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PA Health Policy Update for July 12

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

FY 2024-2025 Budget Update 

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

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

The following are key budget-related pieces of legislation.

General Assembly

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

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

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

Department of Human Services 

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

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

Centers for Medicare and Medicaid Services 

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

Stakeholder Events   

DOH – Organ Donation Advisory Committee – August 8

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

DHS – Consumer Sub-MAAC – July 24

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

DHS – Medical Assistance Advisory Committee – July 25

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

2024-07-12T20:34:18+00:00July 12th, 2024|Federal Medicaid issues, Financial, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for July 12
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PA Health Policy Update for June 7

The following is an update of selected state health policy developments in Pennsylvania from June 3 – 7.  (Some of the language used below is taken directly from state documents). 

General AssemblyHarrisburg, PA capital building

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

  • The Senate passed Senate Bill 1102, which increases the availability of long-term care training courses for nurse aides and expands eligibility for individuals to take the nurse aide competency exam, by a vote of 42 – 8. The bill was subsequently sent to the House and referred to the Health Committee.
  • The Senate passed Senate Bill 1104, which allow high school juniors and seniors to earn up to two credits toward their graduation requirement for employment in a congregate health care setting, by a vote of 29 – 21. It was subsequently sent to the House and referred to the Education Committee.
  • The Senate passed Senate Bill 1165, which makes certain statutory changes that will enable the state to join, among others, the medical and nursing interstate licensure compacts, by a vote of 46 – 4. The bill will now be sent to the House for consideration.
  • The House passed House Bill 2234, which creates a pilot program to give small grants to individuals to assist them with purchasing health insurance on Pennie, Pennsylvania’s state-based insurance exchange, by a vote of 106 – 96. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program, by a vote of 123-79. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 851, which establishes the menstrual hygiene products grant program under the Public School Code, by a vote of 117-85. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1867, which prohibits health insurers from restricting the method of payment for in-network clinical services, by a vote of 181 – 21. The bill will now be sent to the Senate for consideration.
  • The House Aging & Older Adult Services Committee held an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3. A recording of the meeting is viewable here.
  • The House Insurance Committee convened on Monday, June 3 and favorably reported, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. A recording of the meeting is viewable here.
  • The Senate Aging & Youth Committee met on Tuesday, June 4 and favorably reported Senate Bill 840, which creates an Alzheimer’s Disease and Related Disorders Division in the Department of Aging, and House Bill 1853, which requires the Department of Health to meet annually with licensed nursing facilities in an effort to improve communication and collaboration around facility surveys. A recording of the meeting in viewable here.
  • The Senate Health & Human Services Committee convened on Tuesday, June 4 and favorably reported Senate Bill 1000, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse effect on pharmacies and patients. A recording of the meeting is viewable here.
  • The House Children & Youth Committee met on Wednesday, June 5 and favorably reported, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. A recording of the meeting is viewable here.
  • The House Health Committee convened Wednesday, June 5 and favorably reported House Bill 2283, which requires operating rooms to utilize surgical smoke evacuation systems. A recording of the meeting is viewable here.

The state House of Representatives and Senate will convene for voting session again next Monday, June 10 through Wednesday, June 13.

Department of Human Services 

The Department of Human Services (DHS) has published a Medical Assistance Bulletin to advise providers of the updates to the Medical Assistance (MA) program dental fee schedule.

DHS has issued Provider Quick Tip #207 with information about fee schedule updates to Act 62, the Autism Insurance Act, procedure codes. 

Department of Health

  • DOH, in partnership with the Bradbury-Sullivan LGBT Community Center and Public Health Management Corporation (PHMC), has announced the start of the Pennsylvania LGBTQ Health Needs Assessment Survey, which is a biannual survey conducted to evaluate health needs, health disparities, and barriers to care impacting LGBTQ+ Pennsylvanians. 

Department of Aging 

The Department of Aging has announced the release of Aging Our Way PA, which is the state’s 10-year strategic plan that will help transform service delivery and serve as a roadmap for older adult services in Pennsylvania, ensuring services meet the needs of older adults as they address everyday issues such as healthcare, transportation, housing, long-term care and social connections. 

Department of State 

Several of the state’s professional licensure boards have adopted a statement of policy regarding conversion therapy. Following are the respective boards’ conversion therapy statements of policy.

 Stakeholder Events   

Pharmaceutical Assistance Advisory Board – June 17

The Department of Aging’s Pharmaceutical Assistance Advisory Board will hold a public meeting on Monday, June 17 from 1:00 p.m. to 2:00 p.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

 

2024-06-07T20:44:00+00:00June 7th, 2024|Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for June 7
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PA Health Policy Update for May 31

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

General Assembly

The state House of Representatives and Senate will return to Harrisburg for voting session Monday, June 3 through Wednesday, June 5. Following is an overview of selected health care-related legislative activity currently scheduled.

  • The House Aging & Older Adult Services Committee will hold an informational meeting on Alzheimer’s Disease and other related dementias on Monday, June 3 at 10:00 a.m. The meeting will take place in Room 140 of the Main Capitol. It will also be livestreamed here.
  • The House Insurance Committee will convene on Monday, June 3 at 10:30 a.m. to consider, among other bills, House Bill 1754, which requires public and private insurers to cover biomarker testing, and Senate Bill 739, which provides for coverage of telemedicine services. The meeting will be held in the East Wing, Room 60. It will also be livestreamed here.
  • The House Children & Youth Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider, among other bills, House Bill 2037, which enables pharmacists to administer injectable medications, biologicals, and immunizations, and House Bill 2175, which creates a permanent Office of Child Advocate. The meeting will be held in East Wing, Room 60. It will also be livestreamed here.
  • The House Health Committee will convene on Wednesday, June 5 at 10:00 a.m. to consider House Bill 2283, which requires operating rooms utilize surgical smoke evacuation systems. The meeting will be held in Room G-50 of the Irvis Office Building. It will also be livestreamed here.

Department of Human Services 

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule as a result of the 2024 Healthcare Common Procedures Coding System (HCPCS) updates. 

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PA-HAN 751) with information for health care providers about 2024 West Nile and other arboviral infections in Pennsylvania.

DOH has announced the publication of an updated list of academic clinical research centers (ACRC) under the Medical Marijuana program on the department’s website and established the time period during which applications for clinical registrants (CR) will be accepted by the department. Find additional information in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has announced it disapproved the Bureau of Professional and Occupational Affairs final-form regulation that lists criminal convictions directly related to each of the 29 professional and occupational licensing boards and commissions. IRRC indicated the regulation was not in the public interest due to the removal of certain offenses that may have direct bearing on the conduct, services, and practices of various occupations and professions. Find additional information in this Pennsylvania Bulletin notice. 

Stakeholder Events   

DHS – Long-Term Services and Supports Subcommittee – June 5

The Long-Term Services and Supports Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on Wednesday, June 5 at 10:00 a.m. Find additional information and details on how to participate here. 

The Patient Safety Authority – June 20

The Patient Safety Authority will hold a public meeting of the Authority’s Board on Thursday, June 20 at 10:30 a.m. The meeting will take place at the Central Penn College conference center (600 Valley Road, Summerdale, PA 17093). The meeting will also be held virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-06-03T17:47:33+00:00May 31st, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for May 31
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PA Health Policy Update for April 5

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

General Assembly 

The Senate Aging & Youth Committee held an informational hearing on Wednesday, April 3 to examine challenges facing Pennsylvania’s children and youth services agencies. A recording of the hearing and copies of testimony provided to the committee are viewable here.

The state House of Representatives and Senate will reconvene for session Monday, April 8 through Wednesday, April 10. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Human Services Committee will meet on Monday, April 8 at 9:00 a.m. to consider House Resolution 373, which recognizes the week of April 11 through 17, 2024, as “Black Maternal Health Week” in Pennsylvania. The meeting will be held in Room 515 of the Irvis Office Building.
  • Following its voting meeting, the House Human Services Committee will hold an informational meeting on the delivery of quality home care services under Community HealthChoices. The meeting will be livestreamed here.
  • The House Health Committee will hold an informational meeting on Thursday, April 11 on advancing social equity through cannabis legalization. The meeting will be held in Room 60 of the East Wing and livestreamed here. 

Department of Human Services

After one year of processing Medicaid eligibility redeterminations following the end of pandemic-related continuous eligibility, the Department of Human Services (DHS) has reported that less than 600,000 applications are left to be processed and it should be completed with this effort by June 30.

About 70 percent of individuals remained eligible for Medicaid following their redetermination. To continue assisting Medicaid recipients with their annual redeterminations, providers are reminded to:

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has provided an update on certification entities. Clinical supervisors and counselors that provide clinical treatment services in licensed substance use disorder (SUD) treatment facilities have a number of ways to meet minimum qualifications. One of those ways is full certification by a statewide certification body that is a member of a national body. In Pennsylvania, the Pennsylvania Certification Board (PCB) has historically been one of the entities that provides that certification. In addition to PCB, the newly developed Pennsylvania Certification Commission for Addiction Professionals (PCC AP), which is part of the Pennsylvania Association of Addiction Professionals, an affiliate of the National Association of Addiction Professionals (NAADAC), is also an option for certification for clinical counselors and supervisors.  

Department of Insurance

The Department of Insurance has published guidance on how insurers should govern the development, acquisition, and use of certain artificial intelligence (AI) technologies. This department has also informed insurers of the type of information and documentation that the department may request during an investigation or examination of any insurer regarding its use of the technologies and AI systems. Find additional information in this Pennsylvania Bulletin notice. 

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $6.3 billion in General Fund revenue in March, which was $289.9 million, or 4.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.8 billion, which is $366.0 million, or 1.1 percent, above estimate. 

Stakeholder Events 

PHC4 – Meeting Dates

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled the following meetings.

  • Data Systems Committee meeting on April 17, 2024, at 9:00 a.m.
  • Council meetings on May 4 at 8:30 a.m. and July 11 at 10:00 a.m.
  • Payment Data Advisory Group meetings on April 18, May 23, and June 20 at 10:00 a.m.

Agendas will be available 24 hours in advance here. Find details on how to register and participate here. 

Patient Safety Authority – April 25

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

DOH – Special Pharmaceutical Benefits Program Advisory Council – April 25

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, April 25, 2024, from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-04-06T06:34:47+00:00April 5th, 2024|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 5
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PA Health Policy Update for March 1

The following is an update of selected state health policy developments in Pennsylvania from February 26 – March 1.  (Some of the language used below is taken directly from state documents). 

General Assembly 

  • The House Health Committee’s Subcommittee on Health Facilities held an informational meeting on Wednesday, February 28 to examine how to bolster support for rural and independent hospitals. A recording of the hearing is viewable here.
  • The House Aging & Older Adult Services Committee held an informational meeting on Monday, February 26 to examine senior hunger. A recording of the hearing is viewable here. 
  • Next week will conclude the state House of Representatives and Senate Appropriations Committees’ budget hearings. Following are the health-related agencies scheduled to appear next week.
    • The Department of Human Services will appear before the Senate Appropriations Committee on Tuesday, March 5. The hearing will begin at 9:30 a.m. and can be livestreamed here.
    • The Department of Human Services will appear before the House Appropriations Committee on Wednesday, March 6. The hearing will begin at 10:00 a.m. and can be livestreamed here.
    • The Department of Health will appear before the Senate Appropriations Committee on Thursday, March 7 at 9:30 a.m. The hearing can be livestreamed here. 

Department of Health

The Department of Health (DOH) has published information about its Medical Care Availability and Reduction Error (MCARE) Act surcharge for FY 2024, a per unit assessment of approximately $159.10 payable by June 1.  Learn more about the surcharge and the providers to which it applies from this Pennsylvania Bulletin notice. 

Please be aware that the mailing address for DAAC Central Office has changed. Please update your records and staff and ensure that any documents that are given to patients reflect this change. Following is the new address.

Commonwealth of Pennsylvania HUB
Attn: Division of Acute and Ambulatory Care
2525 North 7th Street, Suite 210
Harrisburg, PA 17110

Board of Pharmacy 

The State Board of Pharmacy has published proposed regulations that set forth the criteria for pharmacy technician training programs as well as the standards of practice and registration fees for both pharmacy technicians and pharmacy technician trainees. This proposed rulemaking effectuates Act 140 of 2020, which formally recognizes pharmacy technicians and grants oversight to the Board of Pharmacy. Find the proposed regulations in this Pennsylvania Bulletin notice. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has released the findings of the first phase of the agency’s state-wide stakeholder engagement tour, including what actions will be taken to improve community and treatment provider engagement and access to and delivery of substance use disorder services. The key themes highlighted in the findings are workforce concerns, administrative burdens, treatment assessment, and health equity. Find additional information in this press release. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published comments to the State Board of Medicine regarding its proposed rulemaking related to physician assistants. Find IRRC’s comments in this Pennsylvania Bulletin notice. 

Medicaid Continuous Coverage Unwinding

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

 Stakeholder Events  

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

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

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

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

2024-03-01T21:17:21+00:00March 1st, 2024|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for March 1
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PA Health Policy Update for February 23

The following is an update of selected state health policy developments in Pennsylvania from February 19 – 23.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

The Shapiro administration has released Aging Our Way, PA, which will serve as a 10-year roadmap to meet the needs of the commonwealth’s older adults and improve services for this rapidly growing population. The plan includes priorities, strategies, and tactics to promote health, well-being, and quality of life. It also aims to prepare the commonwealth for a larger, longer-living older adult population and is designed to respond to changing needs, shifting priorities, and available resources. A 30-day public comment period on the plan is now open for interested stakeholders to weigh in. Find additional details on the plan and how to comment here. 

General Assembly

  • The Department of Aging’s budget hearing before the House Appropriations Committee occurred on Thursday, February 22. A recording of the hearing is viewable here.
  • The House Republican Policy Committee held an informational meeting on Thursday, February 22 regarding, “A State Lost in Addiction: Pennsylvania’s Path to Recovery.” Find a copy of the agenda and testimony here.
  • The state House of Representatives and Senate Appropriations Committees will continue their respective budget hearings next week. The health-related agencies scheduled to appear include the Department of Insurance (Monday, February 26) and the Department of Health (Tuesday, February 27). Find the House Appropriations Committee’s complete schedule here and the Senate Appropriations Committee’s complete schedule here.
  • The House Health Committee’s Subcommittee on Health Facilities will hold an informational meeting on Wednesday, February 28 at 10:00 a.m. to examine how to bolster support for rural and independent hospitals. The meeting will be held in Room 60 of the East Wing. It will be livestreamed here.
  • The House Aging & Older Adult Services Committee will hold an informational meeting on Monday, February 26 to examine senior hunger. The meeting will be held in Room 523 of the Irvis Office Building. It will be livestreamed here. 

Department of Human Services 

The Department of Human Services (DHS) has published updated Medicaid ambulance fees that became effective January 1, 2024. Find additional information in this Pennsylvania Bulletin notice.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has announced it is seeking peers, family members, providers, and community members who may be interested in serving on the OMHSAS Mental Health Planning Council (MHPC). An application to serve on the council can be downloaded here. 

Department of Health

The Department of Health (DOH) has published the nursing home patient safety trust fund surcharge for FY 2023-2024 as required by the Medicare Availability and Reduction of Error (MCARE) Act. Find additional information in this Pennsylvania Bulletin notice.

DOH has released an updated schedule for its public meetings seeking feedback on potential priorities for the commonwealth’s Title V Maternal and Child Health Services Block Grant. Find the revised schedule in this Pennsylvania Bulletin notice.   

Office of the Attorney General 

Attorney General Michelle Henry has signed onto a letter with several other state attorneys general advocating for federal-level pharmacy benefit manager (PBM) reforms. 

Medicaid Continuous Coverage Unwinding

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

 Stakeholder Events 

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

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

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

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

Long-Term Care Council – 2024 Meeting Dates

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

2024-02-23T20:37:00+00:00February 23rd, 2024|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 23
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PA Health Policy Update for February 9

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

Governor Shapiro

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

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

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

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

General Assembly 

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

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

Department of Human Services 

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

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

Department of Health 

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

Medicaid Continuous Coverage Unwinding

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

 Stakeholder Events 

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

DHS – Medical Assistance Advisory Committee – February 22

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

2024-02-09T20:45:39+00:00February 9th, 2024|Governments, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for February 9
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PA Health Policy Update for January 19

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

Governor Shapiro 

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

General Assembly 

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

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

Department of Human Services 

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

Department of Health 

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

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

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

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

Medicaid Continuous Coverage Unwinding

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

Stakeholder Events

DHS – Consumer Subcommittee of the MAAC – January 24

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

DHS – Medical Assistance Advisory Committee – January 25

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

Patient Safety Authority – January 25

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

DOH – HIV Community Prevention Planning Committee – January 31

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

DOH – Organ Donation Advisory Committee – February 1

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

DOH – Brain Injury Advisory Board – February 2

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

2024-01-19T21:15:32+00:00January 19th, 2024|Financial, Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for January 19
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PA Health Policy Update for December 15

The following is an update of selected state health policy developments in Pennsylvania from December 11 – 15.  (Some of the language used below is taken directly from state documents.)

FY 2023-2024 Budget 

The General Assembly and Governor Shapiro enacted the remaining pieces of the FY 2023-2024 budget this week, including the Fiscal Code – House Bill 1300. The enactment of the Fiscal Code will enable approximately $1.1 billion that has been delayed since July to begin to be distributed. This includes $50 million for hospital financial relief, tobacco settlement funds, etc.  Find a summary of the various provisions in the Fiscal Code here. 

Governor Shapiro 

Governor Shapiro signed several bills into law this week. Following is a selection of health care-related laws enacted.

  • Senate Bill 414 (Act 59 of 2023) authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.
  • Senate Bill 683 (Act 43 of 2023) requires drug screening for fentanyl and xylazine, if a drug screening is conducted in a general acute care hospital to assist in diagnosing a patient’s condition.
  • Senate Bill 941 (Act 66 of 2023) enables certain flexibilities for addiction treatment providers.
  • House Bill 1131 (Act 50 of 2023) removes the requirement for counties to operate state health centers in counties establishing their own local health departments. 

General Assembly 

The state House of Representatives and Senate convened for their final voting session of 2023 this week. In addition to the bills noted above that were enacted by the General Assembly and the governor, following is an overview of selected health care-related legislative activity from this week.

  • The House of Representatives passed House Bill 1585, which establishes access and coverage for tele-dentistry in Pennsylvania, by a vote of 163-40. The bill will now be sent to the Seante for consideration.
  • The House of Representatives amended House Bill 181, known as the Family Medical Leave Act, on second consideration. The bill was subsequently referred to Appropriations and re-reported as amended. The bill still needs to be passed on third and final consideration before heading to the Senate.
  • The House Health Subcommittee on Health Care met on Wednesday, December 13 for an informational meeting on the “cannabis regulatory landscape.” Find a recording of the proceeding here. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of interprofessional consultation services to the Medical Assistance (MA) program fee schedule. These changes are effective for dates of services on and after January 1, 2024. Find additional information in this Pennsylvania Bulletin notice.
  • The public comment period for Pennsylvania’s proposed 1115 waiver application – Bridges to Success: Keystones of Health for Pennsylvania – is open through January 2, 2024. During this period, interested stakeholders can review the draft waiver application and provide comments online, in writing via mail, during multiple advisory and stakeholder meetings, or through three upcoming virtual forums. Those details can be found here.
  • DHS has issued a Medical Assistance Bulletin to inform providers about updates to the Medical Assistance (MA) program fee schedule related to the administration of COVID-19 vaccines.

Department of Health

  • The Department of Health (DOH) has sent a message to long-term care facilities regarding the methodology for calculating staffing ratios for licensed practical nurses (LPNs) and nurse aides. The new methodology will go into effect January 1, 2024.
  • DOH has published an addendum to its solicitation for substance use disorder navigation services to increase emergency department capacity. Find the addendum and additional information regarding the solicitation here.
  • DOH has asked health care providers to report individuals with blood lead levels of 3.5 μg/dL or higher detected through venous, capillary or unspecified testing within three months after consuming a WanaBana, Schnucks, or Weis brand cinnamon applesauce or apple purée product containing cinnamon by securely emailing the following information to RA-DHBOE-RESPONSE@pa.gov or by fax: 717-772-6975. Find additional information in this Health Advisory issued by DOH. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its 2022 Hospital Performance Report. The report includes risk-adjusted, hospital-specific mortality and readmission ratings as well as volume of cases and average charges for patients discharged from Pennsylvania’s acute care hospitals between October 1, 2021, through September 30, 2022 

State Board of Medicine 

The State Board of Medicine has published proposed rulemaking submitted by the Board of Medicine effectuating Act 79 of 2021, which among other things, enables physician assistant written agreements to be effective upon being filed rather than approved. Find additional information in this Pennsylvania Bulletin notice. 

Department of Labor & Industry 

The Department of Labor & Industry has determined the maximum compensation payable under the Workers Compensation Act shall be $1,325 per week for injuries occurring on or after January 1, 2024. Find additional information in this Pennsylvania Bulleton notice. 

Medicaid Continuous Coverage Unwinding

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.

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

Stakeholder Events

Pharmaceutical Assistance Board – December 18

The Department of Aging Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, December 18 from 1 p.m. to 2:30 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

 

2023-12-18T16:30:15+00:00December 16th, 2023|long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for December 15
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PA Health Policy Update for November 17

The following is an update of selected state health policy developments in Pennsylvania from November 13 – 17.  (Some of the language used below is taken directly from state documents.) 

General AssemblyHouse Chamber of the State House

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

  • The House of Representatives unanimously passed Senate Bill 500, which provides Medicaid coverage for pasteurized donor human milk, as amended. The Senate subsequently concurred with the House amendments and sent it to the governor’s desk.
  • The Senate unanimously passed House Bill 507, which requires health care providers to obtain informed consent, both verbal and written, before performing a pelvic examination, a rectal examination, or a prostate examination while the patient is anesthetized or unconscious. The House subsequently concurred with the Senate amendments and sent it to the governor’s desk.
  • The Senate unanimously passed Senate Bill 668, which permits certified nurse aides to become certified medication aides (CMA) in long-term care facilities, assisted living residences, and personal care homes. Following Senate passage the bill was received in the House and referred to the Health Committee.
  • The House Human Services Committee held a meeting on Monday, November 15 and favorably reported House Bill 1650, which authorizes the establishment of a grant program for recovery houses, and House Bill 1690, which establishes a public awareness campaign about the growing threat of Xylazine.
  • The House Health Committee held a meeting on Wednesday, November 15 and favorably reported House Bill 1657, which eliminates exemptions in the state’s Clean Indoor Air Act and expands the definition of smoking to include e-cigarettes, and Senate Bill 414, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services.

Department of Human Services

  • The Department of Human Services (DHS) has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through December. Find the updated calendar here.
  • DHS has announced it will add sexually transmitted infection (STI) test kits for at-home specimen collection to the Medical Assistance (MA) Program fee schedule, effective with dates of services on and after December 1, 2023. Find additional information in this Pennsylvania Bulletin notice.

Department of Health 

The Department of Health is soliciting applications from hospitals and health systems for up to $325,000 in grant funding to support care navigators in emergency departments as part of the Pennsylvania Substance Use Navigation Program. One grantee will be selected in each of four regions, based on the location of the emergency department where care will be provided, and funds can be used to build and implement health system-wide clinical capacity to screen, diagnose, and support longitudinal care for opioid use disorder and stimulant use disorder and support recovery for adults and adolescents. The RFA closes on January 16, 2024.

In anticipation of the holiday season, DOH has issued vital safety tips to avoid holiday accidents. On behalf of DeBrunner & Associates, we hope you don’t burn the turkey and wish you a very happy Thanksgiving. 

Medicaid Continuous Coverage Unwinding

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.

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

Stakeholder Events 

DOH – HIV Community Prevention Planning Committee – November 29

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, November 29 from 9:00 a.m. to 4:30 p.m. The meeting will be conducted in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

Patient Safety Authority – December 7

The Patient Safety Authority will hold a public board meeting on Thursday, December 7 at 1:00 p.m. The meeting will be held virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-11-17T21:07:32+00:00November 17th, 2023|Governments, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for November 17
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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