Pennsylvania safety-net hospitals Archives - Page 15 of 20 - Safety-Net Association of Pennsylvania

340B Program Under the Microscope

Federal officials continue to cast a wary eye on a program that gives discounts on prescription drugs to hospitals that care for large numbers of low-income patients.
The federal 340B Prescription Drug Program requires drug manufacturers to give discounts to eligible providers for the prescriptions they provide patients on an outpatient basis; the hospitals then provide their low-income patients with their prescriptions at a discount or free of charge. The program has grown a great deal in recent years and now, critics argue that some hospitals that currently receive the discounts should not qualify for them and others are not reinvesting the savings the program generates in care for low-income patients.
Hospitals, meanwhile, note that program savings enable them to fund clinics and otherwise unaffordable programs and services and help them absorb the cost of uncompensated care.
The controversy has drawn congressional interest, and the federal agency that administers the program, the Health Resources and Services Administration, was expected to produce new guidelines governing eligibility and the use of prescription drug discounts. Those guidelines have been delayed in the wake of a federal court ruling involving orphan drug sales that has called into question the agency’s regulation-issuing authority.
Most Pennsylvania safety-net hospitals participate in the program.
Learn more about the 340B Prescription Drug Program, its growth in recent years, the concerns raised about it amid that growth, and what to expect next in this Kaiser Health News article.

PA Safety Net Admin2014-06-25T06:00:32+00:00June 25th, 2014|Uncategorized|Comments Off

SNAP Speaks Out on PA Budget Issues

In a series of three new position papers, the Safety-Net Association has laid out the case for why Pennsylvania needs to fund its Medicaid program adequately in the state’s upcoming 2015 fiscal year.
The first paper, “Pennsylvania Safety-Net Hospitals: Economic Engines Driving Pennsylvania Communities,” documents the degree to which safety-net hospitals not only provide significant numbers of jobs but also offer higher wages than other hospitals and other Pennsylvania employers.
The second paper, “The Importance of Preserving Uncompensated Care Payments,” notes that Pennsylvania’s safety-net hospitals, just 25 percent of the state’s acute-care hospitals, provide nearly 50 percent of the $1 billion worth of uncompensated care hospitals in the state provide every year. The state helps underwrite some of those costs through Tobacco Uncompensated Care fund payments – proceeds of the national tobacco settlement of 1998 – but that funding is now in jeopardy.
And the third paper, “The Need for Stable and Predictable Funding Amid Increasing Challenges,” outlines the enormous and at times conflicting pressures that government and others are exerting on hospitals and explains that while safety-net hospitals look forward to these challenges, they need stable and predictable Medicaid funding to help them rise to the occasion.
SNAP issues these papers as lawmakers in Pennsylvania struggle with an FY 2014 revenue shortfall of more than $500 million and an anticipated shortfall of another $880 million in the coming 2015 fiscal year.
See SNAP’s three new position papers here.

PA Safety Net Admin2014-06-20T06:00:20+00:00June 20th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Stop Hurting Hospitals That Serve the Poor, HHS Told

Medicare’s hospital readmissions reduction program is unfairly penalizing hospitals that serve especially large numbers of low-income patients, 34 members of Congress have written in a letter to recently appointed Health and Human Services Secretary Sylvia Mathews Burwell and Centers for Medicare & Medicaid Services (CMS) administrator Marilyn Tavenner.
The letter, sponsored by Rep. James Renacci (R-Ohio), notes that while the program has

…incentivized hospitals to reduce readmissions, there are some factors outside of a hospital’s control that make it difficult for the patient to avoid readmission. The current penalty methodology…has created an unintended consequence for hospitals that service our most vulnerable populations – dual-eligible beneficiaries; low-income seniors, or people with disabilities that are eligible for both Medicare and Medicaid.

The letter also notes financial penalties imposed by the program “jeopardizes the viability of hospitals that service our nation’s most vulnerable population” and that H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmissions Program,

…adjusts the penalty methodology for hospitals servicing larger amounts of dual-eligible beneficiaries and excludes patients with certain extenuating circumstances from the penalty calculations. Adjusting the penalty to account for certain disparities in patient population can make a big difference to hospitals across the country and the nine million dually-eligible beneficiaries that rely on these hospitals for their critical care needs.

Pennsylvania’s safety-net hospitals are among those hurt by the program in its current form.
Read the House letter to Secretary Burwell and Administrator Tavenner here.

PA Safety Net Admin2014-06-19T06:00:16+00:00June 19th, 2014|Uncategorized|Comments Off

Late Budget for PA?

Pennsylvania’s constitution calls for the state to adopt a budget for the next fiscal year by June 30, the end of its fiscal year, but it is looking more and more as if the legislature and governor will miss that deadline this year.
Although budgets typically come easily when the same party controls the governor’s mansion and both chambers of the General Assembly, the state’s revenue shortfall, a structural deficit that will carry over into next year, and the introduction of additional issues into the budget process appear to be slowing progress toward adopting a spending plan for the state’s 2015 fiscal year.
To reinforce the notion that June 30 may come and go without a budget adopted, state Senate majority leader Dominic Pileggi recently told members of his Republican caucus to put their fourth of July celebration plans on hold because their work for the legislative season may not be done.
At stake for Pennsylvania’s safety-net hospitals is funding for the state’s Medicaid program. The budget includes numerous items that may prove tempting for officials to prune in search of money to close the current revenue shortfall. Most tempting may be millions in Tobacco Uncompensated Care Fund revenue frozen by the Corbett administration last year in response to an arbitrator’s decision to reduce the state’s proceeds from the national tobacco settlement.
Tobacco Uncompensated Care funds help underwrite some of the $1 billion in charity care Pennsylvania’s hospitals provide annually – more than 40 percent of it provided by the 25 percent of acute-care hospitals in the state that are safety-net hospitals. The Safety-Net Association of Pennsylvania (SNAP) is conveying its concern about the possibility of reducing this funding to legislators.
Learn more about the potential delay in adopting a state budget in this PA Politics report and this York Dispatch article.

PA Safety Net Admin2014-06-18T06:00:38+00:00June 18th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

MedPAC: Keep Paying More For Medicare Primary Care Services

The federal government should continue paying extra for primary care services provided to Medicare patients, Congress has been told by its chief advisor on Medicare payment policy.
According to the Medicare Payment Advisory Commission (MedPAC), the independent federal agency that advises Congress on Medicare payment matters, Medicare has long undervalued primary care services in comparison to specialty medical care, and in 2010 the Affordable Care Act introduced a ten percent bonus for primary care services provided to seniors through 2015.
With the expiration of that bonus coming in a little more than a year, MedPAC has told Congress it should seek to continue the practice but perhaps by making the additional payment on a per beneficiary basis rather than a per visit basis, to make such an approach part of the broader effort to discourage the volume provision of services and to encourage outcomes-oriented care.
In its June 2014 report to Congress, MedPAC also outlines how such a payment might work.
Pennsylvania’s safety-net hospitals all care for significant numbers of Medicare patients, including many low-income seniors.
Learn more about MedPAC’s overall recommendations, including this one involving Medicare primary care payments, in this MedPAC fact sheet. Find the entire MedPAC June 2014 report to Congress here.

PA Safety Net Admin2014-06-17T06:00:28+00:00June 17th, 2014|Affordable Care Act|Comments Off

Thousands in PA Await Word on Medicaid Eligibility

More than 60,000 Pennsylvanians are waiting to hear from the state about their application for Medicaid benefits.
The 60,000 are among more than 1.7 million people nation-wide who have applied for Medicaid are still waiting for a decision on their eligibility – some for as long as eight months.
More than half of those still waiting are in California while some live in states that, like Pennsylvania, have not expanded their Medicaid programs.
The delays have been attributed to problems transferring data received on the federal health insurance exchange to state governments, state programs overwhelmed with volume, technical problems in the states, and other reasons.
Many of those who still await word on their application for Medicaid benefits undoubtedly live in communities served by the state’s private safety-net hospitals.
Learn more about this problem, what is being done about it, and how it affects access to care in this Kaiser Health News article.

PA Safety Net Admin2014-06-10T06:00:52+00:00June 10th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Members of Congress Urge Delay in Medicare DSH Cuts

Fifty-eight members of the House of Representatives have written to House leadership asking them to delay the continued implementation of Affordable Care Act-mandated Medicare disproportionate share (Medicare DSH) cuts.
The letter, to House Speaker John Boehner and minority leader Nancy Pelosi, notes that

…hospitals that qualify for Medicare DSH are, by definition, the very providers caring for the greatest numbers of low-income and low-income elderly patients. In recent years, hospitals have incurred $270 billion in Medicare cuts, including reductions in their annual cost-of-living adjustments, penalties through Medicare’s value-based purchasing and readmissions reduction programs, reduced Medicare bad debt reimbursement, and continued cuts from sequestration. Medicare DSH cuts at this time could jeopardize the health care safety net that our constituents and yours need and deserve.

Medicare DSH payments are vital to most of Pennsylvania’s private safety-net hospitals.
Read the entire congressional letter here.

PA Safety Net Admin2014-06-05T06:00:07+00:00June 5th, 2014|Affordable Care Act|Comments Off

CMS to Examine How States Set Medicaid Managed Care Rates

The Centers for Medicare & Medicaid Services (CMS) is launching an initiative to explore how states set the rates they pay managed care organizations to serve Medicaid patients.
The initiative consists of two parts: first, CMS is examining the adequacy of the process states employ to set their rates – a process that affects the adequacy of the rates themselves; and second, it is drafting updated Medicaid managed care regulations.
Because Pennsylvania safety-net hospitals serve so many Medicaid patients, this effort could have a future impact on the payments they receive for serving these patients.
Learn more about this new undertaking in this Kaiser Health News report.

PA Safety Net Admin2014-05-29T06:00:25+00:00May 29th, 2014|Pennsylvania Medicaid policy|Comments Off

Study Points to Risk of DSH Cuts

A new study suggests that future cuts in Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments could pose problems for hospitals that serve large numbers of uninsured patients.
According to a new report in the journal Health Affairs,

Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.

Medicare DSH and Medicaid DSH payments help underwrite the uncompensated care hospitals provide to their uninsured patients. These payments are a vital source of revenue for Pennsylvania’s safety-net hospitals and Pennsylvania is among the states that have not yet adopted Medicaid expansion.
Even after Affordable Care Act reforms take effect, 25 to 30 million Americans are expected to remain uninsured. Medicare DSH payments are expected to decline $22.1 billion between now and 2019 and Medicaid DSH payments, temporarily delayed by two separate actions of Congress, are expected to decline $17.1 billion through 2020.
Learn more about the Health Affairs study in this Washington Post article and find the study itself here, on the web site of Health Affairs.

PA Safety Net Admin2014-05-07T06:00:01+00:00May 7th, 2014|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Recoups Tobacco Money in Court Ruling

A Philadelphia court has restored $120 million of Pennsylvania’s share of the annual proceeds from the master settlement that tobacco manufacturers entered into with state governments in 1998.
Last year, an arbitration panel ruled that Pennsylvania had failed to enforce selected tax collection requirements properly and reduced the state’s share of the settlement proceeds by $180 million. The state appealed the ruling, and last week the court restored $120 million of the $180 million reduction mandated by the arbitration panel.
Pennsylvania uses the proceeds of the tobacco settlement for a number of purposes, including to make Tobacco Uncompensated Care Fund payments to hospitals that serve especially large numbers of uninsured patients and to underwrite clinical, health services, and biomedical research under the state’s Commonwealth Universal Research Enhancement Program (CURE).
Tobacco Uncompensated Care Fund payments are a vital source of support for many Pennsylvania safety-net hospitals.
Learn more about the tobacco funding issue, the court’s ruling, and the implications of that ruling in this Allentown Morning Call article.

PA Safety Net Admin2014-04-15T06:00:29+00:00April 15th, 2014|Medicaid supplemental payments|Comments Off

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