01-23T06:00:07+00:00January 23rd, 2015|Safety-Net Association of Pennsylvania|Comments Off

PA Closing in on Classification Criteria for New Medicaid Recipients

Among the features of Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion program is the consolidation of 14 current adult benefits packages into just two packages: the “Healthy” package for new recipients considered low-risk patients and the “Healthy Plus” package for those who are considered high-risk patients, or medically frail.
But ever since the Corbett administration unveiled its Medicaid expansion plan last fall, the question of how new recipients would be evaluated to determine which benefit package they will receive has remained unanswered.
Now, the Pennsylvania Department of Public Welfare (DPW) appears to be getting closer to providing a clear answer.
Recently, DPW’s Medical Assistance Advisory Committee (MAAC) circulated three working documents that present the state’s latest thinking on the classification process.
The first document presents an overview of the latest version of state’s screening tool, including what the tool is, how it defines “medically frail,” and how it will be used. It also notes that use of the tool is not mandatory.
This next document offers additional information about how the state envisions defining “medically frail.”
And this third document is a draft of the screening tool itself, the health care needs questionnaire.
Pennsylvania’s Medicaid expansion is scheduled to take effect on January 1, 2015, but people who think they may be eligible may begin enrolling on December 1 through the state’s enrollment web site or at any state county assistance office.

PA Safety Net Admin2014-10-31T06:00:57+00:00October 31st, 2014|Healthy PA|Comments Off

Medicaid Directors Weigh in On Managed Care Regulation

The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs.
In a paper entitled “Medicaid Managed Care Modernization: Advancing Quality Improvement,” the National Association of Medicaid Directors urges the Centers for Medicare Services (CMS) to work with the states to develop quality reporting measures that are both useful and not overly burdensome.
The association also asks CMS to leave decisions about accrediting requirements for state Medicaid managed care programs in state hands and not to establish a national quality rating system for Medicaid managed care plans.
The regulation of Medicaid managed care plans is especially important to Pennsylvania safety-net hospitals because they care for so many Medicaid patients and managed care has become the primary means through which the state’s Medicaid program serves those patients.
Learn more about Medicaid directors’ recommendations for improving and regulating state Medicaid managed care programs in this National Association of Medicaid Directors correspondence with the Center for Medicaid and CHIP Services.

PA Safety Net Admin2014-10-27T06:00:19+00:00October 27th, 2014|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Introducing…The Pennsylvania Department of Human Services

The Pennsylvania Department of Public Welfare is no more.
The state executive branch agency whose Office of Medical Assistance Programs has overseen Pennsylvania’s Medicaid program since its inception has officially been renamed the Department of Human Services.
The legislation requiring the name change takes effect in November and the department will phase-in its new name over time.
Read the press release from the governor’s office announcing the name change here.

PA Safety Net Admin2014-09-25T06:00:40+00:00September 25th, 2014|Uncategorized|Comments Off

PA Aging Waiver Program Struggles With Backlog

A Pennsylvania program to help the elderly remain in their own homes instead of moving into nursing homes is struggling with backlogs.
The state’s Aging Waiver Program is a Medicaid program that enables those who meet certain medical and financial criteria to receive assistance in their own homes from nurses and home health aides rather than go into a nursing home.
Currently the program serves more than 32,000 people – nearly twice as many as it did six years ago – but applications are taking as long as two months to process. The biggest challenge is verifying financial eligibility, but the state recently added staff to help address the backlog.
Learn more about Pennsylvania’s Aging Waiver Program in this Pittsburgh Tribune-Review article.

PA Safety Net Admin2014-08-11T06:00:49+00:00August 11th, 2014|Pennsylvania Medicaid policy|Comments Off

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