pennsylvania OMHSAS Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for February 3

The following is an update of selected state health policy developments in Pennsylvania from January 28 to February 3. (Some of the language used below is taken directly from state documents.)

Governor Shapiro

Governor Shapiro has signed an executive order seeking to improve the state’s licensing, permitting, and certification processes, launching a review of how long it takes agencies to process applications and how workers and businesses apply online. This executive order seeks to establish definitive dates for when applicants for licenses, permits, and certificated will hear back from the state, and if applicants do not receive a response by that date, the agency responsible will refund their application fee. Learn more from this news release from the governor’s office and from the executive order.

General Assembly

State Representative Lynda Schlegel Culver won a special election this week to replace former state Senator John Gordner, who resigned to become counsel to Senate President Kim Ward. Senator-elect Culver will represent the 27^th district, which includes all of Columbia, Montour, Northumberland, and Snyder counties and part of Luzerne County. Once she resigns from her state House seat a special election will be scheduled to replace her.

Department of Human Services

The Department of Human Services (DHS) has notified hospitals with accredited Level I, II, III, or IV trauma centers of the required annual attestation for inclusion in the FY 2022-23 Trauma DSH Program. The deadline to submit completed attestations is February 24. Potentially eligible trauma centers that have not been notified should contact DHS at RA pwdshpymt@pa.gov. Questions regarding the attestation form and the Trauma DSH Program also should be directed to this address.
DHS has posted information for providers on how to check the status of their electronic Medical Assistance provider enrollment application and what to do if their application was returned for additional information. Find it here.
DHS has posted information for group providers on how to reactivate, revalidate, or make
changes to group members. Find it here.
DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has announced a grant program through which qualified entities may apply for funding to invest in technology and training for behavioral health telehealth providers. The state has allocated $4 million for one-time grants of up to $50,000 for providers that meet a number of criteria, including having fewer than 50 employees and at least 51 percent of their clients enrolled in Medicaid. Learn more about the program, eligibility criteria, and how to apply from this OMHSAS notice. Applications will be accepted until December 31 or until the $4 million is exhausted.
DHS has posted the presentations offered during the January 26 meeting of the Medical Assistance Advisory Committee. See presentations from the:

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania declined over the past week and the number of new daily deaths returned to the usual range for COVID-19-related deaths in recent months.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on a ventilator because of the virus, and in hospital ICUs with COVID-19 all declined slightly over the past week.
The CDC reports an 11 percent decrease in the seven-day daily average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
For the week ending February 2, one Pennsylvania county – Cameron – experienced a low rate of community transmission of COVID-19; seven counties experienced a moderate rate of community transmission; eight counties experienced a substantial rate of community transmission; and the remaining 49 counties experienced a high rate of community transmission.

Insurance Department

The Insurance Department is conducting a medical professional liability insurance study to determine whether sufficient capacity exists to increase the basic coverage limits of insurance required by the Medical Care Availability and Reduction of Error (MCARE) Act. Learn more about the issues the study will address from this Pennsylvania Bulletin notice. Stakeholder comments are due by March 4.

Stakeholder Events

Department of Health – Preventative Health and Health Services Block Grant Advisory Committee Meeting – February 13

The Department of Health’s Preventative Health Services Block Grant Advisory Committee will meet in Harrisburg on Monday, February 13 at 1:00. For information on the location of the meeting or how to participate virtually, see this Pennsylvania Bulletin notice.

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

The Medical Assistance Advisory Committee’s Managed Long-Term Services and Supports Subcommittee will meet in Harrisburg on Wednesday, March 1 at 10:00. For information on the location of the meeting or how to participate virtually, see this DHS notice.

Department of Aging – Pennsylvania Long-Term Care Council – March 9

The Department of Aging’s Long-Term Care Council will meet in Harrisburg on Thursday, March 9 at 10:00. For information on the location of the meeting or how to participate virtually, 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.

jsteinbock2023-02-03T20:51:28+00:00February 3rd, 2023|COVID-19, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for January 27

The following is an update of selected state health policy developments in Pennsylvania from January 21-27. (Some of the language used below is taken directly from state documents.)

General Assembly

The Legislative Budget and Finance Committee (LBFC) met this week and approved the release of a report entitled “Prescription Drug Pricing Under the Medical Assistance Managed Care Program.” Act 120 of 2020 directed LBFC to conduct a study analyzing prescription drug pricing in the Medical Assistance managed care program; review reimbursement practices by PBMs (pharmacy benefit managers) to pharmacies and to PBMs by MCOs; investigate and compare reimbursement rates by PBMs to independent pharmacies and to chain pharmacies; and study state laws and best practices adopted by other states regarding PBMs and pharmacy reimbursement. Find the report here.
Although the House has not adopted a rules package or formally established standing committees for the 2023-2024 legislation session, the Republican caucus announced its selections for committee chairs this week. Representatives Kathy Rapp and Tina Pickett will remain Republican chairs of the Health Committee and the Insurance Committee, respectively, while Doyle Heffley will be the new Republican chair of the Human Services Committee. In addition, Representative Carl Metzger will be the Republican chair of the Professional Licensure Committee, Steven Mentzer will be the Republican chair of the Aging & Older Adult Services Committee, and Linda Schlegel Culver will be the Republican chair of the Children & Youth Committee. Find the full list of Republican committee chairs here.
The state House Democratic Policy Committee convened in Pittsburgh for an informational hearing examining the health care staffing crisis. Find the meeting agenda and testimony offered during the hearing here.

Department of Human Services

The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin providing guidance for the implementation of Act 65 of 2020, which governs who can provide consent for voluntary mental health treatment of minors who are 14 years of age and less than 18 years of age in both inpatient and outpatient settings. Act 65 also addresses which individuals may grant consent for the release of a minor’s medical records. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin informing providers that it has increased fees for certain ambulance transportation services on the Medical Assistance fee schedule effective with dates of service on or after January 1, 2023. Find that bulletin here.
DHS has published final notice of the assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the Nursing Facility Assessment Program for FY 2023. Learn more about which types of facilities to which the assessment applies and how much their 2023 assessment will be from this Pennsylvania Bulletin notice.
At the January 26 meeting of the Medical Assistance Advisory Committee, DHS’s Office of Long-Term Living offered a presentation on the efforts of the managed care plans that serve Community HealthChoices members to redetermine the eligibility of their current participants in the wake of the upcoming end of continuous Medicaid eligibility and vaccination rates among Community HealthChoices participants. Find that presentation here.
DHS has updated its physical health managed care enrollment report.

Department of Health

Pennsylvania’s Executive Board has approved a reorganization of the Department of Health. Find an organizational chart that reflects this reorganization in this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania held steady over the past week, remaining higher than prior to Thanksgiving, and the number of new daily deaths rose more than 50 percent over the past week after a decline of 50 percent the week before.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined seven percent last week after a 14 percent decline the previous week; the number on a ventilator because of the virus remained steady; and the number in hospital ICUs fell 15 percent after a six percent decline the week before.
The CDC reports a slight decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
As of January 25, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; 15 counties are experiencing a substantial rate of community transmission; and the remaining 48 counties are experiencing high rates of community transmission.

Stakeholder Events

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.

jsteinbock2023-01-27T21:38:47+00:00January 27th, 2023|COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

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 48^th 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.