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

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.

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.

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 Pennsylvaniais 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.

 

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.

PA Health Policy Update for October 6

The following is an update of selected state health policy developments in Pennsylvania from October 2 – 6.  (Some of the language used below is taken directly from state documents.) 

FY 2023-20204 Budget Update 

The General Assembly continues to work on finalizing the FY 2023-2024 state budget. This week the state House of Representatives passed an amended version of the Fiscal Code (House Bill 1300) by a vote of 121-82 and sent it back to the Senate for consideration. The House of Representatives also passed an addendum to the General Appropriations Act (House Bill 1456) and a tax code (House Bill 1219) and sent them to the Senate for consideration. These pieces of legislation were not negotiated with Senate leadership in advance, so it is unclear how the Senate will proceed, or when the FY 2023-2024 budget process will be completed. 

General Assembly 

  • The state House of Representatives and Senate convened for session in Harrisburg this week. The following is an overview of selected health care focused legislative activity.
    • The House of Representatives adopted House Resolution 165, which directs the Legislative Budget and Finance Committee to examine the effect of workforce shortages on state-supported Medicaid home and community-based services waiver programs.
    • The Senate Health & Human Services Committee held an informational meeting on Tuesday to examine barriers to addiction treatment. Immediately following the information meeting, the committee held a voting meeting and favorably reported the following bills.
      • Senate Bill 941, which enables certain flexibilities for addiction treatment providers.
      • Senate Bill 721, which establishes the Women, Infants, and Children (WIC) advisory board.
      • House Bill 1351, which makes certain changes to the Rural Health Redesign Center Authority.

Find a recording of the hearing here.

    • The House Health Committee’s Subcommittee on Health Facilities held an informational meeting on Wednesday to examine the effects of hospital consolidation. Find a recording of the hearing here.
    • The House Human Services Committee and Aging & Older Adult Services Committee held a joint informational meeting Wednesday on personal care homes and assisted living facilities. Find a recording of the hearing here.
  • The state House of Representatives and Senate are now recessed until Monday, October 16. 

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to make one-time enhanced supplemental payments to eligible public and non-public Medical Assistance (MA) nursing facilities. Find additional information in this Pennsylvania Bulletin notice.
  • DHS Secretary Dr. Val Arkoosh has reminded Pennsylvanians who receive health care coverage through Medicaid or CHIP that the cost of COVID-19 vaccines, tests, and treatments are covered by the programs. Find additional information in this press release issued by DHS.
  • DHS has issued a Medical Assistance Bulletin announcing the addition of new procedure codes to the Medical Assistance (MA) program for vaccine administration.
  • DHS has issued a Medical Assistance Bulletin notifying providers about updates to the provision of Medicaid-covered services to beneficiaries experiencing homelessness when delivered in their lived environment, also known as “street medicine.”
  • DHS has published Provider Quick Tip #270 with important information for providers who are required to revalidate clinicians at multiple locations.
  • DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on September 28.

Department of Health 

The Department of Health (DOH) has invited stakeholders to participate in an information-gathering listening session regarding patient access to controlled substances in the commonwealth. The listening session will be held on Wednesday, October 11 from 10:00 – 11:30 a.m. Find additional information on how to register and participate here.

DOH has announced it will be implementing new regulatory requirements for all long-term care facilities beginning October 31. The new requirements include changes to the application for licensure, which will require additional information, documentation, and public disclosure. DOH has provided interpretive guidance for these changes on its website here.

Revenue Collection Update 

The Department of Revenue has announced Pennsylvania collected $4.1 billion in General Fund revenue in September, which was $140.2 million, or 3.3 percent, less than anticipated. Fiscal year-to-date General Fund collections total $9.8 billion, which is $167.4 million, or 1.7 percent, below estimate. 

Medicaid Continuous Coverage Unwinding 

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

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 – Renal Disease Advisory Committee – October 20

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – October 26

The Special Pharmaceutical Benefits Advisory Council will hold a public meeting on Thursday, October 26 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Traumatic Brain Injury Advisory Board Meeting – November 3

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, November 3 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 in the Cambria conference room. Find additional information in this Pennsylvania Bulletin notice.

PA Health Policy Update for August 4

The following is an update of selected state health policy developments in Pennsylvania from July 31 – August 4.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update

Governor Shapiro signed House Bill 611 – the FY 2023-2024 General Appropriations Act – into law yesterday shortly after it was formally signed in the Senate and sent to his desk. The enactment of House Bill 611 will enable funding to be disbursed to, among other entities, county governments and school districts. The Governor and the General Assembly still need to finalize enabling legislation (i.e., code bills) in order for the budget to be fully enacted. Read more in this press release issued by the Governor’s office. 

General Assembly

The Center for Rural Pennsylvania held a public hearing on rural hospital and healthcare sustainability to explore difficulties facing rural hospitals and health systems. Details from the hearing, including the agenda and testimony, may be viewed here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin updating guidelines for the delivery of physical health services via telehealth. The bulletin applies to all providers enrolled in the Medical Assistance (MA) Fee-for-Service program.
  • DHS has issued Provider Quick Tip # 85 with information about the department’s Breast & Cervical Cancer Prevention & Treatment Program.
  • DHS has shared the following information from the Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting on August 2.

Centers for Medicare and Medicaid Services

CMS has issued new guidance to state Medicaid programs as they work to return to normal operations after the end of COVID-19 flexibilities. Specifically, this guidance announces an update of CMS’s policy regarding the end date for flexibilities approved in states’ section 1915(c) Home and Community-Based Services waiver Appendix K amendments.  Under CMS’s prior policy, these flexibilities were set to expire six months after the expiration of the COVID-19 public health emergency, but in this letter CMS explains that these flexibilities may remain in effect for a longer period of time.  

Department of Health 

The Department of Health (DOH) has recently issued two Health Advisories (PAHAN – 713 & PAHAN –711) alerting providers of possible measles exposure in Blair, Clearfield, and Montgomery Counties.

DOH has issued a Health Advisory (PAHAN – 712) notifying providers of a nationwide shortage of Penicillin G benzathine (Bicillin L-A®). 

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Counsel (PHC4) has announced it launched a new website. The new website, which is aimed at increasing consumer engagement, may be found here. 

Revenue Collection Update 

The Department of Revenue announced Pennsylvania collected $2.9 billion in General Fund revenue in July, the first month of the 2023-2024 fiscal year. Note, the July collection data does not include a comparison against anticipated amounts because the official estimate for the 2023-2024 fiscal year has not been certified. 

Medicaid Continuous Coverage Unwinding 

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

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.

PA Health Policy Update for June 30

The following is an update of selected state health policy developments in Pennsylvania from June 26 – 30.  (Some of the language used below is taken directly from state documents.) 

FY 2023-2024 Budget Update 

As of 4:00 p.m. Friday, June 30 Governor Shapiro and the General Assembly have not enacted a final Fiscal Year (FY) 2023-2024 spending plan despite being hours away from the state’s constitutionally mandated deadline. The Senate is preparing to vote on a $45.5 billion spending plan, but the Democratic leaders of the House haven’t signaled support for the measure. Negotiations are ongoing. 

Shapiro Administration

Dr. Val Arkoosh officially became Secretary of the Department of Human Services (DHS) in accordance with the Pennsylvania Constitution this week. Find additional information in this press release issued by the DHS.

Governor Shapiro officially recalled the nomination of Dr. Debra Bogen to serve as Secretary of Health. The recall followed a confirmation hearing held by the Senate Health & Human Services Committee. A recording of the confirmation hearing for Dr. Bogen, as well as Dr. Arkoosh, can be viewed here. 

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings. Please note the House and Senate remain in session as of 4:00 p.m. Friday, June 30. As a result, this is not an exhaustive list of legislative proceedings.

  • The House passed HB 106, “The Patient Safety Act,” on third and final consideration Wednesday, June 28 by a vote of 119 – 84. The bill, which would implement specific nurse-to-patient ratios, was amended on second consideration to decrease the penalties for violations and create a grant program – funded by the penalties paid by hospitals – for nursing recruitment and retention for rural and high Medical Assistance hospitals. The amendment also delays the ability of the Department of Health to impose penalties on rural and high Medical Assistance hospitals for two years and extended the effective date for the remainder of hospitals to one year, instead of six months. The bill now goes to the Senate for consideration.
  • The Senate Health and Human Services Committee held a voting meeting Tuesday, June 27 to consider HB 479, which requires both the Medical Assistance Capitation and Fee-for-Service programs to pay for all loaded ambulance miles at $4 per loaded mile beginning on January 1, 2025. A recording of the meeting can be viewed here.
  • The Senate Banking and Insurance Committee held a voting meeting Tuesday, June 27 to consider SB 739, which defines telemedicine, offers guidelines outlining who can provide telemedicine services, and addresses insurance company reimbursement for these services. The bill was reported as amended. A recording of the meeting can be viewed here.
  • The House Human Services Committee met this week to consider the following bills:
    • HB 1515, to extend the current nonnarcotic medication assisted treatment program in the county correctional system to all mediation assisted treatments. The bill was reported as committed.
    • HB 1218, which requires the Department of Human Services to submit a waiver to the Centers for Medicare and Medicaid to establish a program allowing spouse caregivers to receive payment for the services they provide. The bill was reported as amended.

A recording of the meeting can be found here.

  • The House Human Services Committee is expected to reconvene for a voting meeting Friday, June 30 at the call of the chair to consider HB 876, which requires any entity providing goods or services reimbursable under the medical assistance program to have either a National Provider Identification (NPI) or receive a State Provider Identification number (SPI). The meeting will be held in Room 60 East Wing and livestreamed here.
  • The House Aging and Older Adult Services Committee is expected to hold a voting meeting at the call of the chair Friday, June 30 to consider HB 1527 to increase the personal needs allowance deduction for residents of nursing facilities to $60 per month and HR 165 to direct the Legislative Budget and Finance Committee to study the effect of the workforce shortage on State supported Medicaid home and community based waiver programs and the Pennsylvania Lottery funded OPTIONS programs. The voting meeting will be held in Room G-50 of the Irvis Office Building and will be livestreamed here.

Medicaid Continuous Coverage Unwinding 

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

Department of Human Services

  • The Department of Human Services (DHS) has published its annual list of exceptional Durable Medical Equipment (DME) in this Pennsylvania Bulletin notice.
  • DHS has issued several Medical Assistance Bulletins related to prior authorization guideline changes. Following are the various bulletins.
  • DHS has issued a Medical Assistance Bulletin with Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program periodicity schedule and coding matrix.
  • DHS has issued a Remittance Advice Alert to regarding the department’s delay in implementing Version 38.0 and 39.0 of the APR DRG classification system for Medical Assistance (MA) program enrolled general acute-care hospitals.

Department of Health

  • The Department of Health (DOH) has published answers to frequently asked questions about new long-term care facility regulations that come into effect on July 1, 2023.
  • DOH has provided a staffing ratio calculation tool to assist long-term care facilities planning for compliance with new regulatory requirements as of July 1. Use of the tool is not required but may be useful when calculating the required number of nursing hours as well as the staff ratios. Click here for instructions, which opens in a Word document, and here for the tool, which opens as an Excel spreadsheet.
  • DOH has issued a Health Advisory (2023 – PAHAN – 707) to share information and notify clinicians, public health authorities, and the public about locally acquired malaria cases and concern for a potential rise in imported malaria cases associated with increased international travel during the summer.
  • DOH has issued a Health Advisory (2023 – PAHAN – 706) to request that clinicians continue to test for influenza in patients with respiratory illness throughout the summer due to the severity of recent human infections with avian influenza A(H5N1). 

Stakeholder Events 

PHC4 – Council Meeting – July 6

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet on Thursday, July 6 at 10:00 a.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice. 

DHS – Medical Assistance Consumer Subcommittee – July 26

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will meet on Wednesday, July 26 at 1:00 p.m. Click here to register to participate.

DHS – Medical Assistance Advisory Committee – July 27

The MAAC will meet on Thursday, July 27 from 10:00 a.m. to 12:00 p.m. Click here to register to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

PA Health Policy Update for June 23

The following is an update of selected state health policy developments in Pennsylvania from June 20 – 23.  (Some of the language used below is taken directly from state documents.)

Medicaid Continuous Coverage Unwinding 

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

General Assembly

The House and Senate returned to Harrisburg this week for voting session. The following are selected health-related proceedings.

  • The Senate voted to confirm Governor Josh Shapiro’s nominees for the Department of Drug and Alcohol Programs, Dr. Latika Davis-Jones, and Pennsylvania Insurance Department, Michael Humphreys. A recording of the Senate Health and Human Services Committee confirmation hearing can be viewed here. A recording of the Senate Banking and Insurance Committee confirmation hearing can be viewed here.
  • The General Assembly passed SB 262, which requires the Maternal Mortality Review Committee to publish severe maternal mortality data. The bill will now be sent to the governor.
  • The House unanimously passed HB 1209 and HB 1407, which enable Pennsylvania to meet its obligations under the 1998 Master Settlement Agreement (MSA) with tobacco product manufacturers and ensure the state is able to continue receiving funds from the tobacco settlement for health-related programs.
  • The Senate adopted SR 46 to establish the Task Force on Women Veterans’ Health Care to study the health care and access issues facing women veterans.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, June 20 at 10:30 a.m. to consider the following bills.
    • SB 683, which requires an acute-care hospital to include testing for fentanyl if the hospital conducts a urine drug screening to assist in the diagnosis of a patient’s condition. The bill was reported as amended, to include xylazine.
    • SB 768, which makes changes to the Pennsylvania Rural Health Redesign Center Authority (RHRCA) Act, including financing of the authority and board membership. The bill was reported as committed.
    • SB 817, which creates a primary care workforce initiative for Federally Qualified Health Centers (FQHCs). The bill was reported as committed.

A recording of the meetings can be viewed here.

  • The House Human Services Committee held a voting meeting Wednesday, June 22 at 11:30am to consider HB 850, which requires the Departments of Health and Human Services to apply for a waiver if the U.S. Department of Agriculture’s Food and Nutrition Service creates and makes a waiver available to the states that would allow those receiving SNAP and WIC to use those programs for menstrual hygiene products. The bill was reported as amended. A recording of the meeting can be viewed here.

The House and Senate will return to Harrisburg for voting session Monday, June 26.

Department of Human Services

  • The Department of Human Services (DHS) issued a Medical Assistance Bulletin to inform Medical Assistance (MA) providers that DHS has added CPT code 0174A to the MA Program Fee Schedule for the administration of an additional bivalent dose of the COVID-19 vaccine manufactured by Pfizer, Inc.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through July. Find the updated calendar here.
  • DHS has announced the proposed Nursing Facility Assessment Program details for FY 2023-24, including the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the assessment under the Nursing Facility Assessment Program. Find additional information in this Pennsylvania Bulletin notice. 

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume one of its annual analysis of the financial performance of Pennsylvania’s acute-care hospitals.  The analysis found that hospital total margins across the state decreased 7.59 percentage points in FY 22. Go here to find a PHC4 news release describing the agency’s report, the report itself, and a link to downloadable data from the report. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) submitted comments to the Department of Human Services on their regulation #14-543Protective Services for Adults. 

Stakeholder Events 

DOH – Medical Marijuana Advisory Board – June 28

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

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

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

DOH – Specialty Pharmaceutical Benefits Program – July 20

The next Specialty Pharmaceutical Benefits Program Advisory Council meeting will be held virtually on Thursday, July 20 from 10:00 a.m. to 12:00 p.m. Go here for details on how to participate. 

DOH – Newborn Screening and Follow-Up Technical Advisory Board – July 27

The Newborn Screening and Follow-Up Technical Advisory Board will hold a public meeting on Thursday, July 27 from 10:00 a.m. until 1:00 p.m. The meeting will be conducted in person. The agenda will include discussions about Board member terms; updates from the Bureau of Family Health; and updates from the Lysosomal Storage Disorders/X-ALD, Cystic Fibrosis, Hemoglobinopathy and Critical Congenital Heart Defects subcommittees. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2023-06-23T21:27:26+00:00June 23rd, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 23

PA Health Policy Update for June 16

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

Medicaid Continuous Coverage Unwinding 

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

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

Governor Shapiro

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

General Assembly

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

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

A recording of the meeting can be viewed here. 

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

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

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

Department of Health 

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

Department of Human Services

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

Department of Drug & Alcohol Programs 

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

Department of Aging 

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

Stakeholder Events

DHS – Medical Assistance Advisory Committee Meeting – June 22

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

DOH – Medical Marijuana Advisory Board – June 28

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

PID – 1332 Waiver Reinsurance Program Public Forum – June 28

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

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