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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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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.

2023-10-10T14:33:03+00:00October 6th, 2023|Financial, Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for October 6
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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.

2023-08-04T18:51:26+00:00August 4th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for August 4
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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.

2023-06-30T20:28:31+00:00June 30th, 2023|Medicaid Eligibility Redetermination , Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania proposed FY 2024 budget|Comments Off on PA Health Policy Update for June 30
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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 #14-543: Protective 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
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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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PA Health Policy Update for May 26

The following is an update of selected state health policy developments in Pennsylvania from May 22 – 26.  (Some of the language used below is taken directly from state documents.) 

Medicaid Continuous Coverage Unwinding 

The Department of Human Services (DHS) has updated its 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. 

Governor Shapiro

On Thursday Governor Shapiro signed Executive Order 2023-09 directing the Department of Aging to prepare and develop a Master Plan for Older Adults, which will serve as a 10-year roadmap to meet the needs of Pennsylvania’s senior population and improve commonwealth services for older Pennsylvanians. Find additional information in this press release issued by the governor’s office. 

General Assembly 

The state House returned to Harrisburg for voting session Monday, May 22. The following are selected health-related proceedings.

  • The House Health Committee held a voting meeting Monday, May 22 to consider, among several resolutions, HB 1131 sponsored by Representative Lisa Borowski, which would remove the requirement for counties to operate state health centers in counties establishing their own local health departments. The bill was unanimously reported as committed. A recording of the meeting can be viewed here.
  • The House Human Services Committee held a voting meeting Tuesday, May 23 to consider, HB 849 sponsored by Representative Mike Schlossberg, to allocate funding for the Behavioral Health Commission on Adult Mental Health’s recommendations for funding, and HB 931 sponsored by Representative Eddie Day Pashinski, to establish the Kinship Care Legal Assistance Grant Program, which was reported as amended. HB 849 was reported as amended and the amended text can be found here. A recording of the meeting can be viewed here.

The state House and Senate will return to Harrisburg for voting session Monday, June 5. The following are selected health-related proceedings.

  • The House Human Services Committee will hold a joint hearing with the House Veteran Affairs and Emergency Preparedness Committee Monday, June 5 on the next generation of emergency and mental health response. The hearing will be held at 10:30am in Room 140 of the Main Capitol and will be live streamed here.
  • The House Health Committee will hold a voting meeting Tuesday June 6 to consider HB 106, the Patient Safety Act, which sets nursing staffing ratios and HB 754, which provides a standard notice to each nursing home resident and their designated representatives at the time of their admission into a nursing home facility that they have the option of having legal representation to assist with the application for Medicaid benefits. The meeting will be held at 10:00am in Room 205 of the Ryan Office Building and will be live streamed here.
  • The Senate Health and Human Services Committee will hold a public hearing Tuesday, June 6 on Pennsylvania’s EMS crisis and long-term sustainability. The hearing will be held in Room 8E-A East Wing and will be live streamed here. 

Department of Health 

The Department of Health has issued a Health Advisory (2023 – PAHAN – 697) with information from the Centers for Disease Control and Prevention (CDC) regarding an outbreak of suspected fungal meningitis among U.S. patients hospitalized in Texas. 

Department of Human Services

  • The Department of Human Services (DHS) has announced the addition of certain procedure codes to the Medical Assistance (MA) program fee schedule for the administration of additional bivalent doses of the SARS-CoV-2 vaccines manufactured by Moderna and Pfizer. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced updates to the MA program fee schedule for evaluation and management (E&M) procedure codes, including making adjustments to the fees for some procedure codes. These updates are effective for dates of service on and after June 1, 2023. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the addition of procedure codes G0312 and G0315 to the MA program fee schedule for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and novel coronavirus (COVID-19) vaccine counseling only visits. Find additional information in this Pennsylvania Bulletin notice.
  • Materials from the May 24 meeting of the Consumer Subcommittee of the Medical Assistance Advisory Committee viewed here.
  • Materials from the May 25 meeting of the Medical Assistance Advisory Committee meeting may be viewed here. 

Independent Fiscal Office 

The Independent Fiscal Office (IFO) released its initial revenue estimate for FY 2023-2024. The IFO estimates General Fund revenues of $45.292 billion for FY 2023-2024, which is a 1.3 percent increase over the current fiscal year. Find the report and corresponding presentation here.  

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission posted the following final regulations for public comment.

Stakeholder Events

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.

2023-05-28T01:20:56+00:00May 26th, 2023|Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on PA Health Policy Update for May 26
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PA Faces Major Challenge Reviewing Medicaid Eligibility

As many as 30 percent of Pennsylvanians currently on the state’s Medicaid rolls may soon become ineligible for the program, according to a new report.

When the COVID-19 pandemic began, Congress temporarily expanded Medicaid eligibility and directed additional money to states for their Medicaid programs.  The catch?  Once deemed eligible, participating states were prohibited from dropping those Medicaid participants from their programs for the duration of the public health emergency.

Health Benefits Claim FormThat continuous Medicaid eligibility, however, will end on April 1 and states have one year to redetermine Medicaid eligibility for everyone currently enrolled in the program.  In Pennsylvania, the state estimates that nearly 600,000 of the 3.6 million people now participating in the program will lose their eligibility and another nearly 600,000 may be in danger of doing so.

The implications of reduced Medicaid enrollment for the state’s safety-net hospitals are serious:  hundreds of thousands of people who have health insurance today may soon be without health insurance but will continue turning to hospitals – and especially, to safety-net hospitals – for care.

Learn more about the challenge Pennsylvania faces today and how the state plans to address it from the AP article “Resuming Medicaid case checks confronts 3.6M in Pennsylvania.”

2023-02-15T22:31:50+00:00February 16th, 2023|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19|Comments Off on PA Faces Major Challenge Reviewing Medicaid Eligibility
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SNAP Hospitals Benefit From New PA Health Care Funding

While a recent Pennsylvania law will result in all hospitals receiving supplemental funding to help with employee recruitment and retention, SNAP member hospitals will receive a little something extra.

Safety-Net Association of Pennsylvania logoPennsylvania Act 2, passed earlier this year, appropriates $225 million in federal money and the state has earmarked a portion of that money for hospitals based on how many beds they have.  Hospitals that serve especially high proportions of Medicaid patients, however, will receive funding over and above the amount targeted to them based on bed count alone.

All Safety-Net Association of Pennsylvania members – hospitals distinguished by their service to especially large numbers of low-income Pennsylvanians – will receive a portion of these additional resources.

All hospitals and other selected providers will share $100 million of the $225 million total; this portion will be distributed on a per-bed basis.  Pennsylvania safety-net hospitals, along with critical access hospitals and inpatient and residential behavioral health facilities, also will receive part of a separate, larger pool of $110 million.

Over the years, SNAP has consistently urged state officials to provide additional funding to Pennsylvania safety-net hospitals that care for especially high proportions of Medicaid and uninsured patients.  In this situation, state officials did exactly that.

Learn more about the $225 million appropriation and how it will be distributed from this Wolf administration news release and this list of funding recipients, which includes all SNAP members.

 

2022-03-25T13:10:50+00:00March 25th, 2022|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Hospitals Benefit From New PA Health Care Funding
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Vaccination Rates Low Among Medicaid Recipients

Individuals enrolled in Medicaid are less likely to have received COVID-19 vaccines than the population as a whole, according to a recently published report.

Among the possible reasons for this low rate, observers speculate, is greater vaccine hesitancy among low-income individuals (as identified in a nation-wide survey), less flexible work schedules, and economic barriers such as lack of transportation or child care.

This can pose a special challenge for Pennsylvania safety-net hospitals because the communities they serve have more Medicaid beneficiaries than the typical community.

Learn more about the extent of the problem around the country and what state Medicaid programs are doing to encourage more Medicaid beneficiaries to roll up their sleeves and get vaccinated in the Roll Call article “Medicaid beneficiaries less likely to get COVID-19 shots.”

 

 

2021-07-07T20:30:43+00:00July 8th, 2021|Coronavirus, COVID-19, Pennsylvania safety-net hospitals|Comments Off on Vaccination Rates Low Among Medicaid Recipients
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  • P: (717) 234-6970

  • 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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